grouping of patients in a number of diseases would eliminate a number
of issues related to study replication and extrapolation of results
among sub groups. As well, more and more researchers are separating
patients with co-occurring depression or anxiety from those who do not
have co-occurring depression or anxiety - regardless of whether the
depression is considered clinical or situational. Many of the
questions relating to emotions in the CODI Index are generic and could
apply equally to people without disease.
Qual Life Res. 2012 Feb 26. [Epub ahead of print]
Clinical dimensions of fibromyalgia symptoms and development of a
combined index of severity: The CODI index.
Cuesta-Vargas A, Luciano JV, Pe=F1arrubia-Mar=EDa MT, Garc=EDa-Campayo J,
Fern=E1ndez-Vergel R, Arroyo-Morales M, Serrano-Blanco A; The FibroQoL
Study Group.
Departamento de Psiquiatr=EDa y Fisioterapia, Universidad de M=E1laga,
M=E1laga, Spain,
Abstract
BACKGROUND:
Although a large body of work indicates that fibromyalgia (FM) is not
a discrete entity, few studies have attempted to classify the
heterogeneity of FM symptoms.
The objectives of the present study were to confirm the existence of
two latent dimensions underlying FM symptoms (Core-FM symptoms and
Distress) by means of factor analysis techniques, and to develop and
validate a new combined index of symptom severity (the CODI).
METHODS:
We analyzed and combined the baseline scores on six visual analog
scales of the FIQ (pain, general fatigue, morning fatigue, stiffness,
anxiety, and depression) and on the STAI-T (trait anxiety) of 216
Spanish patients diagnosed with FM (97.7% women) who were
participating in a randomized, controlled trial.
RESULTS:
The principal component analysis indicated the presence of two
correlated factors (labeled as Core-FM symptoms and Distress) that
explained 64% of total variance. The subsequent confirmatory factor
analysis yielded more empirical support for the two-factor model than
the one-factor model (all items loading on one latent dimension). The
two factors possessed adequate internal consistency and construct
validity given the pattern of significant correlations with the
Euroqol items.
The Core-FM dimension had a stronger relationship with mobility,
self-care, usual activities, and pain/discomfort than with
anxiety/depression, whereas the Distress dimension showed the opposite
pattern. Finally, summing the standardized scores of the two
dimensions, a new combined index of symptom severity (the CODI) was
developed.
CONCLUSION:
The clinical implications and utility of the CODI are discussed in
relation to previous research on FM.
http://www.springerlink.com/content/7h823pp41884410t/
The CODI index can be found here: http://www.salud.uma.es/calculaCODI/engli=
sh/
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