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Abstract
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To the Editor
I read with great interest Chandan et al. enlightening article describing the association of childhood maltreatment with the subsequent development of fibromyalgia and other similar maladies. Using a large UK primary care database, they found that, when compared to an unexposed cohort, maltreated children have significantly higher risk for fibromyalgia development later in life (aIRR = 2.06; 95%CI = 1.71-2.48). Fifty-eight percent of maltreated children were female. We are not told what percentage of abused children developing fibromyalgia were women. This seems to be an important point considering fibromyalgia a female-predominant illness. Around 90% of fibromyalgia patients seeking medical care are women.
Fibromyalgia is clearly a stress-related disorder. The key issue in fibromyalgia research is to define how different stressful circumstances including childhood abuse could lead to chronic pain, and why females are predominantely affected.
Our research proposes fibromyalgia as a stress-related sympathetically-maintained neuropathic pain syndrome. The recently recognized link between fibromyalgia and small fiber neuropathy reinforces this pathogenetic model. We propose
Language: en |