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The Incidence of Fibromyalgia and Its Associated Comorbidities: A Population-Based Retrospective Cohort Study Based on International Classification of Diseases, 9th Revision Codes

Weir, Peter T. MD*; Harlan, Gregory A. MD, MPH; Nkoy, Flo L. MD, MS, MPH; Jones, Spencer S. BS*; Hegmann, Kurt T. MD, MPH; Gren, Lisa H. MSPH*; Lyon, Joseph L. MD, MPH*

JCR: Journal of Clinical Rheumatology: June 2006 - Volume 12 - Issue 3 - p 124-128
doi: 10.1097/01.rhu.0000221817.46231.18
Original Article

Background: The epidemiology of fibromyalgia is poorly defined. The incidence of fibromyalgia has not been determined using a large population base. Previous studies based on prevalence data demonstrated that females are 7 times more likely to have fibromyalgia than males and that the peak age for females is during the childbearing years.

Objective: We have calculated the incidence rate of fibromyalgia in a large, stable population and determined the strength of association between fibromyalgia and 7 comorbid conditions.

Methods: We conducted a retrospective cohort study of a large, stable health insurance claims database (62,000 nationwide enrollees per year). Claims from 1997 to 2002 were examined using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes to identify fibromyalgia cases (ICD code 729.1) and 7 predetermined comorbid conditions.

Results: A total of 2595 incident cases of fibromyalgia were identified between 1997 and 2002. Age-adjusted incidence rates were 6.88 cases per 1000 person-years for males and 11.28 cases per 1000 person-years for females. Females were 1.64 times (95% confidence interval = 1.59–1.69) more likely than males to have fibromyalgia. Patients with fibromyalgia were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis.

Conclusion: Females are more likely to be diagnosed with fibromyalgia than males, although to a substantially smaller degree than previously reported, and there are strong associations for comorbid conditions that are commonly thought to be associated with fibromyalgia.

This epidemiologic study challenges the perception that fibromyalgia is far more common in females. It also quantifies associations with comorbid conditions.

From the *Department of Family and Preventive Medicine, the †Department of Pediatrics, and the ‡Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, Utah.

Reprints: Peter T. Weir, MD, Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.