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BackgroundFibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome.MethodsApplication was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28), the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients.ResultsThe ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%), Physical-Activity (15%), Active Coping (9%) and Passive Coping (6.3%). A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs.ConclusionsThis study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self-assessment questionnaire based on elements from well known tests.

Temporary work disability (TWD) is more common in patients with fibromyalgia (FM) than among the rest of the workers. To describe the differences between patients who take sick leave (TWD group) and those who continue to work regularly (control group). To determine what factors are associated with TWD. Multicentre, cross-sectional study with a cohort of patients with FM seen in rheumatology clinics throughout Spain. The following information was recorded: demographic data, clinical manifestations, comorbidities, health self-perception, emotional issues, functional capacity, physical function tests, utilization of healthcare resources, TWD during the past 12 months, and quitting paid employment due to the disease. Descriptive statistics was used to compare variables between the TWD group and the control group. A logistic regression analysis was done to determine which factors are associated with TWD. The study cohort was composed of 301 patients with FM (women: 96.7%) with a mean age of 48.7 ± 8.5 years and a disease duration of 11.5 ± 9.1 years. There were 56.8% active workers, of whom 67.8% had had some TWD. The mean TWD length was 44 ± 69.6 days/year. TWD correlated significantly with sedentary work, clinical manifestations, comorbidities, self-perceived health, poor functional capacity, physical function, and healthcare resource utilization. The factors independently associated with TWD are sedentary work, more clinical manifestations, fatigue, and poor flexibility. Of the cases of people who quit their jobs, 66.9% were associated with FM. TWD in patients with FM is associated with sedentary work, a worse clinical situation, and worse functional capacity.

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