Women with a history of intimate partner violence are more likely to develop fibromyalgia, as well as chronic fatigue syndrome (CFS), according to a recent study.
These findings highlight the need to investigate the biological and psychological pathways that lead to fibromyalgia, and also help to inform healthcare professionals on the risk factors and best management for this patient population, researchers say.
Their study, titled “Intimate Partner Violence and the Risk of Developing Fibromyalgia and Chronic Fatigue Syndrome,” was published in the Journal of Interpersonal Violence.
Experiencing abuse can have long-lasting impacts on both mental and physical health. For example, childhood abuse and sexual trauma have been linked to an increased risk of both fibromyalgia and CFS.
An estimated one in three women experience intimate partner violence (IPV). However, whether experiencing this kind of abuse during adulthood is associated with an increased risk of fibromyalgia and/or CFS hasn’t been thoroughly investigated. Of note, fibromyalgia is associated with pain without a clear source, and CFS is similar, but characterized by extreme fatigue.
The new study set out to determine whether such an association exists using data from 1995 to 2017 from The Health Improvement Network, which collects medical data from hundreds of practices in the United Kingdom.
Data was obtained for 18,547 women in the network who had a recorded history of IPV (the “exposed” group), as well as for 74,188 women who did not have such a recorded history (the “unexposed” group).
In the exposed group, the rate of fibromyalgia was 1.4%, and it was 0.5% for CFS. In the unexposed group, the rates were 0.7% for fibromyalgia and 0.4% for CFS. Moreover, the exposed group also had significantly higher rates of obesity, smoking, and excessive drinking.
Statistical models were constructed to compare the risk of developing each syndrome in the exposed group compared with the unexposed group. After adjusting for variables such as smoking and drinking, risk of both was significantly increased in the exposed group: by 73% for fibromyalgia and by 92% for CFS.
“[F]emale survivors of IPV during adulthood were almost twice as likely to develop fibromyalgia and CFS,” the researchers wrote. “Following adjustment for important covariates, this relationship persists suggesting an underlying association between a history of IPV and development of fibromyalgia or CFS.”
Interestingly, the risk of these syndromes decreased substantially after statistical adjustment for anxiety and depression, which suggests that mental health likely plays some role in this association.
This study was not designed to detect a cause-and-effect relationship, and further research will be needed to understand the mechanisms connecting IPV and fibromyalgia or CFS.
“Therefore, a history of abuse should be explored in patients suspected of fibromyalgia or CFS,” the researchers wrote. “Equally, a diagnosis of fibromyalgia/CFS should be considered if women present with fatigue, chronic pain, cognitive impairment, or sleep disorder, particularly if there is a known background of IPV.”
“Considering the prevalence of IPV, it is important for clinicians to bear in mind this as a risk factor, thereby reducing diagnostic delay for fibromyalgia and CFS,” they said.