title: Correlation of invalidation with symptom severity and health status in fibromyalgia.
abstract: OBJECTIVE
  Invalidation is a new construct in health psychology, especially in diseases with inherently invisible symptoms such as FM. It can potentially affect both the quality of life and disease severity in patients with FM. This study aimed to investigate the correlation of illness invalidation with health status and symptom severity in FM.
  
  
  METHODS
  A total of 112 consecutive patients with FM referred to the rheumatology clinic were enrolled. Invalidation was measured by the Illness Invalidation Inventory (3*I). To measure patient status and progress of FM, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used and patients' quality of life was assessed by the 12-item Short Form Health Survey (SF-12). Multiple linear regression analyses were performed and Spearman's correlations were calculated.
  
  
  RESULTS
  All the patients were female and aged between 18 and 61 years. No significant differences in discounting and lack of understanding between various sources of invalidation were found. The strongest correlation was observed between FIQR symptom score and discounting by work (r = 0.519, P < 0.05). Multiple linear regression analyses revealed that only discounting from the spouse significantly predicted FIQR total scores of FM patients [P = 0.03 (CI 0.28, 10.64)].
  
  
  CONCLUSIONS
  Discounting correlated more strongly with SF-12 subscales and FIQR domains than did lack of understanding. The current study revealed that active negative social responses and the source of invalidation are important in predicting symptom severity and quality of life in FM.
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Banafsheh
authors.initials: B
authors.lastname: Ghavidel-Parsa
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran. alireza.am427@gmail.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Amir Maafi
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Aarabi
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Afrooz
authors.initials: A
authors.lastname: Haghdoost
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Monire
authors.initials: M
authors.lastname: Khojamli
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Omid
authors.initials: O
authors.lastname: Sanaei
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Student Research Committee, Guilan University of Medical Sciences, Rasht, Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture & Research, Tehran, Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan and Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Bidari
mesh_terms: D000293:Adolescent; D000328:Adult; D001524:Behavioral Medicine / Q000379:methods*; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: fibromyalgia; health status; invalidation