WORK AND DISABILITY STATUS OF PERSONS WITH FIBROMYALGIA

Objective, To determine the prevalence and determinants of self-report ed work disability in persons with fibromyalgia (FM). Methods. A longi tudinal, multicenter survey of 1604 patients with FM from 6 centers wi th diverse socioeconomic characteristics was begun in 1988, Assessment s were by self-report questionnaire and telephone contact, and include d work and disability events that occurred before and after 1988. Comp arative analyses were performed on the entire data set and, separately , on the Wichita data set. Results, More than 16% of patients reported receiving US Social Security disability (SSD) payments (highest cente r rate 35.7%; lowest center rate 6.3%) compared to 2.2% of the US popu lation (US Social Security Administration data) and 28.9% of patients with rheumatoid arthritis seen at the Wichita outpatient rheumatology clinic. Overall, 26.5% reported receiving at least one form of disabil ity payment when SSD and other sources of disability payments were con sidered. In Wichita, less than 25% of SSD awards were made specificall y for FM, but after 1988 that figure increased to 46.4%, Work disabili ty was greatest at the San Antonio and Los Angeles centers. Multivaria te predictors (correlates) included pain, Health Assessment Questionna ire disability, and unmarried status, In addition, more than 70% of pa tients reporting being disabled did receive disability payments. On th e other hand, 64% reported being able to work all or most days, and mo re than 70% were employed or were homemakers, Conclusion, Although mos t patients (64%) report being able to work, we found high rates of sel f-reported work disability awards among persons with FM followed in 6 rheumatology centers. But we also found great variability among center s as to awards and as to self-reported work ability. Center difference s in work disability might reflect clinic referral patterns, physician beliefs, or socioeconomic status.