Clinical Phenomenology of Fibromyalgia Syndrome in male patients - Same but Different.

Abstract

Background The majority of knowledge about fibromyalgia syndrome (FMS) derives from studies of female patients. Little is known about the clinical characteristics and treatment outcomes of male FMS patients. Objective We investigated whether male FMS patients differ from female patients in terms of 1.) symptom burden, 2.) psychological characteristics, and 3.) clinical treatment response. Methods For this retrospective cohort study with a prospective posttreatment-follow-up, we identified 263 male (4%) out of 5,541 FMS patients completing a three-week multimodal pain-treatment program. Male FMS patients (51.3±9.1 years) were age- and time-matched (1:4) with female FMS patients (N = 1052, 51.3±9.0 years). Data on clinical characteristics, psychological comorbidities and treatment response were obtained from medical records and validated questionnaires. Results Levels of perceived pain, psychological comorbidity, and functional capacity were similar between genders, although male FMS patients showed a higher prevalence for alcohol abuse. Compared to female patients, male FMS patients experienced themselves less often as overly accommodating (Cohen’s d=-0.42), but more often as self-sacrificing (d = 0.26) or intrusive (d = 0.23). Regarding pain coping, male patients were less likely to utilize mental distraction, rest- and relaxation techniques, or counteractive activities (d = 0.18–0.27). Male FMS patients showed a slightly worse overall response rate than women (69% vs. 77%), although differences between individual outcome measures were small (d < 0.2). Conclusion Although male and female FMS patients in our cohort were similar in clinical presentation and treatment response, the gender-specific differences in interpersonal problems and pain coping suggest a consideration of these aspects in the treatment of male FMS patients.