Sexual & physical abuse in women with Fibromyalgia (FM): association with outpatient health care utilization & pain medication usage

OBJECTIVE: To evaluate the relationship between sexual and/or
physical abuse and health care usage in patients with
fibromyalgia (FM) and identify variables that may influence
this relationship.

METHODS: We assessed history of
sexual/physical abuse, health care utilization, and medication
usage, as well as related variables in 75 women with FM using
standardized questionnaires, structured interviews, and
laboratory pain perception tasks.

RESULTS: Fifty-seven percent
of FM patients reported a history of sexual/physical abuse.
Compared to non- abused patients, abused patients reported
significantly greater utilization of outpatient health care
services for problems other than FM and greater use of
medications for pain (P < or = 0.025). Consistent with our
expectations, abused patients also were characterized by
significantly greater pain, fatigue, functional disability,
and stress, as well as by a tendency to label dolorimeter
stimuli as painful regardless of their intensities (P < or =
0.05). Additional analyses suggested that the high frequency
of sexual/physical abuse in our patients was associated
primarily with seeking health care for chronic pain rather
than the FM syndrome itself or genetic factors.

There is an association in FM patients between sexual/physical
abuse and increased use of outpatient health care services and
medications for pain. This association may be influenced by
clinical symptoms, functional disability, psychiatric
disorders, stress, and abnormal pain perception. The
relationships among these variables should be further tested
in prospective, population-based studies.

Alexander RW, Bradley LA, Alarcon GS, Triana-Alexander M, Aaron LA, Alberts KR, Martin MY, Stewart KE

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