Stressful Life Events and Psychosomatic Symptoms in Fibromyalgia Syndrome and Rheumatoid Arthritis

The study analyzed the role of traumatic experiences and psychosomatic components as potential predictors of the likelihood of chronic pain patients having or not having fibromyalgia.

We examined the role of stressful life events (Traumatic Experiences Checklist), psychosomatic syndromes (Toronto Alexithymia Scale and Diagnostic Criteria for Psychosomatic Research), pain, and psychological distress (Beck Depression Inventory-II and State-Trait Anxiety Inventory) in 104 patients with fibromyalgia compared with a sample of 104 patients with rheumatoid arthritis.

Patients with fibromyalgia reported significantly more traumatic events, a higher prevalence of psychosomatic syndromes, and higher levels of pain, anxiety and depressive symptoms compared with patients with rheumatoid arthritis (all p < 0.01). Hierarchical binary logistic regression with group membership as the dependent variable showed that somatization syndromes (OR = 3.67), pain (OR = 1.56), and childhood trauma (OR = 1.11) were statistically significant predictors of group belonging, and the model explained 67% of the variance in diagnosis [χ²(9) = 143.66, p < 0.001].

These results highlighted that patients with fibromyalgia are characterized primarily by marked somatization and a high prevalence of early stressful life events compared with patients with rheumatoid arthritis, a primarily nociceptive chronic pain condition. A better knowledge of these mechanisms could allow clinicians to develop tailored interventions that take greater account of the psychological dimension of the disease.