Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study

Abstract

Background. Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). Objective. The main objective of this study consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. Method. Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. Results. The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. Conclusions. Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. Trial registration: ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.

The association between violence against women and chronic pain: a systematic review and meta-analysis

“…When the diagnostic categories are combined the achieved results are significant; to obtain the same effects from subcategories it could be necessary to increase the number of studies that have evaluated them. However, the fibromyalgia results show a positive and significant association, in line with the original hypothesis and previous studies [ 19 , 29 , 30 ].…”

“…Previously, researchers studied health conditions and violence types separately, such as the association between sexual trauma and pelvic pain [ 27 , 28 ], or psychological trauma and fibromyalgia [ 29 , 30 ]. It is crucial to approach chronic pain as a broad concept because irrespective of the affected body area, individuals can seek assistance from pain therapy departments or clinics.…”

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“…Sociodemographic and clinical data were collected using a specialized medical history questionnaire developed within our department. This questionnaire is administered by healthcare professionals and is divided into two sections: the first part focuses on collecting sociodemographic data, while the second part gathers information concerning the patient’s psychiatric history even the presence and nature of trauma [ 41 ]. After the initial screening phase, patients underwent the following psychometric scales to measure the presence of complex trauma, the severity of anxiety symptoms, and the presence of dissociative symptomatology.…”

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“…Higher maternal adverse childhood experiences (ACEs) scores corresponded with depressive symptoms and greater anxiety, greater sleep disturbances and fatigue, and greater pain intensity in mothers [51] Clinical…”

“…There is growing evidence that traumatic experiences during childhood influence pain sensitivity and the development of chronic pain in adulthood [49]. For example, child abuse increases the risk of developing fibromyalgia in adulthood [50,51]. In addition, children hospitalized following a road traffic accident and those who experienced maternal death and familial financial hardship have an increased risk of developing widespread chronic pain in adulthood [5].…”