ORIGINAL PAPER
Prevalence of fibromyalgia in medical students and its association with lifestyle factors – a cross-sectional study
1
Student Scientific Circle of Clinical Rheumatology, Department of Internal Diseases, Connective Tissue Disorders and Geriatrics, Medical University of Gdansk, Poland
2
Department of Internal Diseases, Connective Tissue Disorders and Geriatrics, Medical University of Gdansk, Poland
Submission date: 2021-03-24
Final revision date: 2021-05-04
Acceptance date: 2021-05-12
Online publication date: 2021-06-14
Publication date: 2021-07-16
Reumatologia 2021;59(3):138-145
KEYWORDS
TOPICS
Assessment of disease activity and quality of life in rheumatic diseasesPain in rheumatic diseasesEpidemiologyHealth care problems
ABSTRACT
Introduction:
Fibromyalgia (FM) is a chronic widespread pain syndrome, known to be associated with several other symptoms. Chronic stress is suspected to be a contributing factor in the pathogenesis of FM. It is known that medical students are under a constant state of stress originating from personal and social expectations. The aim of the study was to assess the prevalence of FM in this population and identify lifestyle parameters influencing FM severity.
Material and methods:
An online survey of first- and final-year medical students was conducted using the ACR modified 2016 criteria and FANTASTIC checklist. The survey acquired demographic information such as age, gender, year, and division of studies. A subgroup analysis based on gender, year of studies, and division of studies was performed.
Results:
439 medical students (71% females) completed the survey. The overall prevalence of FM in our cohort was 10.48%. The ratio of females to males was 3 : 1. A significant negative correlation between better quality of lifestyle and worse FM severity was observed in all subgroups. The “insight”, “sleep and stress”, “behavior” and “career” domains of lifestyle were found to have a significant negative correlation with FM severity on univariate analysis.
Conclusions:
The prevalence of FM in medical students seems to be considerably higher than in the general population. Chronic stress levels, sleep problems, social support, and behavior seem to be the major factors influencing FM severity in this population. Our findings suggest that medical students must be considered a “high-risk” group for FM, and hence must be identified, educated, and managed accordingly. It is, therefore, important for medical universities to implement programs educating students about FM, the importance of a healthy lifestyle, and stress coping strategies, while also making systemic changes to curb stressors in medical training.
Fibromyalgia (FM) is a chronic widespread pain syndrome, known to be associated with several other symptoms. Chronic stress is suspected to be a contributing factor in the pathogenesis of FM. It is known that medical students are under a constant state of stress originating from personal and social expectations. The aim of the study was to assess the prevalence of FM in this population and identify lifestyle parameters influencing FM severity.
Material and methods:
An online survey of first- and final-year medical students was conducted using the ACR modified 2016 criteria and FANTASTIC checklist. The survey acquired demographic information such as age, gender, year, and division of studies. A subgroup analysis based on gender, year of studies, and division of studies was performed.
Results:
439 medical students (71% females) completed the survey. The overall prevalence of FM in our cohort was 10.48%. The ratio of females to males was 3 : 1. A significant negative correlation between better quality of lifestyle and worse FM severity was observed in all subgroups. The “insight”, “sleep and stress”, “behavior” and “career” domains of lifestyle were found to have a significant negative correlation with FM severity on univariate analysis.
Conclusions:
The prevalence of FM in medical students seems to be considerably higher than in the general population. Chronic stress levels, sleep problems, social support, and behavior seem to be the major factors influencing FM severity in this population. Our findings suggest that medical students must be considered a “high-risk” group for FM, and hence must be identified, educated, and managed accordingly. It is, therefore, important for medical universities to implement programs educating students about FM, the importance of a healthy lifestyle, and stress coping strategies, while also making systemic changes to curb stressors in medical training.
REFERENCES (40)
1.
Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16: 645–660, DOI: 10.1038/ s41584-020-00506-w.
2.
Plesner KB, Vaegter HB. Symptoms of Fibromyalgia According to the 2016 Revised Fibromyalgia Criteria in Chronic Pain Patients Referred to Multidisciplinary Pain Rehabilitation: Influence on Clinical and Experimental Pain Sensitivity. J Pain 2018; 19: 777–786, DOI: 10.1016/j.jpain.2018.02.009.
3.
