Post-Traumatic Stress Disorder, Alexithymia and Somatoform Dissociation in Patients with Fibromyalgia

Abstract

Objective: We investigated the prevalence of post-traumatic stress disorder, alexithymia, and somatoform dissociative symptoms in patients with fibromyalgia (FM). Material and Methods: Fifty-six consecutive patients with FM admitted to the outpatient department were enrolled in this study after providing informed consent. Forty-six patients with rheumatoid arthritis (RA) were enrolled as controls. Participants completed the Somatoform Dissociation Questionnaire (SDQ), the Post-traumatic Diagnostic Scale (PDS), the Toronto Alexithymia Scale (TAS), and The Childhood Trauma Questionnaire (CTQ). The impact of FM was measured with the Fibromyalgia Impact Questionnaire (FIQ). Results: The number of patients reporting at least one traumatic event was higher in the FM (19, 33.9%) than in the RA (6, 13%) (X2=5.9, p=0.015) group. Post-traumatic stress disorder (PTSD) was found in six (10.7%) of the 56 subjects with FM. In the RA group, no patients met the criteria for PTSD. Current PTSD prevalence was higher in the FM than in the RA group. Among those with FM group and traumatic experiences, FIQ scores were higher in patients with than without PTSD (p=0.02). Additionally, a positive correlation between traumatic experiences and use of analgesics (r=0.415, p=0.002) was also observed. FM patients had significantly higher scores than did RA patients on the CTQ, SDQ and TAS. Conclusion: The results of this study indicate that PTSD, alexithymia, and dissociative symptoms positively influence the levels of pain and FM-related disability in FM patients. Treatment strategies may be developed to manage psychiatric conditions in fibromyalgia.