Symptom ResearchMore than half of all outpatient visits are trigged by physical symptoms which, in turn, are not adequately explained by medical disorders at least half of the time. Further, the presence and severity of somatic symptoms often correlate more strongly with psychological, cognitive and behavioral factors than with physiological or biological findings. Finally, our understanding of the etiology, evaluation, and management of somatic symptoms and functional syndromes is less advanced than our knowledge of many defined medical and psychiatric disorders. This special section, edited by Kurt Kroenke, M.D., will highlight original studies that advance the science and clinical care of somatic symptoms.The Spanish version of the FibroFatigue Scale: validation of a questionnaire for the observer's assessment of fibromyalgia and chronic fatigue syndrome
Introduction
Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are both chronic clinical conditions characterized by a variety of nonspecific symptoms, including prominent fatigue, myalgia and sleep disturbances. Despite different diagnostic criteria, FM and CFS have many demographic and clinical similarities with few differences in the domains of symptoms [1], [2]. Up to 70% of the patients with CFS-like illnesses may have concurrent FM [3]. In fact, Wessely et al. [4] found a substantial overlap even within the entire group of functional somatic syndromes, including FM, CFS, irritable bowel syndrome and multiple chemical sensitivity, among others.
These two conditions have been assessed with self-rated scales; Fibromyalgia Impact Questionnaire (FIQ) [5] has been one of the most used questionnaires, to our knowledge, for the evaluation of the functional limitations and disability of FM, and several scales for the screening of CFS have been published [6], [7]. However, in psychiatry, observer's rating scales are also considered quite important in addition to self-rating scales [8]. For this reason, FibroFatigue Scale (FFS) was designed as a new observer's rating scale aimed at the assessment of core symptoms and treatment outcome in FM and CFS [9]. Due to substantial overlap in symptomatology between both conditions, the authors decided to develop a scale suitable for FM and CFS.
FFS is a 12-item observer's rating instrument, partially derived from the Comprehensive Psychopathological Rating Scale [10], [11], which measures pain, muscular tension, fatigue, concentration difficulties, failing memory, irritability, sadness, sleep disturbances, autonomic disturbances, irritable bowel symptoms, headache and subjective experience of infection [9]. FFS, in part, has been used as a primary endpoint in clinical trials evaluating the efficacy of different interventions in FM and CFS [12], [13], [14]. This scale has been already been translated into Italian and validated with acceptable psychometric properties [15].
The aim of the study is to validate a translated Spanish version of the FFS, that is, to examine the internal consistency, test–retest reliability, interrater reliability and construct validity of the data obtained with the Spanish version of the FFS.
Section snippets
Patients
The sample was made up of 120 patients (116 women and 4 men), aged 24–62 years (mean 46.7 years, S.D. 7.1 years) belonging to the Fibromyalgia and Chronic Fatigue Syndrome Association of Aragon. They were treated at the Somatoform Disorders Unit of the Miguel Servet University Hospital (Zaragoza, Spain). All of the patients from the Association who had attended the Unit during the year 2004 were invited to participate. To be included in the study, they had to fulfill either the American College
Results
One hundred twenty patients participated in the study. The median and the interquartile range (IQR) of the 12 items of the questionnaire are summarized in Table 1.
Discussion
The present data demonstrate the favorable psychometric characteristics of the data obtained with the Spanish version of the FFS that should define a valid and reliable test: internal reliability, test–retest reliability and interrater reliability. Construct validity has been demonstrated, as was expected, showing significant correlations between FFS and self-reported symptoms of FM (measured by FIQ) and significant inverse correlations between FFS and quality of life (assessed by EuroQol-5D).
Acknowledgments
This work has been possible thanks to the Red de Investigación en Actividades de Prevención y Promoción de la Salud/Research Network on Preventative Activities and Health Promotion (REDIAPP-G03/170), nodo de Aragón and Red Temática de Investigación Cooperativa “Psiquiatría de Enlace” (G03/128) from Instituto de Salud Carlos III, Madrid, Spain.
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Use of the Hospital Anxiety and Depression Scale (HADS) to evaluate anxiety and depression in fibromyalgia patients
2012, Revista de Psiquiatria y Salud MentalAssessment of Fatigue in Adults with Disabilities
2009, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :Findings on physical examination include tenderness in 11 of 18 point sites on digital palpation.39 The Fibromyalgia Impact Questionnaire,40,41 the Multidimensional Fatigue Inventory,42 and the FibroFatigue Scale43 have been used to assess fatigue in patients with fibromyalgia. Fatigue may be caused by respiratory disorders such as chronic obstructive pulmonary disease, obstructive sleep apnea, or sarcoidosis.
Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia
2008, Medicina ClinicaCoping with fibromialgia: Usefulness of the Chronic Pain Coping Inventory-42
2007, PainCitation Excerpt :If a patient’s condition falls between anchoring points, a score of 1, 3, or 5 (which are not defined) is assigned. Our group developed and validated a Spanish version of the FFS (Garcia-Campayo et al., 2006). The HADS (Zigmond and Snaith, 1983) is a self-report scale that screens for the presence of depression and anxiety in patients with organic disorders.
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