Journal
JOURNAL OF RHEUMATOLOGY
Volume 36, Issue 12, Pages 2806-2812Publisher
J RHEUMATOL PUBL CO
DOI: 10.3899/jrheum.090579
Keywords
FIBROMYALGIA; CROSS-SECTIONAL STUDY; PSYCHOLOGICAL STRESS; QUALITY OF LIFE; CLUSTER ANALYSIS
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Objective. We tested the hypothesis that fibromyalgia syndrome is a biopsychosocial continuum disorder. Methods. A cross-sectional survey of a representative sample of the Get-man general population with persons 2: 14 years of age was conducted based on face-to-face contacts. Physical distress was measured by the regional pain scale (RPS) and the Patient Health Questionnaire 15 (PHQ-15), psychological distress by the PHQ-9, and social distress by the Oslo Social Support Scale. Health-related quality of life (HRQOL) was measured by the 12-item form of the Medical Outcome Study Short Form Health Survey. A k-means clustering procedure with 2-8 clusters preset was used to classify the scores of the RPS, PHQ-9. and PHQ-15. The number Of Clusters retained was based on the stability and interpretability of the clusters. The Cluster analysis was first performed with a randomly selected half of the sample and then cross-validated on the second half of the total sample. Results. A 4-cluster solution produced the most stable and meaningful results. Cluster I was very low on all symptom scores. Cluster 2 was low on pain sites, somatic symptoms, and depression. Cluster 3 was high on pain scores, moderate on somatic symptoms, and low on depression. Cluster 4 was high on all symptom scores. The centroids of cluster 4 met the survey criteria of fibromyalgia syndrome. Cluster 4 reported a lower HRQOL and less social support compared to the other 3 groups. Conclusion. A cluster within the continuum of biopsychosocial distress can be labeled fibromyalgia syndrome. (First Release Nov 15 2009; J Rheumatol 2009;36:2806-12; doi: 10.3899/jrheum.090579)
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