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Perceived physical & emotional trauma as precipitating events in fibromyalgia (FM). Associations with health care seeking & disability status but not pain severity

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By Aaron LA, Bradley LA, Alarcon GS, Triana-Alexander M, Alexander RW, Martin MY, Alberts KR • www.ProHealth.com • March 15, 1997


OBJECTIVE: We examined relationships between perceived
physical and emotional trauma that occur prior to, or that
initiate, pain onset and health care seeking for fibromyalgia
syndrome (FMS). We also assessed associations between
perceived trauma and levels of health care usage, symptom
severity, functional disability, and receipt of disability
compensation among patients with FMS.

METHODS: We evaluated
these variables using interviews and standardized instruments
in a consecutive series of FMS patients and community
residents who met the American College of Rheumatology
criteria for FMS but had not sought medical care
("nonpatients").

RESULTS: Emotional trauma was associated with
status as an FMS patient independently of demographics,
physical trauma, and sexual/physical abuse (P = 0.007). Among
patients, emotional trauma was related to a high number of
physician visits (P = 0.013), functional disability ratings (P
= 0.012), and fatigue (P = 0.029), but physical trauma was
associated with receipt of disability compensation (P =
0.019). Trauma history was not related to pain severity or
pain thresholds.

CONCLUSION: Perception of physical trauma is
a greater determinant of disability compensation for FMS than
is perceived emotional trauma, symptom severity, or
functional disability. Effort should be devoted to
understanding the social and legal factors underlying this
observation, as well as to reducing high health care usage
among FMS patients with emotional trauma.




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