Table 4.

Risk markers for chronic widespread pain and fibromyalgia in adult samples.

Risk marker	Modifiable	Pain context	Type of study	Population or clinic	Number of participants	Multivariate analysis	Reference	Overall quality∗
Female sex	No	CWP	Prospective population cohort	Population	28,367	Yes	Mundal et al. [66]	+++
		CWP	Systematic review	N/A	N/A	N/A	Mansfield et al. [67]	N/A
		CWP	Review	N/A	N/A	N/A	Mogil [68]	N/A
		FMS	Random population survey	Population	830	No	Vincent et al. [69]	++
Psychosocial factors
(i) Stress, anxiety, and depression	Yes	CWP	Prospective population cohort	Population	28,367	Yes	Mundal et al. [66]	+++
		CWP	Prospective population cohort	Population	3,171	Yes	Gupta et al. [70]	+++
		CWP	Twin survey	Population Population Population	3,266 9,26 3,266	Yes Yes Yes	Burri et al. [38, 71, 72]	++++
(ii) Emotional intelligence (low)	Possibly	CWP	Twin survey	Population	3,266	Yes	Burri et al. [71]	++++
(iii) Posttraumatic stress disorder	Possibly	CWP	Prospective population cohort	Population	1,312	Yes	Raphael et al. [73]	+++
		FMS	Cross-sectional	Clinic	395	No	Häuser et al. [74]	++
(iv) Socioeconomic status (low)	Possibly	CWP	Prospective population cohort	Population	2,509	No	Davies et al. [52]	+++
(v) Family dysfunction	Possible	CWP	Case-control cross-sectional	Clinic	75	Yes	Hayaki et al. [75]	++
(vi) Maladjusted behavior	Yes	CWP	Prospective population cohort	Population	8572	Yes	Pang et al. [76]	+++
Preterm birth	No	CWP	Prospective population cohort	Population	8572	Yes	Littlejohn et al. [77]	+++
Sleep problems	Yes	CWP	Prospective population cohort	Population	3,171	Yes	Gupta et al. [70]	+++
		FMS	Review	N/A	N/A	N/A	Choy [78]	N/A
Physical trauma	No	CWP	Prospective cohort	Clinic	948	No	Hu et al. [79]	++
Functional/primary pain disorders	Yes	CWP	Prospective cohort	Clinic	423	Yes	Viniol et al. [80]	++
		CWP	Retrospective cohort	Clinic	512	Yes	Kindler et al. [81]	++
		FMS	Case-control	Clinic	625	Yes	Warren et al. [82]	++
		FMS	Cross-sectional	Clinic	1,123	Yes	de Tommaso et al. [83]	++
		FMS	Controlled trial	Clinic	86	No	Giamberardino et al. [84]	+
Overweight and obesity	Yes	CWP	Prospective population cohort	Population	28,367	Yes	Mundal et al. [66]	+++
		CWP	Prospective population cohort	Population	1,553	Yes	Magnusson et al. [85]	+++
		FMS	Review	N/A	N/A	N/A	Ursini et al. [86]	N/A
Iron deficiency	Yes	FMS	Case-control	Clinic	92	No	Ortancil et al. [87]	+
Hemochromatosis	Yes	FMS	Cross-sectional	Clinic	295	No	Mohammad et al. [88]	+
HPA dysfunction	Possibly	CWP	Prospective population cohort	Population	241	Yes	McBeth et al. [89]	+++
Infectious illness	Possibly	FMS	Review	N/A	N/A	N/A	Buskila et al. [90]	N/A
		FMS	Review	N/A	N/A	N/A	Häuser et al. [91]	N/A
		FMS	Prospective cohort controlled	Population	1,244	Yes	Chen et al. [92]	+++

^∗Overall quality:  + , very low;  ++ , low;  +++ , moderate;  ++++ , high.