Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, General Practitioner Research Unit, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.
Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway.
Scand J Pain. 2024 Apr 19;24(1). doi: 10.1515/sjpain-2023-0143. eCollection 2024 Jan 1.
The purpose of this study was to explore the prevalence of fibromyalgia (FM) according to different diagnostic criteria in a clinical sample and to explore the clinical characteristics in cases and non-cases by the diagnostic criteria used.
A sample of 182 participants, both positive (n = 120) and negative (n = 62) FM individuals according to a clinical, pragmatic classification was used. Their characteristics were explored according to three different FM diagnostic criteria, i.e., the American College of Rheumatology (ACR) 1990, ACR 2016, and APS Pain Taxonomy (AAPT), respectively. Thus, impact of FM (FIQ), symptoms of anxiety and depression (HADS), tender point (TP) counts, and mechanical pressure sensitivity (in kPa) were compared in cases versus non-cases depending on diagnostic criteria of FM used. Descriptive analyses used chi-square statistic for categorical variables and non-parametric Mann-Whitney U tests for continuous variables.
From the clinical positive FM sample (n = 120), n = 99, 108, and 110 persons were diagnosed positive according to the ACR 1990, ACR 2016, and AAPT FM diagnostic criteria, respectively. All these three diagnostic tools discriminated FM positively from diagnostic FM non-cases when measuring TP-counts, mechanical pressures, and most FIQ-items, but they varied for anxiety and depression.
The prevalence of FM differed somewhat with the use of ACR 1990, ACR 2016, and the AAPT as diagnostic tools. The anxiety and depression symptoms differed significantly between cases and non-cases using some but not all the diagnostic criteria. Regarding other FM symptoms, e.g., TPs and most FIQ items, all diagnostic criteria contrasted case from non-case.
本研究旨在探讨临床样本中不同诊断标准下纤维肌痛（FM）的患病率，并根据使用的诊断标准探讨病例和非病例的临床特征。
采用临床实用分类法，对 182 名参与者进行研究，其中阳性（n=120）和阴性（n=62）FM 个体各占一半。根据三种不同的 FM 诊断标准，即美国风湿病学会（ACR）1990 年标准、ACR 2016 年标准和 APS 疼痛分类法（AAPT），分别对其特征进行探讨。因此，根据使用的 FM 诊断标准，比较病例和非病例的 FM 影响指数（FIQ）、焦虑和抑郁症状（HADS）、压痛点数（TP）计数和机械压力敏感度（kPa）。分类变量采用卡方检验，连续变量采用非参数 Mann-Whitney U 检验进行描述性分析。
从临床阳性 FM 样本（n=120）中，根据 ACR 1990 年标准、ACR 2016 年标准和 AAPT FM 诊断标准，分别有 n=99、108 和 110 人被诊断为阳性。当测量 TP 计数、机械压力和大多数 FIQ 项目时，这三种诊断工具均能将 FM 病例与 FM 非病例区分开来，但在焦虑和抑郁方面有所不同。
使用 ACR 1990 年标准、ACR 2016 年标准和 AAPT 作为诊断工具时，FM 的患病率略有不同。使用某些而非所有诊断标准时，病例和非病例之间的焦虑和抑郁症状存在显著差异。至于其他 FM 症状，如 TP 和大多数 FIQ 项目，所有诊断标准均能将病例与非病例区分开来。
