title: Vulnerability to traumatic stress in fibromyalgia patients: 19 month follow-up after the great East Japan disaster.
abstract: BACKGROUND
  The aim of this study was to investigate vulnerability and long-term influence of traumatic stress caused by the Great East Japan Disaster which occurred on March 11, 2011, in patients with fibromyalgia, which is a chronic pain syndrome probably involving central sensitization.
  
  
  METHODS
  A total of 60 female patients with fibromyalgia were compared with female patients with rheumatoid arthritis (RA, n = 23) as another chronic pain disease, and with female healthy controls (HC, n = 26) in the observational study. To evaluate responses to traumatic stress, the scores of Impact of Event Scale-Revised (IES-R) were assessed one month after the disaster and every six months until 19 months after the disaster. We also evaluated levels of depression during the study period. To know the score of IES-R of patients with fibromyalgia during usual living, we assessed IES-R in another population of fibromyalgia patients without exposure to a great disaster.
  
  
  RESULTS
  The mean score of IES-R one month after the disaster in the fibromyalgia group (24.6 [SD 18.9]) was significantly higher than that of RA group (13.4 [SD 14.5]) or HC group (9.1 [9.2]) (F = 9.96, p < 0.0001). However, the mean score of IES-R in fibromyalgia patients without exposure to a great disaster was (20.3 [SD 18.7]), which was almost the same value as the fibromyalgia group seven months after the disaster (20.2 [SD 19.5]). Repeated measures analysis of variance showed significant effect of time course in the depression-related symptoms (F = 6.68, P = 0.001), and a post-hoc test revealed that the number of depression-related symptoms one month before the disaster was significantly different from other time points until 19 months after the disaster, respectively.
  
  
  CONCLUSIONS
  Although response to acute stress induced by the great earthquake was likely to be settled within seven months after the disaster, depression-related symptoms have been increasing for more than one year after the disaster, despite exclusion of patients with major depression at baseline. This long-lasting worsening of depression-related symptoms may have been in response to chronic stress induced by the fear of radiation due to the nuclear power disaster. These findings suggest that patients with fibromyalgia are vulnerable to chronic stress rather than acute stress.
authors.forename: Chie
authors.initials: C
authors.lastname: Usui
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hatta
authors.forename: Satoko
authors.initials: S
authors.lastname: Aratani
authors.forename: Naoko
authors.initials: N
authors.lastname: Yagishita
authors.forename: Kenya
authors.initials: K
authors.lastname: Nishioka
authors.forename: Satoko
authors.initials: S
authors.lastname: Okamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Itoh
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Nozomu
authors.initials: N
authors.lastname: Asukai
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Kusuki
authors.initials: K
authors.lastname: Nishioka
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001172:Arthritis, Rheumatoid / Q000208:ethnology / Q000473:pathology / Q000523:psychology; D044466:Asian People; D003863:Depression / Q000523:psychology; D004190:Disasters; D055866:Earthquakes; D005260:Female; D005356:Fibromyalgia / Q000208:ethnology / Q000473:pathology / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008875:Middle Aged; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D040701:Stress Disorders, Traumatic, Acute / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D013997:Time Factors