Fibromyalgia linked to PTSD but not major depression

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Fibromyalgia linked to PTSD but not major depression

June 16, 2004 Zosia Chustecka

Rheumawire

Berlin, Germany - An investigation of fibromyalgia (FM) in former

Israeli soldiers has revealed a link between posttraumatic stress

disorder (PTSD) and the development of the condition, but no association

with major depression [1].

In the study, presented at the EULAR 2004 meeting last week,

fibromyalgia was found in nearly half (49%) of the men with PTSD,

compared with only 5% of those who suffered from depression, and none at

all in a control group of healthy men (p<0.0001). " Normal average males

have no tender spots on their bodies, so it was very unusual to find

such a high number of men showing this level of pain, " says lead

investigator Dr Amital (Hadassah-Hebrew University School of

Medicine, Jerusalem, Israel).

The study was chosen by the scientific committee for inclusion in the

official EULAR press pack. As fibromyalgia is commonly seen in women,

it's unusual for a study of the condition to focus exclusively on males.

The findings from this study, however, also overturn the common

assumption that the psychiatric illnesses often seen alongside

fibromyalgia result as a consequence of the chronic pain, the EULAR

press release comments.

This study suggests that PTSD precipitates the emergence of

fibromyalgia, Amital says. " It is not that psychiatric illness is

necessarily correlated with fibromyalgia, but PTSD certainly is, " he

comments. " The symptoms may overlap, but the degree and intensity of

these disorders are so closely related that it cannot be just a

coincidence. "

Amital et al conducted their study in 3 groups of men, all now in their

40s, who had served at some stage in the military forces. One group of

49 men acted as controls and were recruited on a scheduled routine

annual physical examination at the Sheba Medical Center. Another group

of 20 men had major depression, while the third group of 55 men had been

diagnosed with PTSD. " The major traumatic event in all the PTSD patients

was combat-related and sustained during wars fought by the Israeli

Defense Forces (IDF), " the researchers explained. All of them were

considered to be too deeply affected to benefit from rehabilitation and

had been classified as " nonrehabilitative " by the Israeli defense

ministry.

On average, the number of " tender points " among the PTSD patients was

8.9, compared with 2.85 in the group with depression and 0.18 in the

normal controls (p<0.0001). A significant correlation was found between

the FM tender-point score and measures of PTSD, sleep quality, and

disability, the researchers noted. In comparison with the group of men

who had major depression, the men with PTSD showed a significant

impairment on both vocational and familial aspects of the Sheehan

Disability Scale, they added, although both groups scored similarly on

the Clinical Global Impression Scale.

In male patients, PTSD is highly associated with fibromyalgia, and the

degree and impact of these disorders is significantly related, the

researchers concluded. They also commented that the link between PTSD

and fibromyalgia in male patients that they found in their study

contrasts with the lack of any such link with major depression, despite

the fact that the severity of both psychiatric ailments was similar.

Source

Amital H, Amital D, Fostick L, et al. Fibromyalgia in

men and post-traumatic stress disorder. Presented at: EULAR 2004;

Berlin, Germany; June 9-12, 2004. Abstract PO0029.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org