Bernatsky S, Dobkin P L, De Civita M, Penrod J R
Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.
Swiss Med Wkly. 2005 Feb 5;135(5-6):76-81. doi: 10.4414/smw.2005.10774.
To describe comorbidity in women with FM, and to examine the effects of different types of comorbidity on physician use.
Women (n = 180) with primary FM were evaluated at baseline and 6 months later for self-reported health resource use and covariates. Reported comorbidity was classified into 4 categories: medical, psychiatric, "functional", and unknown. The category for "functional" conditions included disorders that have been classified by previous authors as medically unexplained symptoms such as the irritable bowel and chronic fatigue syndromes. Logistic regression models were developed to examine associations between types of comorbidity and physician use.
Comorbid conditions were reported by over 90% of the sample. Total number of comorbid complaints was associated with high number of physician visits. In logistic regression models (controlling for age, ethnicity, education, disability, pain, and psychological vulnerability) medical comorbidity was a much stronger determinant of high number of physician visits than was "functional" comorbidity.
Comorbidity with other disorders, both functional and medical, was high in this sample. Medical and psychiatric comorbidity were stronger determinants of high physician use than "functional" comorbidity.
描述纤维肌痛（FM）女性患者的共病情况，并研究不同类型共病对就医行为的影响。
对180例原发性FM女性患者在基线期及6个月后进行评估，了解其自我报告的健康资源利用情况及协变量。报告的共病分为4类：医学类、精神类、“功能性”及不明类型。“功能性”疾病类别包括先前作者归类为医学上无法解释的症状的疾病，如肠易激综合征和慢性疲劳综合征。建立逻辑回归模型以研究共病类型与就医行为之间的关联。
超过90%的样本报告有共病情况。共病主诉总数与高就诊次数相关。在逻辑回归模型中（控制年龄、种族、教育程度、残疾、疼痛和心理易损性），医学共病比“功能性”共病更能决定高就诊次数。
该样本中与其他疾病（包括功能性和医学性疾病）的共病率较高。医学和精神共病比“功能性”共病更能决定高就医率。
