Imbierowicz Katrin, Egle Ulrich T
Department of Psychotherapy and Psychosomatics, University Hospital Bonn, Bonn, Germany.
Eur J Pain. 2003;7(2):113-9. doi: 10.1016/S1090-3801(02)00072-1.
Primary fibromyalgia is regarded as disorder with a complex symptomatology, and no morphological alterations. Findings increasingly point to a dysfunction of the central nervous pain processing. The study aims to discuss vulnerability for fibromyalgia from a developmental psychopathological perspective. We investigated the presence of psychosocial adversities affecting the childhood of adult fibromyalgia patients (FM) and compared them to those of patients with somatoform pain disorders (SOM) and a control group (CG) with medically explained chronic pain. Using the structured biographical interview for pain patients (SBI-P), 38 FM patients, 71 SOM patients, and 44 CG patients were compared on the basis of 14 childhood adversities verified as relevant regarding longterm effects for adult health by prospective studies. The FM patients show the highest score of childhood adversities. In addition to sexual and physical maltreatment, the FM patients more frequently reported a poor emotional relationship with both parents, a lack of physical affection, experiences of the parents' physical quarrels, as well as alcohol or other problems of addiction in the mother, separation, and a poor financial situation before the age of 7. These experiences were found to a similar extent in the SOM patients, but distinctly less frequently in the CG. The results point to early psychosocial adversities as holding a similar etiological meaning in fibromyalgia as well as in somatoform pain disorders. The potential role of these factors as increasing the vulnerability for fibromyalgia is discussed.
原发性纤维肌痛被视为一种症状复杂且无形态学改变的病症。研究结果越来越多地指向中枢神经疼痛处理功能障碍。本研究旨在从发展性心理病理学角度探讨纤维肌痛的易感性。我们调查了影响成年纤维肌痛患者（FM）童年的社会心理逆境的存在情况，并将他们与躯体形式疼痛障碍患者（SOM）以及患有医学上可解释的慢性疼痛的对照组（CG）进行比较。使用针对疼痛患者的结构化传记访谈（SBI - P），基于14种经前瞻性研究证实对成年健康有长期影响的童年逆境，对38名FM患者、71名SOM患者和44名CG患者进行了比较。FM患者童年逆境得分最高。除了性虐待和身体虐待外，FM患者更频繁地报告与父母双方情感关系不佳、缺乏身体关爱、经历父母身体争吵，以及母亲存在酒精或其他成瘾问题、父母分居和7岁前经济状况不佳。这些经历在SOM患者中也有类似程度的发现，但在CG中出现的频率明显较低。结果表明，早期社会心理逆境在纤维肌痛和躯体形式疼痛障碍中具有相似的病因学意义。本文讨论了这些因素作为增加纤维肌痛易感性的潜在作用。
