Subjective Experiences and Sensitivities in Women with Fibromyalgia: A Quantitative and Comparative Study

Abstract

Fibromyalgia is a chronic widespread pain syndrome associated with chronic fatigue. Its pathogenesis is not clearly understood. This study presents subjective experiences and sensitivities reported by fibromyalgia patients, which should be considered in primary care to avoid medical nomadism, as well as stigmatization of the patients. The prevalence of significant characteristics was compared with others patients consulting at the same pain unit who suffer from rebel and disabling form of chronic migraine. Psychometric tests were anonymously completed by 78 patients of the Pain Unit (44 fibromyalgia patients and 34 migraine patients). Tests evaluated pain (Visual Analog scale), childhood traumas (Childhood Trauma Questionnaire), lack of parental affection, stressful life events (Holmes and Rahe Scale), anxiety and depression (Hospital Anxiety and Depression Scale), perceived hypersensitivity to 10 stimuli, and hyperactivity before illness. However, pain scores were comparable in the two groups, and the prevalence was significantly higher in fibromyalgia patients than in migraine patients for anxiety (81.8% versus 51.5%) and depression (57.1% versus 8.8%). Childhood physical abuses were more frequently reported in fibromyalgia than in migraine cases (25% versus 3%). Similarly, the feeling of lack of parental affection, subjective hypersensitivity to stress and stimuli (cold, moisture, heat, full moon, and flavors) or hyperactivity (ergomania), appeared as prominent features of fibromyalgia patients. Fibromyalgia patients considered themselves as being hypersensitive (mentally and physically) compared to migraine patients. They also have higher depression levels. Beyond somatic symptoms, precociously taking account of psychosocial and behavioral strategies would highly improve treatment efficiency of the fibromyalgia syndrome.

Figure 1

Childhood trauma evaluation. (a) Results of the Childhood Trauma Questionnaire (CTQ) assessing maltreatments of children from their familial environment: percentage of adult fibromyalgia and migraine patients who reported childhood abuses and neglects. (b, c) Percentage of patients who declared having often or very often suffered from maternal (b) or paternal (c) affective deprivation during childhood. Statistical significances between the two groups: ∗p < 0.05, ∗∗p < 0.01, and  ∗∗∗p < 0.001.

Figure 2

Results of the Hospital Anxiety and Depression (HAD) scale (scores varied from 0 to 21 and score ≥11 was considered as pathological). Percentage of fibromyalgia and migraine patients with pathological anxiety and/or depression. Statistical significances between the two groups: ^∗∗p < 0.01  and  ^∗∗∗p < 0.001.

Figure 3

Results of the Holmes and Rahe stress scale measuring the level of stress associated with life events occurred in the past 2 years. Events were scored from 11 to 100. If global score>150, the stress level is high or very high and could contribute to the illness. When total score ≤150, the stress was considered as moderate to low. Results show the percentage of fibromyalgia and migraine patients with low (on the left) or high (on the right) score of stress. Statistical significances between the two groups ^∗∗∗p < 0.001.

Figure 4

Evaluation of the subjective hypersensitivity perceived by the patients. Questionnaire concerned sensitivity to 10 different stimuli. Results show percentage of fibromyalgia and migraine patients who answered “yes” to the question, “would you say that you are very sensitive to the following stimuli?” Statistical significances between the two groups ^∗p < 0.05, ^∗∗p < 0.01, and  ^∗∗∗p < 0.001.

Figure 5

Evaluation of the subjective hyperactivity reported by the patients. Results show percentage of fibromyalgia and migraine patients who answered “Often true” or “Very often true” to the question, “Before my illness, I was a very active person”. The other possible answers were “Never true,” “Rarely true,” and “Sometimes true.” Statistical significance between the two groups: ^∗p < 0.05.