Prevalence and impact of posttraumatic stress disorder-like symptoms on patients with fibromyalgia syndrome

Objective: Traumatic events can result in a set of symptoms including night mares, recurrent and intrusive recollections, avoidance of thoughts or acti vities associated with the traumatic event, and symptoms of increased arous al such as insomnia and hypervigilance. These posttraumatic stress disorder (PTSD)-like symptoms are frequently observed in persons with chronic pain syndromes. Little is known about how these two phenomena interact with one another. The present study evaluated PTSD-like symptoms in patients with fi bromyalgia syndrome (FMS) and examined the relation between PTSD-like sympt oms and problems associated with FMS. Design: Ninety-three consecutive patients underwent a comprehensive FMS eva luation and completed self-report questionnaires measuring PTSD-like sympto ms, disability, and psychosocial responses to their pain condition. Subject s were divided in two groups based on level of self-reported PTSD-like symp toms. Results: Approximately 56% of the sample reported clinically significant le vels of PTSD-like symptoms (PTSD+). The PTSD+ patients reported significant ly greater levels of pain (p < 0.01), emotional distress (p < 0.01), life i nterference (p < 0.01), and disability (p < 0.01) than did the patients wit hout clinically significant levels of PTSD-like symptoms (PTSD-). Over 85% of the PTSD+ patients compared with 50% of the PTSD-patients demonstrated s ignificant disability. Based on response to the Multidimensional Pain Inven tory, a significantly smaller percentage of PTSD+ patients were classified as adaptive copers (15%) compared with the PTSD-group (48.2%). Conclusions: Results suggest that PTSD-like symptoms are prevalent in FMS p atients and may influence adaptation to this chronic illness. Clinicians sh ould assess the presence of these symptoms, as the failure to attend to the m in treatment may impede successful outcomes.