RES: Factors explaining variance in perceived pain in women with fibromyalgia

[Guest guest]

Research article

Factors explaining variance in perceived pain in women with fibromyalgia

Eva Albertsen Malt1 , Snorri Olafsson2 , Anders Lund1 and Holger Ursin3

1 Department of Psychiatry, University of Bergen Haukeland University

Hospital, N-5022 Bergen, Norway

2 Department of Internal Medicine, University of Bergen Haukeland University

Hospital, N-5022 Bergen, Norway

3 Department of Biological And Medical Psychology, Division of Physiological

Psychology University of Bergen, N-5022 Bergen, Norway

BMC Musculoskeletal Disorders 2002 3: 12

This article is available from: http://www.biomedcentral.com/1471-2474/3/12

Received 29 Jan 2002

Accepted 25 Apr 2002

Published 25 Apr 2002

© 2002 Malt et al; licensee BioMed Central Ltd. Verbatim copying and

redistribution of this article are permitted in any medium for any purpose,

provided this notice is preserved along with the article's original URL.

----------------------------------------------------------------------------

----

Abstract

Background

We hypothesized that a substantial proportion of the subjectively

experienced variance in pain in fibromyalgia patients would be explained by

psychological factors alone, but that a combined model, including

neuroendocrine and autonomic factors, would give the most parsimonious

explanation of variance in pain.

Methods

Psychometric assessment included McGill Pain Questionnaire, General Health

Questionnaire, Hospital Anxiety and Depression Rating Scale, Eysenck

personality Inventory, Neuroticism and Lie subscales, Toronto ithymia

Scale, and Multidimensional Health Locus of Control Scale and was performed

in 42 female patients with fibromyalgia and 48 female age matched random

sample population controls. A subgroup of the original sample (22

fibromyalgia patients and 13 controls) underwent a pharmacological challenge

test with buspirone to assess autonomic and adrenocortical reactivity to

serotonergic challenge.

Results

Although fibromyalgia patients scored high on neuroticism, anxiety,

depression and general distress, only a minor part of variance in pain was

explained by psychological factors alone. High pain score was associated

with high neuroticism, low baseline cortisol level and small drop in

systolic blood pressure after buspirone challenge test. This model explained

41.5% of total pain in fibromyalgia patients. In population controls,

psychological factors alone were significant predictors for variance in

pain.

Conclusion

Fibromyalgia patients may have reduced reactivity in the central sympathetic

system or perturbations in the sympathetic-parasympathetic balance. This

study shows that a biopsychosocial model, including psychological factors as

well as factors related to perturbations of the autonomic nervous system and

hypothalamic-pituitary-adrenal axis, is needed to explain perceived pain in

fibromyalgia patients.

-----------------------------------------------------

Full Text article and PDF download at:

http://www.cfsresearch.org/fib/1.htm

Nico Vanden Eynde