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Chronic widespread pain and its comorbidities: a population-based study.
Arch Intern Med 2006 Aug 14-28; 166(15):1649-54AI

Abstract

BACKGROUND

Chronic widespread pain (CWP), the cardinal symptom of fibromyalgia, is prevalent and co-occurs with numerous symptom-based conditions such as chronic fatigue syndrome, joint pain, headache, irritable bowel syndrome, and psychiatric disorders. Few studies have examined the comorbidities of CWP in the general population. Furthermore, little is known about the importance of familial (genetic and family environmental) factors in the etiology of co-occurrence.

METHODS

Data were obtained from 44 897 individuals in the Swedish Twin Registry via computer-assisted telephone interview from 1998 through 2002 (age >/=42 years; 73.2% response rate). Screening for CWP was based on the American College of Rheumatology criteria without clinical evaluation. Measures for comorbidities were based on standard criteria when available. Odds ratios (ORs) were calculated in case-control and co-twin control designs to assess the effect of familial confounding in the associations.

RESULTS

Considerable co-occurrences were found in CWP cases for chronic fatigue (OR, 23.53; 95% confidence interval [CI], 19.67-28.16), joint pain (OR, 7.41; 95% CI, 6.70-8.21), depressive symptoms (OR, 5.26; 95% CI, 4.75-5.82), and irritable bowel syndrome (OR, 5.17; 95% CI, 4.55-5.88). In co-twin control analyses, ORs were no longer significant for psychiatric disorders, whereas they decreased but remained significant for most other comorbidities. No changes in ORs were observed for headache.

CONCLUSIONS

Associations between CWP and most comorbidities are mediated by unmeasured genetic and family environmental factors in the general population. The extent of mediation via familial factors is likely to be disorder specific.

Authors+Show Affiliations

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden. Kenji.Kato@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Twin Study

Language

eng

PubMed ID

16908799

Citation

Kato, Kenji, et al. "Chronic Widespread Pain and Its Comorbidities: a Population-based Study." Archives of Internal Medicine, vol. 166, no. 15, 2006, pp. 1649-54.
Kato K, Sullivan PF, Evengård B, et al. Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med. 2006;166(15):1649-54.
Kato, K., Sullivan, P. F., Evengård, B., & Pedersen, N. L. (2006). Chronic widespread pain and its comorbidities: a population-based study. Archives of Internal Medicine, 166(15), pp. 1649-54.
Kato K, et al. Chronic Widespread Pain and Its Comorbidities: a Population-based Study. Arch Intern Med. 2006;166(15):1649-54. PubMed PMID: 16908799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic widespread pain and its comorbidities: a population-based study. AU - Kato,Kenji, AU - Sullivan,Patrick F, AU - Evengård,Birgitta, AU - Pedersen,Nancy L, PY - 2006/8/16/pubmed PY - 2006/9/15/medline PY - 2006/8/16/entrez SP - 1649 EP - 54 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 166 IS - 15 N2 - BACKGROUND: Chronic widespread pain (CWP), the cardinal symptom of fibromyalgia, is prevalent and co-occurs with numerous symptom-based conditions such as chronic fatigue syndrome, joint pain, headache, irritable bowel syndrome, and psychiatric disorders. Few studies have examined the comorbidities of CWP in the general population. Furthermore, little is known about the importance of familial (genetic and family environmental) factors in the etiology of co-occurrence. METHODS: Data were obtained from 44 897 individuals in the Swedish Twin Registry via computer-assisted telephone interview from 1998 through 2002 (age >/=42 years; 73.2% response rate). Screening for CWP was based on the American College of Rheumatology criteria without clinical evaluation. Measures for comorbidities were based on standard criteria when available. Odds ratios (ORs) were calculated in case-control and co-twin control designs to assess the effect of familial confounding in the associations. RESULTS: Considerable co-occurrences were found in CWP cases for chronic fatigue (OR, 23.53; 95% confidence interval [CI], 19.67-28.16), joint pain (OR, 7.41; 95% CI, 6.70-8.21), depressive symptoms (OR, 5.26; 95% CI, 4.75-5.82), and irritable bowel syndrome (OR, 5.17; 95% CI, 4.55-5.88). In co-twin control analyses, ORs were no longer significant for psychiatric disorders, whereas they decreased but remained significant for most other comorbidities. No changes in ORs were observed for headache. CONCLUSIONS: Associations between CWP and most comorbidities are mediated by unmeasured genetic and family environmental factors in the general population. The extent of mediation via familial factors is likely to be disorder specific. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/16908799/Chronic_widespread_pain_and_its_comorbidities:_a_population_based_study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.166.15.1649 DB - PRIME DP - Unbound Medicine ER -