title: The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey.
abstract: BACKGROUND
  Most knowledge of fibromyalgia comes from the clinical setting, where healthcare-seeking behavior and selection issues influence study results. The characteristics of fibromyalgia in the general population have not been studied in detail.
  
  
  METHODS
  We developed and tested surrogate study specific criteria for fibromyalgia in rheumatology practices using variables from the US National Health Interview Survey (NHIS) and the modification (for surveys) of the 2010 American College of Rheumatology (ACR) preliminary fibromyalgia criteria. The surrogate criteria were applied to the 2012 NHIS and identified persons who satisfied criteria from symptom data. The NHIS weighted sample of 8446 persons represents 225.7 million US adults.
  
  
  RESULTS
  Fibromyalgia was identified in 1.75% (95% CI 1.42, 2.07), or 3.94 million persons. However, 73% of identified cases self-reported a physician's diagnosis other than fibromyalgia. Identified cases had high levels of self-reported pain, non-pain symptoms, comorbidity, psychological distress, medical costs, Social Security and work disability. Caseness was associated with gender, education, ethnicity, citizenship and unhealthy behaviors. Demographics, behaviors, and comorbidity were predictive of case status. Examination of the surrogate polysymptomatic distress scale (PSD) of the 2010 ACR criteria found fibromyalgia symptoms extending through the full length of the scale.
  
  
  CONCLUSIONS
  Persons identified with criteria-based fibromyalgia have severe symptoms, but most (73%) have not received a clinical diagnosis of fibromyalgia. The association of fibromyalgia-like symptoms over the full length of the PSD scale with physiological as well as mental stressors suggests PSD may be a universal response variable rather than one restricted to fibromyalgia.
authors.affiliation: National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Walitt
authors.affiliation: National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Nahin
authors.affiliation: Rush University Medical Center, Chicago, IL, United States of America.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Katz
authors.affiliation: Drexel University College of Medicine, Philadelphia, PA, United States of America.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Bergman
authors.affiliation: National Data Bank for Rheumatic Diseases, Wichita, KS, United States of America.
authors.forename: Frederick
authors.initials: F
authors.lastname: Wolfe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis* / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D012219:Rheumatology / Q000379:methods; D057566:Self Report; D012720:Severity of Illness Index; D012943:Social Security; D055815:Young Adult