title: The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects.
abstract: This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.
authors.affiliation: Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Banafsheh
authors.initials: B
authors.lastname: Ghavidel-Parsa
authors.affiliation: Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Bidari
authors.affiliation: Student Research Center, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Amir Maafi
authors.affiliation: Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Ghalebaghi
keywords: Chronic pain; Cost of illness; Economics; Fibromyalgia; Musculoskeletal diseases; Pain