Fibromyalgia--a new cause for disability pension

Area of Science:

• Rheumatology
• Public Health
• Disability Studies

Background:

• Fibromyalgia is a controversial diagnosis for widespread muscular pain.
• It was a leading cause of disability pensions in Norway in 1988.
• Significant regional disparities in fibromyalgia disability incidence were observed.

Purpose of the Study:

• To investigate the reasons behind the marked differences in fibromyalgia disability pension incidence between two neighboring Norwegian counties.
• To determine if observed differences reflect actual morbidity patterns or variations in diagnostic and assessment practices.

Main Methods:

• Retrospective analysis of insurance records for new disability pensioners in 1988.
• Focus on fibromyalgia and related diagnoses.
• Comparative study of two Norwegian counties with contrasting incidence rates.

Main Results:

• The study found that differences in diagnostic approaches by physicians and the assessment criteria used by the insurance system accounted for the observed disparities.
• No significant differences in underlying morbidity patterns between the counties were identified as the primary cause.
• The findings question the utility of fibromyalgia as a distinct diagnostic subgroup.

Conclusions:

• Variations in diagnostic and insurance assessment practices, rather than true differences in illness prevalence, explain the geographical disparities in fibromyalgia disability pensions.
• The study raises questions about the clinical and administrative utility of the fibromyalgia diagnosis in managing musculoskeletal complaints.
• Further research is needed to clarify the role of fibromyalgia in disability assessment and public health strategies for musculoskeletal pain.