title: Is the association of self-reported childhood maltreatments and adult fibromyalgia syndrome attributable to depression? A case control study.
abstract: OBJECTIVE
  Systematic reviews of case-control studies demonstrated an association between self-reported childhood sexual and physical abuse and fibromyalgia syndrome (FMS). We tested in a case-control study if the association of self-reported childhood maltreatments in childhood and in adult FMS-patients is attributable to depression.
  
  
  METHODS
  All consecutive patients diagnosed with FMS of two clinical centres were included into the study from January to June 2011. Randomly selected age- and sex-matched controls from a representative survey of the general German population were used as controls. Childhood maltreatments were assessed by the German version of the Childhood Trauma Questionnaire CTQ and depression by the two-item depression scale of the German version of the Patient Health Questionnaire PHQ-4. The scores of the five CTQ-subscales were compared between FMS-patients and controls using analysis of covariance adjusting for depressed mood.
  
  
  RESULTS
  153 FMS-patients (87.6% women; mean age 50.3 years) and 153 age- and sex matched participants of the general population were included. The comparison between FMS-patients and population controls, adjusted for depressed mood, demonstrated a significant group difference for emotional (p<0.001), and sexual abuse (p=0.01). Depressed mood fully accounted for group difference in physical abuse (p=0.01) and in emotional neglect (p<0.001). Depressed mood partially accounted for group difference in emotional abuse (p<0.001), but did not account for group difference in sexual abuse (p=0.10).
  
  
  CONCLUSIONS
  Reports of FMS-patients some on childhood maltreatments were biased by depressed mood. However, the difference in self-reported childhood sexual abuse between adult FMS-patients and population controls was not attributable to depression.
authors.affiliation: Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser
authors.forename: Daniela
authors.initials: D
authors.lastname: Bohn
authors.forename: Hedi
authors.initials: H
authors.lastname: Kühn-Becker
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Erdkönig
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.forename: Heide
authors.initials: H
authors.lastname: Glaesmer
mesh_terms: D000328:Adult; D000339:Affect; D000367:Age Factors; D000375:Aging; D000704:Analysis of Variance; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002650:Child Abuse, Sexual / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D004644:Emotions; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D057566:Self Report