Objective This meta-analysis systematically examined the association of reported psychological trauma and posttraumatic stress disorder (PTSD) with functional somatic syndromes including fibromyalgia, chronic widespread pain, chronic fatigue syndrome, temporomandibular disorder, and irritable bowel syndrome. Our goals were to determine the overall effect size of the association and to examine moderators of the relationship. Methods Literature searches identified 71 studies with a control or comparison group and examined the association of the syndromes with traumatic events including abuse of a psychological, emotional, sexual, or physical nature sustained during childhood or adulthood, combat exposure, or PTSD. A random effects model was used to estimate the pooled odds ratio and 95% CI. Planned subgroup analyses and meta-regression examined potential moderators. Results Individuals who reported exposure to trauma were 2.7 (95% CI = 2.27 – 3.10) times more likely to have a functional somatic syndrome. This association was robust against both publication bias and the generally low quality of the literature. The magnitude of the association with PTSD was significantly larger than with sexual or physical abuse. Chronic fatigue syndrome had a larger association with reported trauma than either irritable bowel syndrome or fibromyalgia. Studies using non-validated questionnaires or self-report of trauma reported larger associations than those using validated questionnaires. Conclusions Findings highlight limitations of the existing literature and emphasize the importance of conducting prospective studies, further examining the potential similarities and differences of these conditions, and pursuing hypothesis-driven studies of the mechanisms underlying the link between trauma, PTSD, and functional somatic syndromes.
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