Comorbid depression mediates the association of childhood/adolescent maltreatment and fibromyalgia syndrome. A study with patients from different clinical settings.

Emotional and physical abuse and neglect in childhood and adolescence [childhood maltreatments (CMs)] are considered to play a role in the etiology of fibromyalgia syndrome (FMS). Whether the association between FMS and CMs can be explained by mediators has not been studied. CMs of consecutive FMS patients from three different clinical settings were assessed by the German version of the Childhood Trauma Questionnaire. Clinical setting, gender, age, comorbid depression, and health care use were tested for mediators. Of 328 patients (86% women, mean age 50 years), 293 were analyzed; 16% of the patients reported severe emotional, 9% severe physical, and 11% severe sexual abuse and 25% severe emotional and 13% severe physical neglect during childhood. The frequency of CMs was not associated with setting, gender, age, and health care use. FMS patients with a comorbid depression more frequently reported physical abuse (p=0.01) and emotional abuse (p=0.001), as well as emotional neglect (p=0.0008) and physical neglect (p=0.001) compared with FMS patients without a comorbid depression. Comorbid depression is a mediator of the association between CMs and FMS. Prospective population-based studies controlling for depression are necessary to determine the role of CMs in the etiology of FMS.