Stressful life events in fibromyalgia: a case-control study

Background. The aim of the study was to evaluate the prevalence of traumatic events in a group of patients with Fibromyalgia (FM), compared to patients with Rheumatoid Arthritis (RA), and to investigate its association with the clinical and psychological variables. Materials and Methods. Two groups of 101 women with FM and 101 women with RA, matched for age and years of education, were assessed with: Traumatic Experiences Checklist (TEC), Visual Analogue Scale (VAS) for pain, Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20) and the SF-36 for the health-related quality of life (HRQoL). Results. FM patients reported significantly higher levels of pain, anxiety and depressive symptoms and a lower HRQoL compared to RA patients (all p <0.001). Regarding alexithymia, FM patients showed higher difficulties in identify feelings compared to RA patients (p <0.001). Data on the traumatic experiences highlighted a significantly higher number of negative life events in FM (TEC – total score) and a significant higher global impact (TEC - composite score), compared to RA patients (p <0.001). In particular, 57.4% FM vs 22.8% RA patients reported the presence of emotional neglect, and 50.5% FM vs 15.8% RA patients reported the presence of emotional abuse. However, in FM patients, the presence of traumatic experiences seems not to have a direct relationship nor on the clinical neither on the psychological distress variables. Conclusion. The present study revealed a higher prevalence of lifetime trauma in FM patients compared to RA patients. Furthermore, FM patients showed greater impairment in the ability to identify their own emotions. Nevertheless, the higher prevalence of traumatic experiences seems not to have a direct relation with FM symptoms, although FM patients had a worst quality of life and higher pain and psychological distress compared to the RA patients.