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

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


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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