Childhood Abuse Linked to Pain and Depression in Patients with Fibromyalgia

VBCR - September 2012, Volume 1, No 4 - Fibromyalgia

By Rosemary Frei, MSc

Milan, Italy—The combination of childhood emotional abuse and current depression gives rise to higher pain sensitivity, a new study has shown. In a poster presented at the 2012 World Congress on Pain, a group of Belgian researchers showed that among patients with fibromyalgia who suffered childhood emotional abuse, a strong positive correlation exists between depression levels and pain sensitivity. The same correlation does not exist in patients who did not have emotional abuse when they were young.

“Our results show that in emotionally abused fibromyalgia patients, de­pression increases pain symptoms,” lead investigator Eline Coppens, MSc, PhD, a psychologist at the Centre for Algology and Pain Management, Uni­versity Hospitals Leuven, Belgium, told Value-Based Care in Rheuma­tology.

“These data make clear that in treatment of fibromyalgia, it’s important to treat trauma and to address specifically the emotional types and consequences of trauma. They also point to the likely efficacy of giving individualized treatment to subgroups of fi­bromyalgia patients, such as those who are depressed and had childhood trauma,” said Dr Coppens.

Dr Coppens and colleagues conducted the study because clinical lore suggests that a significant subgroup of patients with fibromyalgia experienced subtle forms of emotional abuse and neglect, but it is not clear whether there is a relationship be­tween early-childhood adversity and the severity of pain—the core symptom of fibromyalgia.

The researchers focused on 50 women with fibromyalgia (mean age, 44 years) who were being treated at the Leuven Centre for Algology and Pain Management.

Of these patients, 40% reported emotional abuse in early childhood and 27% reported physical abuse. Furthermore, 40% reported having had emotional neglect.

In addition, 70% of patients who had emotional abuse also reported having physical pain compared with 58% of those without emotional abuse; a significant difference. Sig­nificantly higher levels of pain were also reported among patients with fibromyalgia who had experienced emotional abuse compared with patients who did not report emotional abuse, at all levels of depression.

The researchers concluded that emo­tional abuse affects the relationship between depression and pain, with the combination of emotional abuse and depression giving rise to higher pain sensitivity. They further note that this study improves on pre­vious work, which had signif­i­­cant methodological limitations and fo­cused largely on major early-child­­hood trauma, such as physical and sexual abuse.

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