Gender differences among patients with fibromyalgia undergoing multidisciplinary pain rehabilitation.
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.
Hooten
W Michael
WM
Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. hooten.william@mayo.edu
Townsend
Cynthia O
CO
Decker
Paul A
PA
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