title: Gender differences among patients with fibromyalgia undergoing multidisciplinary pain rehabilitation.
abstract: OBJECTIVE
  This study was conducted to test the hypothesis that gender differences in physical and emotional functioning are present among patients with fibromyalgia undergoing multidisciplinary pain rehabilitation.
  
  
  METHODS
  Retrospective case-matched series. Setting. Multidisciplinary pain rehabilitation center at a tertiary referral medical center.
  
  
  METHODS
  Thirty-three consecutive men with fibromyalgia admitted from January 2002 through June 2005 were matched to 33 women with fibromyalgia for age, treatment dates, and program completion status. Interventions. A 3-week outpatient multidisciplinary pain rehabilitation program based on a cognitive-behavioral model that incorporates analgesic medication withdrawal.
  
  
  METHODS
  Multidimensional Pain Inventory (MPI), Short Form-36 Health Status Questionnaire (SF-36), Coping Strategies Questionnaire-Catastrophizing subscale (CSQ-C), and the Center for Epidemiologic Studies-Depression scale (CES-D) were administered before and after treatment. The numbers of patients using opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines before and after treatment were compared.
  
  
  RESULTS
  Pretreatment MPI and SF-36 scores revealed men had lower health perception (P = 0.017) and more physical limitations (P = 0.004) while women had greater life interference due to pain (P = 0.005). Mean differences in all pre- and post-treatment outcome measures demonstrated a statistically significant treatment response. However, men had lower post-treatment scores on the SF-36 health perception (P = 0.023), role limitations-physical (P = 0.021), and social functioning (P = 0.033) subscales. Significant within-gender reductions in opioid analgesic, NSAID, and benzodiazepine use were observed but no significant between-gender differences were identified.
  
  
  CONCLUSIONS
  These results support the hypothesis that pretreatment gender differences are present among fibromyalgia patients undergoing multidisciplinary pain rehabilitation and post-treatment gender differences persist despite improvements in physical and emotional functioning.
authors.affiliation: Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. hooten.william@mayo.edu
authors.forename: W Michael
authors.initials: WM
authors.lastname: Hooten
authors.forename: Cynthia O
authors.initials: CO
authors.lastname: Townsend
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D018710:Pain Clinics; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function; D012189:Retrospective Studies; D012727:Sex Characteristics; D011795:Surveys and Questionnaires