Rheumatology Advance Access originally published online on June 16, 2003
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Rheumatology 2003; 42: 1324-1331
© 2003 British Society for Rheumatology
Does psychological vulnerability determine health-care utilization in fibromyalgia?
1Division of Clinical Epidemiology, Montreal General Hospital, 2Department of Medicine, McGill University and 3Department of Rheumatology, Jewish General Hospital, Montreal, Canada.
Correspondence to:
P. Dobkin, Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada. E-mail: patricia.dobkin{at}mcgill.ca
Objectives. Patients with fibromyalgia (FM) undergo multiple testing and referral to specialists, and often use complementary/alternative medicine (CAM) services. The objectives of the study were: (i) to document health service utilization, and (ii) to examine whether psychological vulnerability was associated with visits to physicians and CAM providers.
Methods. Women (N = 178) with a diagnosis of primary FM completed a psychosocial test measuring pain, perceived stress, global psychological distress, sexual abuse history, co-morbidity and disability due to FM. Subjects also completed a health services questionnaire, documenting visits to physicians and CAM providers during the previous 6 months. Psychological vulnerability was operationalized as obtaining high scores on psychological distress, perceived stress and reporting at least one abusive event.
Results. The average number of visits was 7.2 to physicians and 11.3 to CAM providers.
Conclusions. The number of physician visits was significantly associated with more co-morbidity. Psychologically vulnerable subjects were more likely to use CAM services than those not so classified.
KEY WORDS: Psychological vulnerability, Fibromyalgia, Health services, Complementary/alternative medicine.