ArticlePosttraumatic stress disorder in fibromyalgia syndrome: Prevalence, temporal relationship between posttraumatic stress and fibromyalgia symptoms, and impact on clinical outcomeHäuser, Winfrieda,b,*; Galek, Alexandraa,b; Erbslöh-Möller, Brigittec; Köllner, Volkerd; Kühn-Becker, Hedie; Langhorst, Jostf; Petermann, Franzg,h; Prothmann, Ulrichi; Winkelmann, Andreasj; Schmutzer, Gabrielek; Brähler, Elmark; Glaesmer, HeidekAuthor Information Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. aDepartment of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken D-66119, Germany bDepartment of Psychosomatic Medicine, Technische Universität München, München D-81675, Germany cRheumatology Medical Practice, Neunkirchen 66538, Germany dDepartment of Psychosomatic Medicine, MediClin Bliestal Kliniken, Blieskastel 66440, Germany ePsychosomatic Medicine and Pain Therapy Medical Practice, Zweibrücken 66432, Germany fDepartment of Internal Medicine V (Integrative Medicine), Kliniken Essen-Mitte, Essen 45726, Germany gCentre of Clinical Psychology and Rehabilitation, University of Bremen, Bremen 28359, Germany hDepartment of Orthopedics, Rehabilitation Centre Oldenburg, Oldenburg 26133, Germany iDepartment of Rheumatology, Knappschaftskrankenhaus Püttlingen, Püttlingen 66346, Germany jDepartment of Physical Medicine and Rehabilitation, Klinikum der Universität München, München 80336, Germany kDepartment of Medical Psychology and Medical Sociology, Universität Leipzig, Leipzig D-04103, Germany *Corresponding author. Address: Department of Internal Medicine, Klinikum Saarbrücken gGmbH, Winterberg 1, Saarbrücken D-66119, Germany. Tel.: +49 681 9632020; fax: +49 681 9632022. E-mail address: firstname.lastname@example.org Submitted January 29, 2013; revised March 13, 2013; accepted March 26, 2013. Pain: August 2013 - Volume 154 - Issue 8 - p 1216-1223 doi: 10.1016/j.pain.2013.03.034 Buy Metrics Abstract The prevalence of posttraumatic stress disorder in 395 fibromyalgia syndrome patients of different clinical settings was 45.3%, and was 3.0% in age- and sex-matched population controls. 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. © 2013 Lippincott Williams & Wilkins, Inc.