ETHNOCULTURAL AND EDUCATIONAL-DIFFERENCES IN ISRAELI WOMEN CORRELATE WITH PAIN PERCEPTION IN FIBROMYALGIA

Objective. To compare the clinical features of patients with fibromyal gia (FM) in 2 ethnic groups in Israel. Methods. One hundred women with FM participated in the study; 70 were of Sephardic (Mediterranean) or igin and 30 of Ashkenazic (European-American) origin. Assessment of FM related symptoms, tenderness, quality of life, and physical functioni ng was conducted in all subjects. Analysis of covariance and multivari ate regression were performed to study the association between these m easures and ethnicity, controlling for age and education. Results. Sep hardic patients with FM reported more frequent and more severe symptom s than Ashkenazic patients. They had higher point counts and decreased quality of life. When the patients were divided into 2 age groups (ag e 45 being the cutoff point), the differences were observed only among the older subjects, most of whom were immigrants. Sephardic older pat ients had significantly higher point counts than Ashkenazic patients, and lower tenderness thresholds. They reported significantly higher le vels of pain, fatigue, and stiffness, and were less satisfied with the ir life. However, these differences observed between the 2 ethnic grou ps in the univariate data analysis disappeared when age and education were jointly controlled in multivariate regression analysis. Age had s ignificantly contributed to the variation in the point count, the repo rted pain, and physical functioning. Education made a significant cont ribution in explaining the point count, quality of Life, pain, and fat igue. Conclusion, Education, rather than ethnic identity, has been fou nd to be an important factor in clinical features of FM. Future studie s should include ethnocultural and educational assessment, especially in countries with high immigration rates and diverse ethnic groups, su ch as the USA and Canada.