Prevalence of abuse in fibromyalgia and other rheumatic disorders at a specialized clinic in rheumatic diseases in Guatemala City.
BACKGROUND
The importance of past adverse experiences is increasingly recognized in patients with rheumatic disease.


OBJECTIVE
The objective of this study was to study the association of physical, verbal, and sexual abuse in patients with rheumatic disorders as compared with healthy volunteers.


METHODS
In this case-control study, 500 new patients attending an outpatient rheumatic clinic were interviewed from September 1, 1999, to August 31, 2001. A total of 187 patients with 3 diagnoses were selected: 58 had fibromyalgia (FM), 74 rheumatoid arthritis (RA), and 55 patients with soft tissue rheumatic disease (STRD). All selected patients were asked to complete a questionnaire designed to obtain information regarding demographics and history of verbal, physical, and sexual abuse. A group of 187 healthy control subjects were also included, matched for sex and age.


RESULTS
The prevalence of abuse was significantly more common in the rheumatic disease group than in the control group (48.1% versus 15%, P < 0.001). The prevalence of abuse among the groups was as follows: 70.7% of patients with FM reported abuse (24.3% verbal, 60.9% physical, and 14.8% sexual), 35.1% of patients with RA had a history of abuse (42.3% verbal, 30.7% physical, and 0% sexual), whereas 41.8% of patients with STRD reported abuse (43.4% verbal, 43.4% physical, and 0% sexual). When comparing the 3 groups, patients with FM showed a higher prevalence of abuse (P < 0.05). The abuse was usually longstanding (range, 1-10 years), and most abusers were close family members.


CONCLUSIONS
Abuse, both physical and psychologic, was significantly increased in our rheumatic disease population, especially in patients with FM. Further studies are needed to fully establish its role. Questions about abuse may provide important information relative to care of our patients.
Castro
Ivette
I
Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Barrantes
Fidel
F
Tuna
Maria
M
Cabrera
Gonzalo
G
Garcia
Cesar
C
Recinos
Mayra
M
Espinoza
Luis R
LR
Garcia-Kutzbach
Abraham
A
D000328:Adult; D000367:Age Factors; D000554:Ambulatory Care Facilities; D016022:Case-Control Studies; D003241:Consanguinity; D017579:Domestic Violence / Q000706:statistics & numerical data*; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D006166:Guatemala; D006801:Humans; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors