Objective
To establish optimal cut-off values for the scores of the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromialgia Assessment Scale (FAS 2019mod), and the Polysymptomatic Distress Scale (PDS) in order to distinguish five levels of FM disease severity.
Methods
Consecutive FM patients were evaluated with the three clinimetric indices, and each patient was required to answer the anchor question: ‘In general, would you say your health is 1 = very good, 2 = good, 3 = fair, 4 = poor, or 5 = very poor?’—which represented the external criterion. Cut-off points were established through the interquartile reconciliation approach.
Results
The study sample consisted of 2181 women (93.2%) and 158 men (6.8%), with a mean age of 51.9 (11.5) years, and mean disease duration was 7.3 (6.9) years. The overall median FIQR, FAS 2019 mod and PDS scores (25th–75th percentiles) were respectively 61.16 (41.16–77.00), 27.00 (19.00–32.00) and 19.0 (13.00–24.00). Reconciliation of the mean 75th and 25th percentiles of adjacent categories defined the severity states for FIQR: 0–23 for remission, 24–40 for mild disease, 41–63 for moderate disease, 64–82 for severe disease and >83 for very severe disease; FAS 2019 mod: 0–12 for remission, 13–20 for mild disease, 21–28 for moderate disease, 29–33 for severe disease and >33 for very severe disease; PDS: 0–5 for remission, 6–15 for mild disease, 16–20 for moderate disease, 21–25 for severe disease and >25 for very severe disease.
Conclusions
Disease severity cut-offs can represent an important improvement in interpreting FM.
Objective
Various studies have shown that overweight and obesity are central features of fibromyalgia syndrome (FM), but the real impact of a high body mass index (BMI) on clinical severity in patients with FM is still controversial. The aim of this study was to analyse the relationships between BMI categories and measures of symptom severity and functional impairment using data from a web-based registry of patients with FM.
Methods
Adult patients with an ACR 2010/2011 diagnosis of FM underwent a complete physical examination and laboratory tests, and were asked to complete a package of questionnaires covering their sociodemographic and treatment details, as well as the following disease-specific questionnaires: the revised Fibromyalgia Impact Questionnaire (FIQR), the modified Fibromyalgia Assessment Status (ModFAS) questionnaire, and the Polysymptomatic Distress Scale (PDS).
Results
A total of 2339 patients were recruited and divided into two weight categories, Underweight/Normal (U/N, n = 1127, 48.39%) and Overweight/Obese (O/O, n = 1212, 51.81%). The total and subscale of FIQR, ModFAS and PSD scores were significantly higher in the O/O patients, as were all of the mean scores of the individual FIQR items (p < 0.001 for all).
Conclusion
Our findings demonstrate that O/O patients with FM are significantly more impaired in all of the symptomatological and functional domains as measured using the FIQR, ModFAS and PDS than U/N patients, thus suggesting that being O/O has an additional effect on symptoms and function.
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