PERCEIVED PHYSICAL AND EMOTIONAL TRAUMA AS PRECIPITATING EVENTS IN FIBROMYALGIA - ASSOCIATION WITH HEALTH-CARE SEEKING AND DISABILITY STATUS BUT NOT PAIN SEVERITY

Objective. We examined relationships between perceived physical and em otional trauma that occur prior to, or that initiate, pain onset and h ealth care seeking for fibromyalgia syndrome (FMS), We also assessed a ssociations between perceived trauma and levels of health care usage, symptom severity, functional disability, and receipt of disability com pensation among patients with FMS. Methods. We evaluated these variabl es using interviews and standardized instruments in a consecutive seri es of FMS patients and community residents who met the American Colleg e of Rheumatology criteria for FMS but had not sought medical care ('' nonpatients''). Results. Emotional trauma was associated with status a s an FMS patient independently of demographics, physical trauma, and s exual/physical abuse (P = 0.007), Among patients, emotional trauma was related to a high number of physician visits (P = 0.013), functional disability ratings (P = 0.012), and fatigue (P = 0.029), but physical trauma was associated with receipt of disability compensation (P = 0.0 19), Trauma history was not related to pain severity or pain threshold s. Conclusion. Perception of physical trauma is a greater determinant of disability compensation for FMS than is perceived emotional trauma, symptom severity, or functional disability, Effort should be devoted to understanding the social and legal factors underlying this observat ion, as well as to reducing high health care usage among FMS patients with emotional trauma.