Cabo-Meseguer A, Cerdá-Olmedo G, Trillo-Mata JL. Fibromyalgia: Prevalence, epidemiologic profiles and economic costs. Med Clínica Engl Ed 2017; 149: 441–448, DOI: 10.1016/j.medcle.2017.10.011.
4.
Marques AP, De Sousa A, Santo E, et al. Prevalence of fibromyalgia: literature review update. Rev Bras Reum Engl Ed 2017; 57: 356–363, DOI: 10.1016/j.rbre.2017.01.005.
5.
Heidari F, Afshari M, Moosazadeh M. Prevalence of fibromyalgia in general population and patients: a systematic review and meta-analysis. Rheumatol Int 2017; 37: 1527–1539, DOI: 10.1007/s00296-017-3725-2.
6.
Jones GT, Atzeni F, Beasley M, et al. The Prevalence of Fibromyalgia in the General Population: A Comparison of the American College of Rheumatology 1990, 2010, and Modified 2010 Classification Criteria. Arthritis Rheumatol 2015; 67: 568–575, DOI: 10.1002/art.38905.
7.
Borchers AT, Gershwin ME. Fibromyalgia: A Critical and Comprehensive Review. Clin Rev Allergy Immunol 2015; 49: 100–151, DOI: 10.1007/s12016-015-8509-4.
8.
Kivimäki M, Leino-Arjas P, Virtanen M, et al. Work stress and incidence of newly diagnosed fibromyalgia: Prospective cohort study. J Psychosom Res 2004; 57: 417–422, DOI: 10.1016/j.jpsychores.2003.10.013.
9.
Galvez-Sánchez CM, Duschek S, Del Paso GAR. Psychological impact of fibromyalgia: Current perspectives. Psychol Res Behav Manag 2019; 12: 117–127, DOI: 10.2147/PRBM.S178240.
10.
Albrecht PJ, Rice FL. Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms. Rev Environ Health 2016; 31: 281–294, DOI: 10.1515/reveh-2015-0040.
11.
Van Houdenhove B, Neerinckx E, Onghena P, et al. Daily Hassles Reported by Chronic Fatigue Syndrome and Fibromyalgia Patients in Tertiary Care: A Controlled Quantitative and Qualitative Study. Psychother Psychoso. 2002; 71: 207–213, DOI: 10.1159/000063646.
12.
Pednekar DD, Amin MR, Fekri Azgomi H, et al. Characterization of Cortisol Dysregulation in Fibromyalgia and Chronic Fatigue Syndromes: A State-Space Approach. IEEE Trans Biomed Eng 2020; 67: 3163–3172, DOI: 10.1109/tbme.2020.2978801.
13.
Barceló-Martinez E, Gelves-Ospina M, Navarro Lechuga E, et al. Serum cortisol levels and neuropsychological impairments in patients diagnosed with Fibromyalgia. Actas Esp Psiquiatr 2018; 46: 1–11.
14.
Bergmann C, Muth T, Loerbroks A. Medical students’ perceptions of stress due to academic studies and its interrelationships with other domains of life: a qualitative study. Med Educ Online 2019; 24, DOI: 10.1080/10872981.2019.1603526.
15.
Vyas KS, Stratton TD, Soares NS. Sources of medical student stress. Educ Heal Chang Learn Pract 2017; 30: 232–235, DOI: 10.4103/efh.EfH_54_16.
16.
Puthran R, Zhang MWB, Tam WW, Ho RC. Prevalence of depression amongst medical students: a meta-analysis. Med Educ 2016; 50: 456–468, DOI: 10.1111/medu.12962.
17.
Almojali AI, Almalki SA, Alothman AS, et al. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Glob Health 2017; 7: 169–174, DOI: 10.1016/j.jegh.2017.04.005.
18.
Quek TTC, Tam WWS, Tran BX, et al. The global prevalence of anxiety among medical students: A meta-analysis. Int J Environ Res Public Health 2019; 16: 2735, DOI: 10.3390/ijerph16152735.
19.
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016; 46: 319–329, DOI: 10.1016/j.semarthrit.2016. 08.012.
20.
Wilson DMC, Nielsen E, Ciliska D. Lifestyle Assessment: Testing the FANTASTIC Instrument. Can Fam Phys 1984; 30: 1863–1866.
21.
Wilhelm K, Handley T, Reddy P. Exploring the validity of the Fantastic Lifestyle Checklist in an inner city population of people presenting with suicidal behaviours. Aust N Z J Psychiatry 2016; 50: 128–134, DOI: 10.1177/0004867415621393.
