RESEARCH - The Symptom Intensity Scale, fibromyalgia, and the meaning of fibromylagia-like symptoms

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Journal of Rheumatology

November 2006

The Symptom Intensity Scale, Fibromyalgia, and the Meaning of

Fibromyalgia-like Symptoms

FREDERICK WOLFE and JOHANNES J. RASKER

ABSTRACT.

Objective. To characterize a scale for the measurement of fibromyalgia

(FM)-like symptoms; to investigate whether FM is a discrete disorder; to

understand the significance of FM-like symptoms; and to investigate causal

and noncausal factors in the development of such symptoms.

Methods. We evaluated 25,417 patients with rheumatic disease using the

Symptom Intensity (SI) Scale, a self-report scale that combines a count of

pain in 19 nonarticular regions with a visual analog scale for fatigue. We

studied this scale in relation to demographics, clinical symptoms, and

serious outcomes, including serious medical illnesses, hospitalization, work

disability, and death.

Results. Compared with other rheumatic disease assessments, the SI scale was

the best identifier of symptoms associated with FM content, including an

increase in general medical symptoms. SI scale elevations were associated

with increases in cardiovascular disorders, hospitalization, work

disability, and death. Persons with socioeconomic disadvantage by reason of

sex, ethnicity, household income, marital status, smoking, and body mass had

increased SI scores. For almost all clinical variables studied, the

prevalence and/or severity of the variable increased linearly with SI

scores.

Conclusion. We identified a clinical marker for general symptom

intensification that applies in all patients and is independent of a

diagnosis of FM. We found no clinical basis by which FM may be identified as

a separate entity. Higher scores on the SI scale were associated with more

severe medical illness, greater mortality, and sociodemographic

disadvantage, and these factors appear to play a role in the development of

FM-like symptoms and symptom intensification. (First Release Sept 1 2006; J

Rheumatol 2006;33:2291-9)

http://www.jrheum.com/abstracts/abstracts06/2291.html

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