Post-traumatic stress disorder among patients with chronic pain and chronic fatigue

被引:68
作者
Roy-Byrne, P
Smith, WR
Goldberg, J
Afari, N
Buchwald, D
机构
[1] Univ Washington, Harborview Med Ctr, Dept Psychiat & Behav Sci, Seattle, WA 98104 USA
[2] Univ Washington, Dept Med, Seattle, WA 98104 USA
[3] Univ Washington, Dept Epidemiol, Seattle, WA 98104 USA
关键词
D O I
10.1017/S0033291703008894
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background. Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD). Method. Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD. Results. The prevalence of lifetime PTSD was 20% and lifetime M DD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR 3.4, 95% Cl 2.0-5.8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% Cl 1.5-7.1) conversely, FM patients without MDD showed no increase in PTSD (OR = 1.3, 95 CI 0.5-3.2). The components of the CFS criteria were not significantly associated with PTSD. Conclusion. Optimal clinical care for patients with FM should Include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.
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页码:363 / 368
页数:6
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共 21 条
  • [1] A review of the evidence for overlap among unexplained clinical conditions
    Aaron, LA
    Buchwald, D
    [J]. ANNALS OF INTERNAL MEDICINE, 2001, 134 (09) : 868 - 881
  • [2] Posttraumatic stress disorder, tenderness and fibromyalgia
    Amir, M
    Kaplan, Z
    Neumann, L
    Sharabani, R
    Shani, N
    Buskila, D
    [J]. JOURNAL OF PSYCHOSOMATIC RESEARCH, 1997, 42 (06) : 607 - 613
  • [3] BENEDIKT RA, 1986, AM J PSYCHIAT, V143, P908
  • [4] COMPARISON OF PATIENTS WITH CHRONIC FATIGUE SYNDROME, FIBROMYALGIA, AND MULTIPLE CHEMICAL SENSITIVITIES
    BUCHWALD, D
    GARRITY, D
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1994, 154 (18) : 2049 - 2053
  • [5] Musculoskeletal injury as a trigger for fibromyalgia/posttraumatic fibromyalgia.
    Buskila D.
    Neumann L.
    [J]. Current Rheumatology Reports, 2000, 2 (2) : 104 - 108
  • [6] POSTTRAUMATIC-STRESS-DISORDER IN CHRONIC POSTTRAUMATIC HEADACHE PATIENTS
    CHIBNALL, JT
    DUCKRO, PN
    [J]. HEADACHE, 1994, 34 (06): : 357 - 361
  • [7] Pain intensity processing within the human brain: A bilateral, distributed mechanism
    Coghill, RC
    Sang, CN
    Maisog, JH
    Iadarola, MJ
    [J]. JOURNAL OF NEUROPHYSIOLOGY, 1999, 82 (04) : 1934 - 1943
  • [8] Prevalence of post-traumatic stress disorder in fibromyalgia patients: Overlapping syndromes or post-traumatic fibromyalgia syndrome?
    Cohen, H
    Neumann, L
    Haiman, Y
    Matar, MA
    Press, J
    Buskila, D
    [J]. SEMINARS IN ARTHRITIS AND RHEUMATISM, 2002, 32 (01) : 38 - 50
  • [9] THE CHRONIC FATIGUE SYNDROME - A COMPREHENSIVE APPROACH TO ITS DEFINITION AND STUDY
    FUKUDA, K
    STRAUS, SE
    HICKIE, I
    SHARPE, MC
    DOBBINS, JG
    KOMAROFF, A
    SCHLUEDERBERG, A
    JONES, JF
    LLOYD, AR
    WESSELY, S
    GANTZ, NM
    HOLMES, GP
    BUCHWALD, D
    ABBEY, S
    REST, J
    LEVY, JA
    JOLSON, H
    PETERSON, DL
    VERCOULEN, JHMM
    TIRELLI, U
    EVENGARD, B
    NATELSON, BH
    STEELE, L
    REYES, M
    REEVES, WC
    [J]. ANNALS OF INTERNAL MEDICINE, 1994, 121 (12) : 953 - 959
  • [10] The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain
    Geisser, ME
    Roth, RS
    Bachman, JE
    Eckert, TA
    [J]. PAIN, 1996, 66 (2-3) : 207 - 214