Determinants of health status in fibromyalgia: A comparative study with systemic lupus erythematosus

Objective. To compare perceived health status in women with fibromyalgia (F M) and systemic lupus erythematosus (SLE) using the Medical Outcomes Study (MOS) Short Form Health Survey (SF-36); and to identify determinants of phy sical and mental health in each patient group. Methods. A cross sectional study of 46 women with EM (mean age 48.13 yrs, S D 9.40) and 59 women with SLE (mean age 42.36 yrs, SD 11.31). Patients with FM were recruited from a rheumatology clinic and a rheumatology practice, while patients with SLE were recruited from 4 rheumatology clinics. Clinica l examination determined disease activity (by Systemic Lupus Activity Measu re) in SLE and a tender point count was used for FM. Patients completed que stionnaires assessing health status (SF-36), stress (Hassles), social suppo rt (Social Support Questionnaire 6), and coping (Coping Inventory for Stres sful Situations). Results, Patients with FM reported more impairment on the following SF-36 s ubscales: physical function (p < 0.001), role physical (p < 0.001), bodily pain (p < 0.001), and vitality (p < 0.001). Physical component summary scor es were also significantly lower(p < 0.001) for the FM group. Four hierarch ical regression analyses were computed to determine factors related to phys ical and mental health in each patient group, with the following variables in the equation: age, income, disease activity (Step 1), hassles (Step 2), emotional and task coping, and social support (Step 3). Better physical hea lth in FM was related to higher income (R-2 = 0.17, p < 0.05). In the SLE g roup, better physical health was associated with younger age, less disease activity, and lower hassles (R-2 = 0.37, p < 0.0001). Worse mental health a mong women with FM was associated with more hassles, more emotional coping, and less satisfaction with social support (R-2 = 0.64, p < 0.0001), while lower income, higher hassles, and more emotional coping were linked to wors e mental health in SLE (R-2 = 0.46, p < 0.0001). Conclusion. Health related quality of life (HRQL) is impaired among women w ith FM and SLE, with FM patients reporting greater impairment along several dimensions. Enhancing the HRQL of patients with FM and SLE requires target ing specific modifiable psychosocial factors.