Traumatic experiences, major life stressors, and self-reporting a physician-given fibromyalgia diagnosis.
The contribution of stress to the pathophysiology of fibromyalgia has been the subject of considerable debate. The primary purpose of the present study was to evaluate the relationship between traumatic and major life stressors and a fibromyalgia diagnosis in a large group of older women and men. Data were from the federally funded Biopsychosocial Religion and Health Study, and subjects were 10,424 of the 10,988 survey respondents-two-thirds women and one-third men-providing responses to a fibromyalgia question. Average age was 61.0+/-13.5 years. A physician-given fibromyalgia diagnosis in a subject's lifetime was reported by 3.7% of the sample, 4.8% of the women and 1.3% of the men. In two multivariable logistic regression models (all respondents and women only, controlling for age, sex, race/ethnicity, and education), two traumatic experience types (sexual and physical assault/abuse) were associated with a fibromyalgia diagnosis. Two other trauma types (life-threatening and emotional abuse/neglect) and major life stress experiences were not. The highest odds ratios in both models were those for sexual assault/abuse followed by physical assault/abuse. The relationship between age and fibromyalgia was curvilinear in both models (odds ratios rising until approximately age 63 and declining thereafter). In the all-subjects model, being a woman increased the odds of a fibromyalgia diagnosis, and in both models, fibromyalgia was associated with being White (versus non-White) and lower education. We recommend that researchers investigate the relationship between stress and fibromyalgia in concert with genetic and biomarker studies.
Haviland
Mark G
MG
Department of Psychiatry, Loma Linda University School of Medicine, Loma Linda, CA, USA. mhaviland@llu.edu
Morton
Kelly R
KR
Oda
Keiji
K
Fraser
Gary E
GE
D000367:Age Factors; D000368:Aged; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012650:Self Disclosure; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology
Semin Arthritis Rheum. 2010 Jun;39(6):448-53
19250656
J Rheumatol. 1999 Jul;26(7):1570-6
10405947
J Clin Psychiatry. 2008;69 Suppl 2:6-13
18537457
Am Fam Physician. 2007 Jul 15;76(2):247-54
17695569
Trauma Violence Abuse. 2007 Jul;8(3):299-313
17596347
Neurology. 1996 Mar;46(3):593-7
8618650
Arthritis Rheum. 2008 Jan;58(1):26-35
18163497
Ann Rheum Dis. 2001 Nov;60(11):1040-5
11602475
Arthritis Res Ther. 2008;10(4):211
18768089
Clin J Pain. 2005 Sep-Oct;21(5):378-86
16093743
Clin Rheumatol. 2009 Jul;28(7):777-86
19277813
Int J Epidemiol. 2009 Dec;38(6):1470-8
19052114
CNS Spectr. 2008 Mar;13(3 Suppl 5):6-11
18323767
Semin Arthritis Rheum. 1981 Aug;11(1):151-71
6944796
J Aging Health. 1993 May;5(2):179-93
10125443
BMJ. 1991 Jul 27;303(6796):216-9
1884057
Sleep Med Rev. 2002 Apr;6(2):97-111
12531146
J Rheumatol. 2004 Mar;31(3):594-7
14994410
Psychosom Med. 1997 Nov-Dec;59(6):572-7
9407574
Psychosomatics. 2001 Jan-Feb;42(1):21-8
11161117
J Rheumatol. 2009 Apr;36(4):671-8
19342721
Arthritis Rheum. 1990 Feb;33(2):160-72
2306288
Arthritis Rheum. 1995 Feb;38(2):235-41
7848314
Am J Med. 2008 Jul;121(7):555-61
18589048
J Behav Health Serv Res. 2005 Apr-Jun;32(2):113-27
15834262
Int J Epidemiol. 2008 Apr;37(2):260-5
17726038
Neuroscientist. 2008 Oct;14(5):415-21
18270311
Curr Pain Headache Rep. 2004 Oct;8(5):369-78
15361321
Psychiatr Serv. 2004 Feb;55(2):157-62
14762240
Curr Pain Headache Rep. 2004 Apr;8(2):99-110
14980144
Arthritis Rheum. 1995 Jan;38(1):19-28
7818567
Harv Rev Psychiatry. 2008;16(1):35-54
18306098
Psychiatr Serv. 2000 Oct;51(10):1299-304
11013331
JAMA. 1987 May 22-29;257(20):2782-7
3553636