Prevalence of fibromyalgia in a low socioeconomic status population

Abstract

BackgroundThe aim of this study was to estimate the prevalence of fibromyalgia, as well as to assess the major symptoms of this syndrome in an adult, low socioeconomic status population assisted by the primary health care system in a city in Brazil.MethodsWe cross-sectionally sampled individuals assisted by the public primary health care system (n = 768, 35–60 years old). Participants were interviewed by phone and screened about pain. They were then invited to be clinically assessed (304 accepted). Pain was estimated using a Visual Analogue Scale (VAS). Fibromyalgia was assessed using the Fibromyalgia Impact Questionnaire (FIQ), as well as screening for tender points using dolorimetry. Statistical analyses included Bayesian Statistics and the Kruskal-Wallis Anova test (significance level = 5%).ResultsFrom the phone-interview screening, we divided participants (n = 768) in three groups: No Pain (NP) (n = 185); Regional Pain (RP) (n = 388) and Widespread Pain (WP) (n = 106). Among those participating in the clinical assessments, (304 subjects), the prevalence of fibromyalgia was 4.4% (95% confidence interval [2.6%; 6.3%]). Symptoms of pain (VAS and FIQ), feeling well, job ability, fatigue, morning tiredness, stiffness, anxiety and depression were statically different among the groups. In multivariate analyses we found that individuals with FM and WP had significantly higher impairment than those with RP and NP. FM and WP were similarly disabling. Similarly, RP was no significantly different than NP.ConclusionFibromyalgia is prevalent in the low socioeconomic status population assisted by the public primary health care system. Prevalence was similar to other studies (4.4%) in a more diverse socioeconomic population. Individuals with FM and WP have significant impact in their well being.

Dr. Tebib replies

“…If their results are confirmed, the discrepancy in terms of sex ratio in RAF compared to control population could make more questionable our hypothesis of a "simple" association. On the other hand, the relative increase of male prevalence could then explain the absence of social status difference between their RA and RAF population, contrary to our results and some others 1,3 . Indeed, more severe psychological distress in women affected by arthritis compared with the male arthritis population is usually pointed out 4 and then associated with a rather lower sociocultural profile 1 , similar to those observed in our study (identical to those of an FM female control population we allowed to participate).…”

Perfil de humor de mulheres com fibromialgia

“…Estudos epidemiológicos demonstram que a prevalência de FM varia de 0,66% a 10,5% 6,7 da população adulta, tendo maior prevalência em mulheres 8 . A maioria dessas pesquisas foi conduzida em países desenvolvidos 9 , sendo mais escassos os dados de prevalência em outras realidades sociais. No entanto, em estudo de abrangência municipal, Senna et al 8 encontraram 2,5% de prevalência de FM na população de Montes Claros (MG), Brasil.…”

Psychological control is a key modulator of fibromyalgia symptoms and comorbidities

“…However, the subjects appear representative of other studies with university educated, married women between the ages of 50 and 55 years who are working and/or housewives 25,26. It has been shown that socioeconomic factors such as age, education, work status, and income may all affect the expression of pain, fatigue, poor sleep, stress, and other related variables 27,28. These factors may have influenced the changes seen in the FM group compared with the HC group.…”