The risk factors for self-reported fibromyalgia with and without multiple somatic symptoms: The Lifelines cohort study, 2022, Creed

Abstract

Objective
The numerous risk factors for fibromyalgia reflect its heterogeneous nature. This study assessed whether the predictors of fibromyalgia onset vary according to number of prior somatic symptoms.

Methods
The prospective, population-based Lifelines cohort study included 138,617 adults without fibromyalgia or marked muscle pain. At baseline socio-demographic status, physical and psychiatric disorders, psycho-social and behavioural variables were assessed as potential predictors. At follow-up (mean 2.4 years later) new onsets of fibromyalgia were recorded by self-report. The predictors of new onsets of self-reported fibromyalgia were assessed using logistic regression with interaction terms between key variables and number of somatic symptoms.

Results
At follow-up 679 (0.5%) participants reported new onset fibromyalgia. The strongest predictors were: female sex, rheumatoid and osteo-arthritis, IBS, impaired sleep, migraine, few years of education and impairment by bodily pain. Interaction terms with somatic symptoms were significant for years of education, low income, rheumatoid arthritis and no. of analgesics; these were predictors only for fibromyalgia with few somatic symptoms. Participants with multiple somatic symptoms had a higher number of predictors than those with few somatic symptoms.

Conclusion
This study suggests that people developing self-reported fibromyalgia with multiple pre-existing somatic symptoms have a high risk factor load reflecting risk factors for both fibromyalgia and multiple somatic symptoms. Self-reported fibromyalgia with few somatic symptoms has fewer predictors which may be specific to fibromyalgia. Future research could usefully study whether different pathophysiological mechanisms occur when fibromyalgia is preceded by high or low number of somatic symptoms.

Open access, https://www.sciencedirect.com/science/article/abs/pii/S0022399922000307

 

This pretty much screams of early onset that gets worse over years, including fewer education years, impaired by illness at the time. I mean a risk factor of "bodily pain" for... bodily pain really doesn't suggest risk factor so much as early phase. And with IBS, migraines, sleep disorder, this all screams typical chronic illness, exact same as we see in LC, making it very likely this is all immunological.

Amazing that even though it's the obvious conclusion, this isn't the conclusion. Instead it kind of suggests that early complaining is a risk factor, almost timid at saying anything. As for what "future research" calls... damn... you couldn't get people in this field of study to find a hole they were digging themselves. As in literally you could ask them to point at a hole, any hole, while they are digging one, and couldn't come up with a useful answer if given a thousand years.

It's obvious by now that it's all about chronic illness being an unspeakable taboo that everything fails. It has nothing to do with technical difficulties, it's that even when something useful is found, it will be avoided. Medicine simply does not want any progress to happen here, consciously or not, and this pervasive refusal is ruining everything. I'm not even sure if the Catholic church's taboo against heliocentrism was even half as fanatical, here it doesn't even need enforcement, the culture takes care of it.

 

i would say the greatest predictor of am fm diagnosis is the systematic failure of medicine . excessive cost cutting limited time with gps and the gross stupidity involved with the you "can only discuss one symptom at a a time appointment system" . what happened to having a full medical history taken and a proper differential diagnosis after the correct tests to confirm or rule out the doctors suspicions .so your actual diagnosis is based on the best evidence available rather than a rushed gp jumping to often wrong diagnosis based on time and cost . being gate keepers for medical services is not working out well for patients in my opinion . the last statistic for wrong diagnoses i remember is 36% . it would be nice if this number has reduced but i doubt it .

 

From what I know about FM and all the reading about it I've done because I have it, these are the prime risk factors:

female sex
middle-age
diagnosis of rheumatologic disorder

 

I’d argue for no more research from these authors. They should all go flip burgers

 

Why on earth was few years of education put forth as a predictor?

 

Yes, it rather begs the question if there is maybe a mild prodromal phase to this and possibly other chronic illnesses that gets missed by the individual. Missing class time and slightly less stamina to do physical or mental work would reflect an altered education/ work trajectory for some.

But as always there could be any number of explanations. BPS adherents seem to have tunnel vision with regards to what BPS is. From endless reading of their papers their only focus is about the treatment (it always works), not about teasing out the various and sometimes nuanced connections that impact being chronically sick.

Giving a little more thought to the issue would help them realise a few things. One being that what they have right now as an instrument of psychological medicine is the equivalent of an anvil. For me the real mystery is how are they so pleased with themselves over propagating this lame idea endlessly?

Results of a age where everything gets a gold star regardless I guess. There are no bad ideas. Except in reality.

 

In BPS land, consequence is risk factor, and vice versa. Also presence of symptoms means no illness, somehow. It's necessary weird, that's their whole argument right there: attributing the consequences of illness as their cause.

 

The data set would have included various demographic information and the study method merely involved interrogating the data set at two time periods. Predictor in this sense is simply which column/row headings appeared against the results of running the equation "data set two, minus data set one" and which had statistical significance.

Higher rate of illness burden matched to fewer years of education and lower income is of no surprise but the researcher is obliged to report the finding. What it means beyond statistical significance is a wholly other matter, but then that would be the subject of further research. As @Snowdrop says - possible prodromal phase.

I haven't read the full article so I don't know what the author is making of the findings but as far as the abstract is concerned use of the term "predictor" doesn't appear to have any sinister meaning.

 

I take your point. On the face of it from the abstract it seems benign. However:

I've been reading these things for nigh on a decade (or more) and the devil is in the details.

For example:

This study was performed using data from the Lifelines project, University of Groningen Netherlands. It was only possible with the help and co-operation of the Lifelines management staff and Judith Rosmalen, Rei Monden and Klaas Wardenaar of University Medical Center Groningen, who worked on the data for a previous paper.

The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University

Here is info on Klaas Waldenaar and the research he has done:

https://www.researchgate.net/profile/Klaas-Wardenaar

and Judith Rosmalen:

https://www.researchgate.net/profile/Judith-Rosmalen

Yet the author is just using their data so not conclusive.

Here is the authors research history:

https://www.researchgate.net/profile/Francis-Creed/3

The way things are expressed in this paper is somewhat more astute than usual but it is all in service to the same treatment modality as always. Despite the use of the term 'patho-physiology' I expect they see the all the above see the underlying aeteology is bodily distress (the mind) producing many symptoms. What could be seen as 'new' is the idea of separating those with few symptoms from those with many.

At least this is how I read it. IMO it would be unusual in this area of medically not as yet understood illnesses for any of the investigation of illness that doesn't include actual biological investigating to be anything other than liaison psychiatry empire building.