纤维肌痛综合征中的创伤后应激障碍:患病率、创伤后应激与纤维肌痛症状之间的时间关系,以及对临床结局的影响。

Posttraumatic stress disorder in fibromyalgia syndrome: prevalence, temporal relationship between posttraumatic stress and fibromyalgia symptoms, and impact on clinical outcome.

机构信息

Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken D-66119, Germany.

出版信息

Pain. 2013 Aug;154(8):1216-23. doi: 10.1016/j.pain.2013.03.034. Epub 2013 Apr 2.

Abstract

A link between fibromyalgia syndrome (FMS) and posttraumatic stress disorder (PTSD) has been suggested because both conditions share some similar symptoms. The temporal relationships between traumatic experiences and the onset of PTSD and FMS symptoms have not been studied until now. All consecutive FMS patients in 8 study centres of different specialties were assessed from February 1 to July 31, 2012. Data on duration of chronic widespread pain (CWP) were based on patients' self-reports. Potential traumatic experiences and year of most burdensome traumatic experience were assessed by the trauma list of the Munich Composite International Diagnostic Interview. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV symptom criteria by the Posttraumatic Diagnostic Scale. Age- and sex-matched persons of a general population sample were selected for controls. Three hundred ninety-five of 529 patients screened for eligibility were analysed (93.9% women, mean age 52.3 years, mean duration since chronic widespread pain 12.8 years); 45.3% of FMS patients and 3.0% of population controls met the criteria for PTSD. Most burdensome traumatic experience and PTSD symptoms antedated the onset of CWP in 66.5% of patients. In 29.5% of patients, most burdensome traumatic experience and PTSD symptoms followed the onset of CWP. In 4.0% of patients' most burdensome traumatic experience, PTSD and FMS symptoms occurred in the same year. FMS and PTSD are linked in several ways: PTSD is a potential risk factor of FMS and vice versa. FMS and PTSD are comorbid conditions because they are associated with common antecedent traumatic experiences.

摘要

纤维肌痛综合征 (FMS) 与创伤后应激障碍 (PTSD) 之间存在关联,因为这两种病症具有一些相似的症状。到目前为止,创伤经历与 PTSD 和 FMS 症状发作之间的时间关系尚未得到研究。2012 年 2 月 1 日至 7 月 31 日,来自不同专业的 8 个研究中心的所有连续 FMS 患者均接受了评估。慢性广泛性疼痛 (CWP) 的持续时间数据基于患者的自我报告。通过慕尼黑综合国际诊断访谈的创伤清单评估潜在的创伤经历和最具负担的创伤经历年份。根据精神障碍诊断和统计手册第四版症状标准,通过创伤后诊断量表诊断 PTSD。选择一般人群样本中的年龄和性别匹配者作为对照。对符合条件的 529 名患者进行筛查,其中 395 名患者(93.9%为女性,平均年龄 52.3 岁,慢性广泛性疼痛发病后平均 12.8 年)进行了分析;45.3%的 FMS 患者和 3.0%的人群对照符合 PTSD 标准。在 66.5%的患者中,最具负担的创伤经历和 PTSD 症状早于 CWP 发作。在 29.5%的患者中,最具负担的创伤经历和 PTSD 症状晚于 CWP 发作。在 4.0%的患者中,最具负担的创伤经历、PTSD 和 FMS 症状同时发生。FMS 和 PTSD 以多种方式相关联:PTSD 是 FMS 的潜在风险因素,反之亦然。FMS 和 PTSD 是共病,因为它们与共同的先前创伤经历有关。

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