Forum Center Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar (PSMAR), Barcelona, Spain.
Department of Psychiatry and Forensic Medicine, Autonomous Universtiy of Barcelona (UAB), Barcelona, Spain.
Pain Res Manag. 2022 Nov 30;2022:2114451. doi: 10.1155/2022/2114451. eCollection 2022.
BACKGROUND: Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). OBJECTIVE: The main objective of this study consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. METHOD: Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. RESULTS: The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. CONCLUSIONS: Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. : ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.
背景：初步证据表明，心理创伤，尤其是童年创伤，是纤维肌痛（FM）发病的一个危险因素。
目的：本研究的主要目的是评估 FM 患者样本中心理创伤的患病率和详细特征、创伤在整个生命周期中的发生时间及其临床症状。我们还计算了童年创伤是否可以预测与不同临床变量的关系。
方法：88 名女性接受了访谈，以评估社会人口统计学数据、合并症、疼痛程度、FM 影响、焦虑、抑郁、失眠、生活质量和心理创伤的临床症状。
结果：大多数参与者（71.5%）符合当前创伤后应激障碍（PTSD）的诊断标准。参与者报告称在整个生命周期中都经历过创伤事件，尤其是在童年和青春期早期，表现为情感虐待、情感忽视、性虐待和身体虐待。创伤事件可预测成年后生活质量差和疼痛程度高。所有患者均表现出明显的焦虑、抑郁、失眠、自杀念头和疼痛症状，以及躯体合并症和生活质量差。疼痛程度可预测焦虑、抑郁、解离和失眠症状。84%的样本在疼痛发作前遭受过一次或多次创伤事件。
结论：我们的数据强调了 FM 患者的临床复杂性以及童年创伤在 FM 的发病和维持中的作用，以及焦虑、抑郁、躯体症状和 FM 之间的高共病性。我们的数据还支持随着年龄的增长，FM 患者会经历进一步的创伤再体验，我们的样本中当前 PTSD 的患病率极高。这些发现强调了为 FM 患者制定多学科方案的必要性，以解决他们的身体疼痛以及他们的精神和躯体状况，特别注意心理创伤的评估，并提供以创伤为重点的干预措施。：ClinicalTrials.gov NCT04476316。于 2020 年 7 月 20 日注册。
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