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.
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.