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Prevalence and Impact of Posttraumatic Stress Disorder-Like Symptoms on Patients With Fibromyalgia Syndrome

Sherman, Jeffrey J. Ph.D.*†; Turk, Dennis C. Ph.D.; Okifuji, Akiko Ph.D.

The Clinical Journal of Pain: June 2000 - Volume 16 - Issue 2 - p 127-134
Article

Objective: Traumatic events can result in a set of symptoms including nightmares, recurrent and intrusive recollections, avoidance of thoughts or activities associated with the traumatic event, and symptoms of increased arousal such as insomnia and hypervigilance. These posttraumatic stress disorder (PTSD)-like symptoms are frequently observed in persons with chronic pain syndromes. Little is known about how these two phenomena interact with one another. The present study evaluated PTSD-like symptoms in patients with fibromyalgia syndrome (FMS) and examined the relation between PTSD-like symptoms and problems associated with FMS.

Design: Ninety-three consecutive patients underwent a comprehensive FMS evaluation and completed self-report questionnaires measuring PTSD-like symptoms, disability, and psychosocial responses to their pain condition. Subjects were divided in two groups based on level of self-reported PTSD-like symptoms.

Results: Approximately 56% of the sample reported clinically significant levels of PTSD-like symptoms (PTSD+). The PTSD+ patients reported significantly greater levels of pain (p < 0.01), emotional distress (p < 0.01), life interference (p < 0.01), and disability (p < 0.01) than did the patients without clinically significant levels of PTSD-like symptoms (PTSD). Over 85% of the PTSD+ patients compared with 50% of the PTSD patients demonstrated significant disability. Based on response to the Multidimensional Pain Inventory, a significantly smaller percentage of PTSD+ patients were classified as adaptive copers (15%) compared with the PTSD group (48.2%).

Conclusions: Results suggest that PTSD-like symptoms are prevalent in FMS patients and may influence adaptation to this chronic illness. Clinicians should assess the presence of these symptoms, as the failure to attend to them in treatment may impede successful outcomes.

*Department of Anesthesiology, University of Washington School of Medicine, Seattle, Washington; †Department of Medicine, University of Washington School of Medicine, Seattle, Washington

Received January 24, 1999; first revision November 5, 1999; second revision December 5, 1999; accepted December 15, 1999.

Address correspondence to Dr. Jeffrey J. Sherman, Departments of Medicine and Anesthesiology, P.O. Box 356370, University of Washington, Seattle, WA 98195. E-mail: jeffreys@u.washington.edu

© 2000 Lippincott Williams & Wilkins, Inc.