title: Does psychological vulnerability determine health-care utilization in fibromyalgia?
abstract: OBJECTIVE
  Patients with fibromyalgia (FM) undergo multiple testing and referral to specialists, and often use complementary/alternative medicine (CAM) services. The objectives of the study were: (i) to document health service utilization, and (ii) to examine whether psychological vulnerability was associated with visits to physicians and CAM providers.
  
  
  METHODS
  Women (N = 178) with a diagnosis of primary FM completed a psychosocial test measuring pain, perceived stress, global psychological distress, sexual abuse history, co-morbidity and disability due to FM. Subjects also completed a health services questionnaire, documenting visits to physicians and CAM providers during the previous 6 months. Psychological vulnerability was operationalized as obtaining high scores on psychological distress, perceived stress and reporting at least one abusive event.
  
  
  RESULTS
  The average number of visits was 7.2 to physicians and 11.3 to CAM providers.
  
  
  CONCLUSIONS
  The number of physician visits was significantly associated with more co-morbidity. Psychologically vulnerable subjects were more likely to use CAM services than those not so classified.
authors.affiliation: Montreal General Hospital, Canada. patricia.dobkin@mcgill.ca
authors.forename: P L
authors.initials: PL
authors.lastname: Dobkin
authors.forename: M
authors.initials: M
authors.lastname: De Civita
authors.forename: S
authors.initials: S
authors.lastname: Bernatsky
authors.forename: H
authors.initials: H
authors.lastname: Kang
authors.forename: M
authors.initials: M
authors.lastname: Baron
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010820:Physicians / Q000706:statistics & numerical data; D011379:Prognosis; D013315:Stress, Psychological / Q000523:psychology*