A cross-sectional survey of 3035 patients with fibromyalgia: subgroups of patients with typical comorbidities and sensory symptom profiles.
OBJECTIVE
Patients with FM are heterogeneous. They present with a variety of pain qualities, sensory abnormalities and additional comorbidities. The aim was to identify clinically distinguishable subgroups of patients.


METHODS
This investigation uses epidemiological and clinical data of 3035 FM patients from a cross-sectional survey (painDETECT) to (i) describe characteristic epidemiological data and comorbidities and (ii) detect subgroups of patients with typical patterns of sensory symptoms and comorbidities.


RESULTS
Clinically relevant sensory abnormalities (strongly, very strongly present) included pressure pain (58%), prickling (33%), burning (30%) and thermal hypersensitivity (24%). Pain attacks were complained by 40% of patients. Moderate to severe comorbid depression occurred in 66% of patients. Only approximately 30% of the patients had optimal sleep. A hierarchical cluster analysis using descriptors of sensory abnormalities as well as the extent of comorbidities revealed five distinct subgroups of patients showing a characteristic clinical profile. Four subgroups of patients suffer from severe sensory disturbances in various combinations but lack pronounced comorbidities. In one subgroup, however, severe comorbidities dominate the clinical picture. Differences in pathophysiological mechanisms of pain generation can be attributed to each subgroup.


CONCLUSIONS
The results of this study indicate that FM patients can be classified on the basis of their sensory symptoms and comorbidities by the use of a patient-reported questionnaire. Subgrouping of patients with FM may be used for future research and to tailor optimal treatment strategies for the appropriate patient.
Rehm
Stefanie E
SE
Sektion Neurologische Schmerzforschung und -therapie, Klinik für Neurologie, Christian-Albrechts-Universität Kiel, Arnold-Heller-Strasse 3, Haus 41, 24105 Kiel, Germany.
Koroschetz
Jana
J
Gockel
Ulrich
U
Brosz
Mathias
M
Freynhagen
Rainer
R
Tölle
Thomas R
TR
Baron
Ralf
R
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires