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Chronic widespread pain and its comorbidities: a population-based study.

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.

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  • Authors+Show Affiliations

    ,

    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden. Kenji.Kato@ki.se

    , ,

    Source

    MeSH

    Adult
    Arthralgia
    Case-Control Studies
    Chronic Disease
    Comorbidity
    Depression
    Fatigue Syndrome, Chronic
    Female
    Fibromyalgia
    Humans
    Irritable Bowel Syndrome
    Male
    Middle Aged
    Odds Ratio
    Pain

    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 -