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Childhood sexual abuse, fibromyalgia linked but not attributed to depression
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Although evidence indicated that childhood sexual abuse was related to the development of fibromyalgia, it was not attributable to depression, according to study results.
In a case-control study, researchers in Germany evaluated 153 patients with fibromyalgia syndrome (FMS; mean age, 50.3 years; 87.6% women) and 153 matched controls. The German equivalent of the Childhood Trauma Questionnaire (CTQ) was used to assess childhood maltreatment, and the two-item depression scale of the German version of the Patient Health Questionnaire (PHQ) was used to measure depression. Analysis of covariance adjusting for depressed mood was used to compare the scores of five CTQ subscales between patients with FMS and controls.
Patients with FMS had a mean depression score of 3.5, which was higher than that of controls (1.1; P<.001). Sixty-four percent of FMS patients scored at least three (depressed mood “nearly every day”) compared with 9.8% of controls in the PHQ depression test (P<.001). When adjusted for depression, there was a group difference for emotional (P<.001) and sexual abuse (P=.01) in comparing patients with FMS and controls. In physical abuse (P=.01) and emotional neglect (P<.001), depression accounted for the group difference. In emotional abuse, depression partially accounted for the group difference (P<.001). Depression did not account for group difference in sexual abuse (P=.1).
“FMS patients reported more emotional, physical and sexual neglect than … the general population,” the researchers reported. “This study gives further evidence that childhood sexual abuse may constitute one [not obligatory] predisposition to FMS.
“Patients diagnosed with FMS can differ in various dimensions: Many but not all … report childhood adversities, and many, but not all … are depressed. The definition of distinct FMS subgroups is necessary to evaluate most appropriate treatment strategies.”
Disclosure: Winfried Häuser, MD, reports receiving a consultancy honorarium for study design from Daiichi Sankyo.
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