Screening women veterans with fibromyalgia for childhood abuse may improve treatment

(Boston)– A new study has shown that women Veterans being treated for fibromyalgia exhibit high rates of childhood abuse.

Fibromyalgia is a chronic disorder characterized by widespread pain with associated fatigue, sleep and mood issues that has been linked to exposure to interpersonal trauma, such as childhood abuse. With female Veterans representing a growing segment of the VA population, standardized screening for military sexual trauma (MST) and post-traumatic stress disorder (PTSD) are helpful in providing complete care to patients diagnosed with fibromyalgia. However, there is currently no standard screening practice for childhood abuse history in these patients.

Researchers from the VA Boston Healthcare System and Boston University School of Medicine (BUSM) examined a subset of women from a larger study of women Veterans' fibromyalgia care experiences at the VA to evaluate the relationship between child abuse history and MST in this patient population.

They found that of the population of female Veterans with fibromyalgia included in the study, 90.9 percent reported experience of MST (of which 68.2 percent reported history of sexual assault). In addition, the average Child Trauma Questionnaire (CTQ) score for these patients indicated moderate to high exposure to abuse in childhood, with many experiencing sexual abuse and emotional neglect. Women Veterans with greater MST exposure reported higher degrees of both childhood abuse and PTSD severity. The researchers conclude that screening for childhood trauma in women Veterans being treated for fibromyalgia would yield important information that may enhance treatment.

"Our fibromyalgia patients have often told us that their disease feels 'invisible' at times. We believe these preliminary study results may help female Veterans with fibromyalgia seek treatment for both their physical symptoms and trauma histories," explained corresponding author Megan Gerber, MD, MPH, medical director of women's health at VA Boston Healthcare System (VABHS) and associate professor of medicine at BUSM. "The VA is uniquely positioned to treat a complex condition like fibromyalgia and additional research is underway here to better understand interventions for this disabling chronic pain syndrome."

The findings appear in the Journal of General Internal Medicine.

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Funding for this study was provided as part of an operational quality initiative through Women's Health Services, Veteran's Health Administration. The research described here was also supported in part by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service (Award Number 1IK2RX000704-01A2).

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Gina DiGravio
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       http://dx.doi.org/10.1007/s11606-018-4594-4 
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