Fibromyalgia present in nearly 40% of US service members seeking PTSD treatment
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The prevalence of fibromyalgia in U.S. active-duty service members entering treatment for PTSD is more than 10-fold higher than the overall population of service members preparing for deployment, according to data.
The researchers additionally found that the predominately male cohort of U.S. service members preparing to deploy demonstrated a fibromyalgia prevalence that was nearly three times that of males in the general civilian population.
“The estimated prevalence of FM in the general population ranges from 1% in males and 3% to 4% in females with prevalence increasing with age,” Katrina M. Lawrence-Wolff, DO, of Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, in Texas, and colleagues wrote in Arthritis Care & Research. “No large-scale studies using self-report surveys to assess FM symptoms in military personnel have been published. Additionally, the prevalence of FM in the active-duty military population involved in the military conflicts in Iraq and Afghanistan has not been reported.”
“This is important to examine since posttraumatic stress disorder (PTSD) and pain are common among U.S. veterans who have deployed to an active theater of combat,” they added. “Although the presence of FM has been shown to be associated with the severity of PTSD, most studies have been retrospective, and the relationship between the two conditions remains unclear. Among active-duty service members seeking treatment for PTSD, the prevalence of comorbid FM is unknown.”
To examine the prevalence of fibromyalgia in U.S. military service members with and without PTSD, Lawrence-Wolff and colleagues analyzed two cohorts — a pre-deployment group and a treatment group — from the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR Consortium). According to the researchers, STRONG STAR is a multi-institutional, multidisciplinary research consortium, led by the University of Texas Health Science Center, investigating the diagnosis, treatment and epidemiology of combat-related PTSD and its comorbid conditions.
For the pre-deployment cohort, the researchers recruited 3,915 participants from a large epidemiological survey of active-duty service members preparing for deployment, and subdivided this group into 3,094 members with and 821 without PTSD. For the treatment cohort, they included 461 service members with PTSD enrolled in three randomized clinical trials on PTSD treatment. Among the total sample of 4,376 service members, 91% were male.
Fibromyalgia and PTSD were documented using the PTSD Checklist Stressor-Specific Version (PCL-S), the PTSD Symptom Scale-Interview (PSS-I), and the 2012 American College of Rheumatology fibromyalgia questionnaire.
According to the researchers, the prevalence of fibromyalgia was 2.9% in the pre-deployment cohort. In addition, fibromyalgia prevalence was 10.8% in service members with PTSD, compared with 0.8% in those without PTSD. In the treatment cohort, in which all of the participants met criteria for PTSD prior to starting treatment, the prevalence of fibromyalgia was 39.7%.
“Our study is the first large cohort study of active-duty military service members assessing for the prevalence of FM with and without PTSD,” Lawrence-Wolff and colleagues wrote. “The prevalence of FM in our pre-deployment cohort of male service was nearly three times reported for that of the general population. The prevalence of FM in service members entering treatment for PTSD was more than ten-fold higher than that of our pre-deployment cohort. We found a significant association between PTSD and FM in service members preparing to deploy.”
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