PT  - JOURNAL ARTICLE
AU  - Frederick Wolfe
AU  - Jacob Ablin
AU  - Emma K.  Guymer
AU  - Geoffrey O.  Littlejohn
AU  - Johannes J.  Rasker
TI  - The Relation of Physical Comorbidity and Multimorbidity to Fibromyalgia, Widespread Pain, and Fibromyalgia-related Variables
AID  - 10.3899/jrheum.190149
DP  - 2019 Aug 01
TA  - The Journal of Rheumatology
PG  - jrheum.190149
4099  - http://www.jrheum.org/content/early/2019/12/09/jrheum.190149.short
4100  - http://www.jrheum.org/content/early/2019/12/09/jrheum.190149.full
AB  - Objective To investigate the relation of physical (non-psychological) comorbidity and multimorbidity to quantitative measures of fibromyalgia (FM) and musculoskeletal pain. Methods We studied 12,215 patients in a research databank with quantitative measures of FM-related variables (FMV) that included binary determinations of FM and widespread pain (WSP), and constituent variables of FM diagnosis that included the WSP index (WPI), the symptom severity score (SSS), and the polysymptomatic distress scale (PSD). We assessed self-reported comorbid conditions and covariates that included age, sex, body mass index, hypertension, smoking history, and total household income. We used nearest-neighbor matching and regression adjustment treatment effects models to measure the effect of comorbidities on FMV. Results We found a positive association between FMV and the probability of having each comorbid condition. Patients with ≥ 1 comorbidities had PSD, WPI, and SSS increases of 3.0 (95% CI 2.7–3.3), 1.8 (95% CI 1.6–2.0), and 1.2 (95% CI 1.1–1.3) units, respectively, and an increase in FM prevalence from 20.4% to 32.6%. As the number of comorbid conditions present increased from 1 to 4 or more, PSD, WPI, SSS, and FM percent increased stepwise. For patients with ≥ 4 conditions, the predicted prevalence of FM was 55.2%. Conclusion FM and FMV are associated with an increase in the number of comorbidities, and the association can be measured quantitatively. However, the association of WSP and FM may be an effect of definitions of WSP and FM, because comorbidity increases are also present with subsyndromal levels of both conditions.