Prevalence and Associated Factors of Post-Traumatic Stress Disorder in People with Fibromyalgia in Primary Care

Abstract Background: Central sensitization syndromes (CSS), including fibromyalgia (FM), are characterized by altered pain processing and heightened sensitivity, often accompanied by fatigue, cognitive issues, and mood disturbances. Psychiatric comorbidities, particularly post-traumatic stress disorder (PTSD), are common among these patients and may exacerbate symptoms. This study explores the prevalence of post-traumatic stress disorder (PTSD) in people with fibromyalgia and other central sensitization syndromes (CSS) in primary care in order to provide evidence that facilitates comprehensive clinical management. Method: Three semi-rural primary health care areas. 254 individuals over 18 years old diagnosed with CSS who gave their written informed consent to participate. An ad hoc questionnaire was applied, including sociodemographic and clinical variables, and the EGEP-5 instrument for PTSD detection. Prevalence of symptoms compatible with PTSD and their relationship with variables such as sex, gender, educational level, employment status, and participation in psychoeducational groups. Results: The sample was mainly composed of women (96.5%) with a mean age of 57.4 years. Fibromyalgia was diagnosed in 68.5% of participants, and 23.6% had both fibromyalgia and chronic fatigue syndrome. PTSD-compatible symptoms were present in 32.7% of participants. The highest rates were observed among those with higher education (48.7%) and women in unpaid work (42.6%) (p < 0.05). The most frequent traumatic events were the violent death of a loved one (54.4%) and psychological harassment (49.4%). Participation in psychoeducational groups was also associated with a higher prevalence of PTSD (40.9%). Conclusions: A high percentage of people with fibromyalgia present PTSD symptoms, associated with psychosocial and gender factors. Exposure to traumatic events is high. Systematic PTSD screening in primary care is recommended to improve the comprehensive management of people with CSS. Trail registration: not applicable