22.
Deluga A, Kosicka B, Dobrowolska B, et al. Lifestyle of the elderly living in rural and urbanareas measured by the fantastic life inventory. Ann Agric Environ Med 2018; 25: 562–567, DOI: 10.26444/aaem/86459.
23.
Gansky SA, Plesh O. Widespread pain and fibromyalgia in a biracial cohort of young women. J Rheumatol 2007; 34: 810–817.
24.
Felson DT. Comparing the prevalence of rheumatic diseases in China with the rest of the world. Arthritis Res Ther 2008; 10: 2–3, DOI: 10.1186/ar2369.
25.
Toda K. The prevalence of fibromyalgia in Japanese workers. Scand J Rheumatol 2007; 36: 140–144, DOI: 10.1080/ 03009740600907949.
26.
Eyigor S, Ozdedeli S, Durmaz B. The prevalence of generalized soft tissue rheumatic conditions in Turkish medical students. J Clin Rheumatol 2008; 14: 65–68, DOI: 10.1097/RHU.0b013e31816b1920.
27.
Omair MA, Alobud S, Al-Bogami MH, et al. Prevalence of fibromyalgia in physicians in training: a cross-sectional study. Clin Rheumatol 2019; 38: 165–172, DOI: 10.1007/s10067-018-4313-x.
28.
Ge L, D’Souza RS, Oh T, et al. Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction. Mayo Clin Proc Innov Qual Outcomes 2019; 3: 78–85, DOI: 10.1016/j.mayocpiqo. 2018.12.002.
29.
Kim CH, Vincent A, Clauw DJ, et al. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia. Arthritis Res Ther 2013; 15: R42, DOI: 10.1186/ar4200.
30.
Conversano C, Poli A, Ciacchini R, et al. A psychoeducational intervention is a treatment for fibromyalgia syndrome. Clin Exp Rheumatol 2019; 37: 98–104.
31.
Rockfeld J, Koppel J, Buell A, Zucconi R. An Interactive Lifestyle Medicine Curriculum for Third-Year Medical Students to Promote Student and Patient Wellness. MedEdPORTAL 2020; 16: 10972, DOI: 10.15766/mep_2374-8265.10972.
32.
Noble H, Reid J, Walsh IK, et al. Evaluating mindfulness training for medical and PhD nursing students. Br J Nurs 2019; 28: 798–802, DOI: 10.12968/bjon.2019.28.12.798.
33.
De Vibe M, Solhaug I, Rosenvinge JH, et al. Six-year positive effects of a mindfulness-based intervention on mindfulness, coping and well-being in medical and psychology students; Results from a randomized controlled trial. PLoS One 2018; 13, DOI: 10.1371/journal.pone.0196053.
34.
McLuckie A, Matheson KM, Landers AL, et al. The Relationship Between Psychological Distress and Perception of Emotional Support in Medical Students and Residents and Implications for Educational Institutions. Acad Psychiatry 2018; 42: 41–47, DOI: 10.1007/s40596-017-0800-7.
35.
Domaradzki J, Walkowiak D. Medical students’ knowledge and opinions about rare diseases: A case study from Poland. Intractable Rare Dis Res 2019; 8: 252–259, DOI: 10.5582/irdr. 2019.01099.
36.
García-Ríos MC, Navarro-Ledesma S, Tapia-Haro RM, et al. Effectiveness of health education in patients with fibromyalgia: A systematic review. Eur J Phys Rehabil Med 2019; 55: 301–313, DOI: 10.23736/S1973-9087.19.05524-2.
37.
Hill MR, Goicochea S, Merlo LJ. In their own words: stressors facing medical students in the millennial generation. Med Educ Online 2018; 23: 1530558, DOI: 10.1080/10872981.2018.1530558.
38.
Slavin SJ, Chibnall JT. Finding the why, changing the how: Improving the mental health of medical students, residents, and physicians. Acad Med 2016; 91: 1194–1196, DOI: 10.1097/ACM.0000000000001226.
39.
Amarasuriya SD, Reavley NJ, Rossetto A, Jorm AF. Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka. BMC Psychiatry 2017; 17: 40, DOI: 10.1186/s12888-017-1192-7.
40.
Heim E, Henderson C, Kohrt BA, et al. Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: A systematic review. Epidemiol Psychiatr Sci 2019; 20: e28, DOI: 10.1017/S2045796019000167.
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