Fibromyalgia Patients Should Be Evaluated for PTSD, Researchers Say

Fibromyalgia Patients Should Be Evaluated for PTSD, Researchers Say

Women with fibromyalgia and chronic widespread pain are more likely to have post-traumatic stress disorder (PTSD) compared with patients with two stomach conditions (achalasia and dyspepsia), according to a new study. The study also showed a link between the severity of PTSD and the severity of pain among these patients.

Women with fibromyalgia also reported more cases of childhood adversities compared with patients with one of the stomach conditions, but the link between these childhood events and the severity of pain could be explained by the presence of PTSD, researchers at the University Hospitals Leuven and KU Leuven said.

Therefore, doctors should look into whether patients being examined for fibromyalgia have PTSD, since management of symptoms could impact the severity of pain and general functioning.

The study, “Prevalence and impact of childhood adversities and post-traumatic stress disorder in women with fibromyalgia and chronic widespread pain,” was published in the European Journal of Pain.

Several earlier studies have noted that patients with fibromyalgia and chronic widespread pain more often report emotionally or physically traumatic events during childhood compared with patients who have other chronic illnesses.

However, few of these studies examined if these events were linked to PTSD. To do so, researchers enrolled 154 women with fibromyalgia or chronic widespread pain. In addition, 83 women with functional dyspepsia — a chronic condition of sensation and movement in the upper digestive tract — and 53 women with achalasia were enrolled.

Achalasia is a condition in which the esophagus fails to press food down, and the valve linking to the stomach doesn’t fully relax, which makes it difficult for food to enter the stomach.

Researchers assessed patients using a childhood trauma questionnaire and a PTSD self-rating inventory.

Almost half (49%) of fibromyalgia and chronic widespread pain patients reported at least one childhood traumatic event, compared to 39.7% of patients with functional dyspepsia and 23.4% of achalasia patients.

The difference was only significant between fibromyalgia and achalasia.

Researchers also noted that patients with fibromyalgia and chronic pain more often reported sexual or emotional abuse and emotional neglect compared with achalasia patients, while physical abuse or physical neglect were similarly common in the two groups.

Researchers did not find any links between the severity of these childhood events and pain.

A much larger difference existed, however, when researchers looked at scores in the PTSD questionnaire: 26% of fibromyalgia and chronic pain patients had PTSD, compared with only 4.9% of those with functional dyspepsia, and 12.2% of achalasia patients.

This translated to a likelihood of PTSD in fibromyalgia of about five to seven times that seen in other patient groups.

The severity of PTSD was higher among fibromyalgia patients, and was highest in those also reporting childhood traumas, with more traumatic events linked to more severe PTSD.

PTSD severity was also related to both quantitative and qualitative ratings of pain, so that fibromyalgia patients with PTSD had more and worse pain than those without the condition.

An advanced statistical analysis suggested that PTSD mediated the effects of traumatic childhood events on pain severity.

These findings underscore the need to treat PTSD among fibromyalgia patients, as such treatment might also improve pain, and hence everyday functioning.

9 comments

  1. Katherine Johnson says:

    There also seems to be a link with childhood sexual abuse and autoimmune disorders like Rheumatoid Arthritis and Lupus. Makes you wonder what kind of long term damage is done to a developing brain and immune system from this kind of trauma.

    • Antonia says:

      I’ve had ptsd from chronic trauma as a child I’ve done research and basically it can really affect the natural developmental stages of a child’s brain

  2. Shana says:

    I began my Fibro symptoms years before any traumatic events happened to me. This study smacks of when people (qualified or not) try to diagnose most people with widespread pain as having conversion disorder. Also why are the other group simply people with upper digestive tract disorders. The lower digestive tract is where the second highest concentration of serotonin is, Next only to the nervous system. And I’m sure there are any number of other diseases affecting other parts of the body (for instance, migraines or heart conditions) that would be more suitable for comparison. I don’t think this study proves anything at all.

    • Katherine Johnson says:

      I don’t think this means it’s “all in your head”. Especially when this is also true with autoimmune diseases like Lupus and Rheumatoid Arthritis. What it does reflect is the long term brain damage and immune system damage that results from childhood trauma. The problem is, despite this article’s suggestion for treating PTSD, there’s actually few effective treatments for PTSD out there. It’s as hard to treat as Fibromyalgia, with few traditional therapies have any effect. The other thing that’s difficult is that we have this fantasy in traditional medicine that mind/body/spirit function independently which is completely untrue. It’s more like a mosh pit, with everything affecting everything else. It’s easy to get offended after being screwed around so much after diagnosis, believe me, I get it, but there’s something to this issue. If nothing else it should make us, as a society to be more motivated to prevent childhood abuse/trauma, as the physical/mental/spiritual damage it causes is far reaching and very expensive for society as a whole.

    • Lynne says:

      I agree with you. It seems everyone, doctors included, want to “blame” other conditions for fibro. Maybe, just maybe, it is a stand alone condition that was never taken seriously for centuries. My PTSD happened years (10+) after my rheumatologist verified it. Oh and I had a textbook Norman Rockwell childhood, that still brings smiles to my face just typing this.

  3. Terri says:

    I was told by a very high credentialed Nutritionist that 5-HTP creates Serotonin that goes all over the body but Tryptophan targets only the brain sleep chemicals. I take it around 8 pm.

  4. Kathy says:

    OK. So, what constitutes childhood trauma? Falling out of a tree? Getting spanked? Falling off a bicycle? Getting smacked by a dirt clod? I would like to look at the form the people filled out.
    I am also wondering if fibro and Epstein barr Virus have any links.

    • Katherine Johnson says:

      The kind of trauma they are talking about in this article is severe trauma that causes PTSD. Personally for me that means being sexually abused from 6-9 years old. For some it’s severe physical abuse. Not mild forgettable incidents like falling out of a tree.

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