• Marco Di Carlo, Sonia Farah, Fabiola Atzeni, Alessandra Alciati, Manuela Di Franco, Cristina Iannuccelli, Laura Bazzichi, Gerolamo Bianchi, Massimo Giovale, Rosella Tirri, Serena Guiducci, Giuliana Guggino, Franco Franceschini, Rosario Foti, Alberto Lo Gullo, Giovanni Biasi, Elisa Gremese, Lorenzo Dagna, Enrico Tirri, Roberto Giacomelli, Alberto Batticiotto, Maurizio Cutolo, Piercarlo Sarzi-Puttini, and Fausto Salaffi.
• Rheumatology Unit, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica Delle Marche, Ancona, Italy.
• Eur J Pain. 2024 Sep 26.

BackgroundGeographic origin may represent a variable capable of influencing health status. This study aims to investigate the presence of differences of disease severity in Italian patients with fibromyalgia from different macro-regions.MethodsThis retrospective, cross-sectional study involved patients included in the Italian Fibromyalgia Registry. Three geographical macro-regions were identified, comprising patients from Northern Italy, Central Italy and Southern Italy. Clinical differences (evaluated through PolySymptomatic Distress Scale [PSD], revised Fibromyalgia Impact Questionnaire [FIQR] and modified Fibromyalgia Assessment Status [FASmod]) among the geographical macro-regions were studied using one-way analysis of variance (ANOVA) and the Scheffé's test.ResultsA total of 6095 patients (5719 females and 376 males) were included, with 1957 from Northern Italy, 2979 from Central Italy and 1159 from Southern Italy. All studied clinical indices showed a trend indicative of greater disease severity in Southern Italy, followed by Northern Italy and then Central Italy (mean values for PSD: 19.97 ± 6.20 in Northern Italy, 18.61 ± 7.12 in Central Italy, 23.01 ± 5.66 in Souther Italy). These differences were statistically significant for the overall scores of all studied indices, evaluated with ANOVA (all p < 0.001) and in the head to head comparisons, evaluted with Scheffé's test.ConclusionsGeographic background is significantly associated with variations in the severity of fibromyalgia in Italian patients.Significance StatementThis is the first study to demonstrate geographical origin-dependent intra-national differences in the severity of fibromyalgia. The results confirm the necessity of considering fibromyalgia within the context of the biopsychosocial model and of implementing healthcare policies targeted towards the most underserved regions.© 2024 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®.

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