The role of lifetime stressors in adult fibromyalgia: systematic review and meta-analysis of case-control studies

Abstract

BackgroundFibromyalgia is a chronic condition characterised by widespread musculoskeletal pain. Although accumulating evidence suggests that exposure to stressful events increases the risk for this complex disorder, this is the first meta-analysis to compare the impact of a full range of lifetime stressors (e.g. physical trauma through to emotional neglect) on adult fibromyalgia.MethodsThis review was performed in accordance with PRISMA guidelines. Random-effects models examined associations between different stressor exposures and fibromyalgia status with meta-regression investigating the effects of publication year and study quality on effect sizes.ResultsNineteen studies were included in the meta-analysis. Significant associations with fibromyalgia status were observed for all six exposure types examined: odds ratios (OR) were highest for physical abuse (OR 3.23, 95% confidence interval 1.99–5.23) and total abuse (3.06, 1.71–5.46); intermediate for sexual abuse (2.65, 1.85–3.79) and smaller for medical trauma (1.80, 1.19–2.71), other lifetime stressors (1.70, 1.31–2.20), and emotional abuse (1.52, 1.27–1.81). Results were not significantly changed when childhood, as opposed to adult, exposures were used in studies that reported both. Meta-regression analyses demonstrated no effect of publication year or study quality on effect sizes.ConclusionsThis study confirmed a significant association between stressor exposure and adult fibromyalgia with the strongest associations observed for physical abuse. Limitations related to current available literature were identified; we provide several suggestions for how these can be addressed in future studies. Stressors are likely to be one of many risk factors for fibromyalgia which we argue is best approached from a biopsychosocial perspective.

Fibromyalgia: one year in review 2022

“…A history of childhood abuse and neglect substantially contributes to physical disease in adulthood, although this has been more widely studied in the context of mental illnesses (41). A meta-analysis of 19 studies by Kaleycheva et al (42) has confirmed significant associations between adult FM and exposure to stressors such as physical abuse, total abuse, sexual abuse, medical trauma, other lifetime stressors, and emotional abuse.…”

Attempt to replicate voxel-based morphometry analysis in fibromyalgia: Detection of below threshold differences framed by contributions of variable clinical presentation to low reproducibility

“…However, while specific gene candidates associated with FM have indeed been identified 18 and include potentially important DNA patterns (e.g., hypomethylation), 19 there is simultaneous acknowledgment of strong evidence pointing to environmental factors. For example, recent meta-analytic findings show a significant association between FM and exposure to traumatic stress, 20 and a systematic review reported that psychological trauma frequently appears to immediately precede onset of FM. 21 These potentially distinctive causal pathways may differentially alter brain structure and function, yielding an assortment of clinical presentations that are relatively unalike despite fitting the FM diagnostic criteria for research.…”

Virtual Reality-Based Therapy Reduces the Disabling Impact of Fibromyalgia Syndrome in Women: Systematic Review with Meta-Analysis of Randomized Controlled Trials

“…(2) comprised by women with FMS; (3) with at least two groups; (4) of which one group received VRBT; (5) compared with controls; (6) and reported quantitative data of different outcomes related with FMS impact (see Section 2.5). The exclusion criteria that were established included (1) experimental studies without a comparison group and (2) studies comprising patients with a variety of musculoskeletal disorders (i.e., not only FMS).…”

“…Fibromyalgia syndrome (FMS) is a chronic disease of unknown etiology that courses with generalized and diffuse non-inflammatory pain and hyperalgesia in different human body points [1]. Other FMS symptoms are joint stiffness [2], generalized fatigue [3], impaired balance [4], anxiety and depression [5], and emotional overload [6] that reduces functional capacity [7] personal autonomy, social relationships [8] and quality of life (QoL) [9,10]. The global prevalence of FMS ranges between 2% and 8% of the population [11], mainly affects women (61-90%) [12] aged 50 years and over [13] and involve a large consumption of social and health resources [14].…”