Addaction, London, UK.
Central Alabama Veterans Health Care System, Montgomery, AL.
Pain Med. 2018 Mar 1;19(3):491-498. doi: 10.1093/pm/pnx155.
To compare the characteristics of people with fibromyalgia (FM) with those with other forms of nonmalignant chronic pain.
A prospective cohort study conducted in a chronic pain management clinic within an academic medical center.
Many symptoms of the chronic pain syndrome FM are common to other pain or musculoskeletal syndromes. FM may be misdiagnosed by clinicians.
Thirty-three patients with a working diagnosis of FM were identified: 26 (78.8%) participated in the study. They were matched by age (mean = 53.0 years) and gender (80.8% female) to a control group with other forms of chronic nonmalignant pain.
Standardized physical examinations for FM were undertaken using the 1990 and revised 2010 American College of Rheumatology (ACR) guidelines. The groups were compared using diagnoses of psychiatric disorders and responses to the Pain Disability Index, Personal Health Questionnaire, Revised Fibromyalgia Impact Questionnaire, and Rapid Estimate Adult Literacy in Medicine.
The most common psychiatric disorders were depression (44.4%) and anxiety (27.3%). Incidence of at least one psychiatric condition was 80.8%, and the only difference (P = 0.002) between the two populations was the mean number of tender points: 5.6 (±4.2) vs controls 3.2 (±2.2). Only three (11.5%) participants with a prior diagnosis of FM fulfilled the 1990 ACR diagnostic criteria, increasing to 38.5% when the 2010 criteria were applied; however, 46.1% of controls also met the revised diagnostic criteria.
FM is commonly misdiagnosed: all patients with a working diagnosis should be reassessed and reviewed to ensure that the most appropriate treatment is provided.
比较纤维肌痛（FM）患者与其他类型非恶性慢性疼痛患者的特征。
在学术医疗中心的慢性疼痛管理诊所进行的前瞻性队列研究。
FM 的许多慢性疼痛综合征症状与其他疼痛或肌肉骨骼综合征共有的。FM 可能被临床医生误诊。
确定了 33 名患有纤维肌痛工作诊断的患者：26 名（78.8%）参与了研究。他们通过年龄（平均=53.0 岁）和性别（80.8%女性）与其他类型慢性非恶性疼痛的对照组相匹配。
使用 1990 年和修订后的 2010 年美国风湿病学会（ACR）指南对 FM 的标准体格检查进行了评估。通过精神病诊断和对疼痛残疾指数、个人健康问卷、修订后的纤维肌痛影响问卷和快速估计成人医学识字能力的反应来比较两组。
最常见的精神疾病是抑郁症（44.4%）和焦虑症（27.3%）。至少有一种精神疾病的发病率为 80.8%，两组之间唯一的区别（P=0.002）是压痛点的平均数量：5.6（±4.2）与对照组 3.2（±2.2）。只有 3 名（11.5%）有纤维肌痛既往诊断的患者符合 1990 年 ACR 诊断标准，当应用 2010 年标准时增加到 38.5%；然而，46.1%的对照组也符合修订后的诊断标准。
纤维肌痛常被误诊：所有有工作诊断的患者都应重新评估和审查，以确保提供最合适的治疗。
