Abstract:

Background/Purpose: the association between Fibromyalgia Syndrome (FMS) and childhood maltreatment and adversity has frequently been proposed but limited data exists regarding the trans-cultural nature of this association, based on retrospective self-report analysis. Moreover, the differences between FMS and other chronic rheumatic disorders such as rheumatoid arthritis have not been extensively analyzed.

Methods: 75 Israeli FMS patients and 23 Rheumatoid Arthritis (RA) patients were compared. Childhood maltreatment was assessed by the Childhood Maltreatment Questionnaire (CTQ) and potential depressive and anxiety disorder were assessed by the Patient Health Questionnaire PHQ-4. FMS severity was assessed by use of the Widespread Pain Index (WPI), the Symptom Severity Score (SSS) and the Fibromyalgia Impact Questionnaire (FIQ). Potential posttraumatic stress disorder (PTSD) was diagnosed according to the Diagnostic and Statis­tical Manual of Mental Disorders IV-TR symptom criteria by the Posttraumatic Diagnostic Scale (PDS). RA severity was assessed by the RA Disease Activity Index (RADAI). Health status was assessed by the Short Form 36 health survey (SF-36).

Results: Similar to previous reports in other countries, high levels of self-reported childhood adversity were reported by Israeli FMS patients. PTSD was significantly more common among FMS patients compared with RA patients, as well as reports of childhood emotional abuse, physical and emotional neglect. The OR for PTSD among FMS patients compared with RA patients, when controlling for anxiety and depression, was 4.9 with 95% CI 1.02-23.6. (p<0.05). Reports of physical and sexual abuse did not significantly differ between FMS and RA patients and no significant difference was found regarding rates of “severe” and “very severe” childhood trauma between the groups. Levels of depression and anxiety were significantly higher among FMS patients compared with RA patients. FMS patients demonstrated significantly lower scores regarding energy/fatigue, emotional wellbeing, and social functioning compared with RA patients.

Conclusion: The study demonstrated the cross cultural association between FMS and childhood maltreatment, including neglect and emotional abuse as well as PTSD. Significant differences were demonstrated between FMS patients and patients suffering from RA, a model of an inflammatory chronic rheumatic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/self-reported-childhood-maltreatment-and-traumatic-events-among-israeli-patients-suffering-from-fibromyalgia-and-rheumatoid-arthritis/