The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12

Abstract

Objective: The current review describes how the health status profile of people with fibromyalgia (FM) compares to that of people in the general population and patients with other health conditions.

Methods: A review of 37 studies of FM that measured health status with the 36-item Medical Outcomes Study Short-Form Health Survey (SF-36) or the 12-item Short-Form Health Survey (SF-12).

Results: Studies performed worldwide showed that FM groups were significantly more impaired than people in the general population on all eight health status domains assessed. These domains include physical functioning, role functioning difficulties caused by physical problems, bodily pain, general health, vitality (energy vs. fatigue), social functioning, role functioning difficulties caused by emotional problems and mental health. FM groups had mental health summary scores that fell 1 standard deviation (SD) below the general population mean, and physical health summary scores that fell 2 SD below the general population mean. FM groups also had a poorer overall health status compared to those with other specific pain conditions. FM groups had similar or significantly lower (poorer) physical and mental health status scores compared to those with rheumatoid arthritis, osteoarthritis, osteoporosis, systemic lupus erythematosus, myofacial pain syndrome, primary Sjögren's syndrome and others. FM groups scored significantly lower than the pain condition groups mentioned above on domains of bodily pain and vitality. Health status impairments in pain and vitality are consistent with core features of FM.

Conclusions: People with FM had an overall health status burden that was greater in magnitude compared to people with other specific pain conditions that are widely accepted as impairing.

Figure 1

Patterns of health status for pain conditions compared with the general population. SF-36 scores expressed as number of standard deviations from the population mean. PF, physical functioning; RP, role functioning difficulties caused by physical problems; BP, bodily pain; GH, general health; VT, vitality; SF, social functioning; RE, role functioning difficulties caused by emotional problems; MH, mental health. Picavet HSJ, Hoeymans N. Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Annals of the Rheumatic Diseases 2004; 63; 723–729. Adapted with permission from the BMJ Publishing Group