Do Illness Perceptions in Patients with Fibromyalgia Differ Across Countries? A Comparative Study

Kevin Kuppens, Hedwig Neels, C. Paul van Wilgen, Nathalie Roussel, Annette Heyrman, Luc Lambrecht, Miriam W. van Ittersum, Jo Nijs

Research output: Contribution to journalArticle


Objective: Illness perceptions, i.e. how patients think about their illness in terms of identity, cause and consequences, are important, as negative illness perceptions are associated with maladaptive illness behavior, more dysfunctioning, poor treatment adherence and treatment outcome. As illness perceptions are influenced by cultural background, former experiences and provided information, the aim of this study was to compare illness perceptions of patients with fibromyalgia syndrome [FMS] living in different countries.

Methods: Dutch speaking participants from two countries were recruited in this international comparative study. In total, 114 Belgian [Flemish] and 283 Dutch FMS patients completed the Illness Perception Questionnaire for Fibromyalgia-Dutch Language version [IPQ-R FM-Dlv]. The Mann–Whitney U test for non-parametric data was used to compare data between the patient groups. Pearson’s chi-squared test was used to compare proportions.

Results: Significant differences in illness perceptions were observed. Belgian patients reported a higher variety of symptoms and believed more strongly that these symptoms are related with their illness. They had more negative beliefs concerning the consequences of their illness and reported more external attributed factors to be the cause of their illness. Dutch patients demonstrated a better understanding and controllability. They indicated more internal attributed factors as a cause.
Conclusions: These findings suggest that illness perceptions in patients with FMS are prone to local influences, including small differences in the health care system. Future studies are advised to measure mood, psychopathology, medical co-morbidity and socio-demographic factors and include them in a multivariate analysis.
Original languageEnglish
Pages (from-to)13-20
Number of pages7
JournalJournal of Musculoskeletal Pain
Issue number1-2
Publication statusPublished - 2015


  • Fibromyalgia
  • regional differences
  • IPQ
  • illness perception questionnaire
  • perceptions of illness

Cite this