[Causal illness attributions and healthcare utilization in fibromyalgia syndrome]

High utilization of medical services has been described for patients with fibromyalgia syndrome (FMS). There are no studies available that assess whether the patients' subjective illness beliefs influence their behavior in utilizing healthcare.

Examinations were performed by taking the history of pain treatment in 100 FMS patients evaluated by experts for the social court and 25 patients attending an outpatient pain center. The subjective illness theories were drawn from the patients' responses to the German Pain Questionnaire (GPQ). The statements made on the GPQ regarding utilization of healthcare services were compared with the records and the answers given in the interview on pain therapy.

Of the patients, 44% specified a somatic, 2% a psychogenic, 9% none, and 45% a psychosomatic illness belief. The patients were classified as high utilizers of specialized medical services in 25% of the cases and of psychiatric-psychotherapeutic services in 14%. No significant correlations between the type of subjective illness theory and utilization of specialized medical or psychiatric-psychotherapeutic services were observed.

From the psychosomatic viewpoint, only part of the FMS patients exhibited an inordinately one-sided somatic illness belief. The utilization of healthcare services cannot be explained by the subjective perception of the illness.