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

Objective: The study analyzed the role of traumatic experiences and psychoso- matic components as potential predictors of the likelihood of chronic pain patients having or not having fibromyalgia. Methods: We examined the role of stressful life events (Trau- matic 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 fibromyal- gia compared with a sample of 104 patients with rheumatoid arthritis. Results: 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 sta- tistically significant predictors of group belonging, and the model explained 67% of the variance in diagnosis [χ2(9) = 143.66, p < 0.001]. Conclusion: 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.