Risk factors for Fibromyalgia
What variables contribute to a patient’s predisposition to developing Fibromyalgia?
The etiology of FM is unknown. However, several variables may contribute to a patient’s predisposition to developing FM as well as the severity of the symptoms:
- • Biologic variables
- Inheritance: genetic polymorphisms have been reported in the COMT enzyme, serotonin transporter and receptor, and the dopamine, β 2 -adrenergic, glutamate and cannabinoid receptor genes.
- Female sex: young and middle-aged females most at risk.
- Sleep architecture abnormalities.
- Neuroendocrine response to stress: attenuated corticotropin-releasing hormone and insulin-like growth factor-1 (somatomedin C) response.
- Autonomic dysregulation: postural orthostasis and tachycardia syndrome.
- • Environmental and sociocultural variables
- Early life developmental experiences: sexual or physical abuse in childhood.
- Family variables: spousal and family support systems.
- Work variables: job satisfaction.
- • Psychologic variables
- Personality traits: perfectionist or self-sacrificing personalities are common.
- Catastrophizing and negative beliefs: belief that pain cannot be controlled.
- Hypervigilance and preoccupation with pain (which may interfere with therapy).
- Low self-efficacy and defective coping mechanisms.
- Depression and anxiety.