The complexities of fibromyalgia and its comorbidities

Lichtenstein, Adi; Tiosano, Shmuel; Amital, Howard

doi:10.1097/bor.0000000000000464

Cited by 93 publications

(85 citation statements)

References 54 publications

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“…Fibromyalgia is a multi-factorial illness primarily characterised by widespread chronic pain and fatigue [1][2][3][4][5][6]. It is also associated with cognitive impairments [7] and affective symptoms such as changes in mood, depression and anxiety disorders [2- 5,7].…”

Section: Introductionmentioning

confidence: 99%

“…It is also associated with cognitive impairments [7] and affective symptoms such as changes in mood, depression and anxiety disorders [2- 5,7]. Associated systemic problems include irritable bowel syndrome/change of bowel habit and bladder symptoms [2, 4,7]. Headaches, sleep and skin disturbances are also reported, as are coordination problems, muscle weakness, hair loss, fever, dry eyes and mouth and sensory sensitivity [2].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy, completeness and accessibility of online information on fibromyalgia

et al. 2019

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Fibromyalgia is a multi-factorial illness primarily characterised by widespread chronic pain and fatigue, with several symptoms and associated conditions. Due to a lack of clinical awareness and an absence of objective diagnostic measures, fibromyalgia patients often engage with online health information. The aim is to investigate the completeness and trustworthiness of the information available online on fibromyalgia. Google.co.uk was searched for 'fibromyalgia', the first 200 webpages were imported and 148 were analysed for standard health information quality criteria (JAMA score, HONcode) as well as completeness of information in terms of symptoms, causes and treatments mentioned. The most frequent typology of webpages was from health professionals (38%), with commercial websites being less frequent (7%). Overall, the quality, completeness and accessibility of online health information was poor. Completeness of coverage for symptoms, causes and associated conditions was especially lacking, with pages from not-for-profit organisations discussing the highest number of symptoms (median 8, min 0, max 11, interquartile range, IQR 4.5; n = 14) compared to the rest of the websites in the search engine results (median 4, min 0, max 11, IQR 4; n = 134). Mean readability was grade 9 (median 9, min 1, max 18, IQR 3), with only 8% websites meeting the recommended readability of grade 6. The Internet provides incomplete information on fibromyalgia, which does not fulfil the most queried aspect(s) by patients, symptoms, and may be difficult to understand by lay persons. Not-for-profit organisations provide the most complete information compared to other types of websites.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy, completeness and accessibility of online information on fibromyalgia

et al. 2019

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“…Other associated symptoms include mood, cognitive and functional impairments, such as fatigue, sleep disturbances and headaches [ 3 , 4 ]. Research indicate that familial, genetic, environmental, endocrine and neurological factors play a role in the emergence of this disorder [ 2 , 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have described comorbidities related to FMS [ 5 ]. The current report evaluated the association of FMS with diabetes mellitus (DM) using the clinical database of Clalit Health Services (CHS), the largest Health Maintenance Organization (HMO) in Israel.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional analysis of the associations between fibromyalgia and diabetes mellitus

Lichtenstein¹,

Tiosano²,

Comaneshter³

et al. 2018

Reumatologia

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BackgroundThe fibromyalgia syndrome (FMS) is a chronic condition consisting of widespread musculoskeletal pain and tenderness together with mood and cognitive dysfunction. Diabetes mellitus (DM) is a common condition causing significant and detrimental morbidity and mortality. Data on the association between the two conditions is scarce and mainly based on small populations therefore lack solid evidence.ObjectivesTo evaluate the association of FMS with DM.Material and methodsThis cross-sectional study used the Clalit Health Services database, the largest Health Maintenance Organization in Israel, serving 4,400,000 members. FMS patients were compared to age- and sex-matched controls regarding chronic comorbid conditions. χ2 and student’s t-tests were used for univariate analysis.ResultsThe study included 14,296 FMS patients and 71,324 age- and sex-matched controls. The FMS group had a significantly higher proportion of DM patients compared to non-FMS controls (19.8% and 17.4 respectively; OR 1.17 , 95% CI: 1.12–1.23, p < 0.001).ConclusionsDM was found to be more common amongst FMS patients compared to matched controls to suggest that the pathophysiology of DM might lead a patient to develop FMS. Consequently, physicians treating DM patients should be aware of the possible risk and asses for clinical signs of FMS in order to diagnose and treat it in time to better their patients’ quality of life and disease management.

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“…Autoantibodies with affinity for a 68/48 kD protein have been found in a subgroup of patients with fibromyalgia but not in healthy controls . Other cytokine changes have been described and co‐morbidities, especially rheumatologic conditions, such as SLE . Our study accentuates these associations in view of the increased prevalence of AID.…”

Section: Discussionmentioning

confidence: 99%

Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases

Greenbaum

Weil

Chodick

et al. 2019

American J Rep Immunol

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Problem:The aim of this study was to investigate the prevalence of and the association between endometriosis, fibromyalgia, and autoimmune disease (AID) in a large population database and to describe healthcare resource utilization (HCRU) in affected women. Methods:A retrospective cross-sectional study was performed using the computerized databases of Maccabi Healthcare Services (MHS), a 2.1-million-member healthcare plan in Israel. Age-sex-specific point prevalence rates of endometriosis and fibromyalgia were calculated for end of 2015. Socio-demographic characteristics, HCRU, co-morbidities, including AID and depression or anxiety were described according to endometriosis/fibromyalgia status and analyzed using ordinary logistic regression models.Results: Among a total population of 781 571 adult women, 6647 were diagnosed with endometriosis (8.5 per 1000) and 25 425 with fibromyalgia (32 per 1000). A total of 401 women (0.5 per 1000) were diagnosed with both conditions. In 2015, the mean age of the women diagnosed with endometriosis and fibromyalgia was 42 and 55 years, respectively. Women with co-occurrence were characterized by increased HCRU and a high prevalence rate of AID compared to women with no diagnosis of endometriosis/fibromyalgia, with 6.2% diagnosed with inflammatory bowel disease (IBD) vs 1% in the comparison group. The prevalence of fibromyalgia in women with endometriosis was 6%. Adjusted ORs (95% CI) for fibromyalgia among endometriosis patients were 4.1 (2.02-8.36) for systemic lupus erythematosus (SLE), 3.1 (1.5-6.2) for Sjögren syndrome, 2.9 (1.87-4.7) for IBD, 2.1 (1.6-2.7) for dispensed antidepressants, and 1.7 (1.37-2.2) for diagnosed anxiety/depression. Conclusion:Co-occurrence of endometriosis and fibromyalgia is associated with a high burden of AID, anxiety/depression, and HCRU. K E Y W O R D Sautoimmune diseases, endometriosis, epidemiology, fibromyalgia, healthcare resource utilization, inflammatory bowel disease

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The complexities of fibromyalgia and its comorbidities

Abstract: A greater proportion of psychiatric and rheumatologic disorders are associated with FMS patients than the population. Consequently, physicians treating patients with either condition should keep in mind that these patients may have such comorbidities and should be treated accordingly.

Cited by 93 publications

References 54 publications

Accuracy, completeness and accessibility of online information on fibromyalgia

Accuracy, completeness and accessibility of online information on fibromyalgia

Cross-sectional analysis of the associations between fibromyalgia and diabetes mellitus

Evidence for an association between endometriosis, fibromyalgia, and autoimmune diseases

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