Effects of type of symptom onset on psychological distress & disability in fibromyalgia (FM) syndrome patients

The purpose of the study was to investigate the differences between
two types of onset (post-traumatic versus idiopathic) in pain,
disability, and psychological distress in patients with
fibromyalgia syndrome (FS). Forty-six FS patients with
post-traumatic onset and 46 FM patients with idiopathic onset,
who were matched in age and pain duration, were included in
the study. All participants completed self-report inventories
assessing their adaptation to the pain conditions, and during
the medical examination, an examining physician completed an
inventory (Medical Examination and Diagnostic Information
Coding System; MEDICS) to indicate the degree of physical

The analysis revealed that the degrees of
physical abnormality of the patients were comparable in the
two groups. However, controlling for the involvement with
financial compensation issues (e.g. disability, litigation),
the post-traumatic FS patients reported significantly higher
degrees of pain, disability, life interference, and affective
distress as well as lower level of activity than did the
idiopathic FS patients. Furthermore, evaluation of the
treatment history in these patients revealed that a
significantly larger number of the posttraumatic FS patients
were receiving opioid medications and had been treated with
nerve block, physical therapy, and TENS. The results suggest
that (1) post-traumatic onset is associated with high level of
difficulties in adaptation to chronic FS symptoms and (2) FS
patients are a heterogeneous group of patients.

Turk DC, Okifuji A, Starz TW, Sinclair JD

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