Investigation of childhood trauma and dissociative experiences in somatization disorder and fibromyalgia syndrome

Objective: The aim of the study was the relationship of somatization disorder (SD) and fibromyalgia syndrome (FMS) with dissociative symptoms / disorder and childhood trauma, investigation of whether childhood trauma have role in the cause of somatization disorder and fibromyalgia syndrome. Materials and methods: The patients, agreed to participate and admitted to Duzce University department of psychiatry between 2013-2014 years, who had been diagnosed as somatization disorder (group I) according to DSM-IV TR and patients (group II) who can appropriately understand and answer the tests, at least elementary school graduate, and the healthy subjects with similar socio-demographic characteristics and at least elementary school graduate for control group were included in the study. Exclusion criterias for SD were mental retardation, psychosis, the presence of additional organic disease or substance abuse mimicking somatization and additional organic diseases for FMS. 60 people group I (somatization disorder), 60 people in the study group II (fibromyalgia syndrome), 69 people in group III (control) from 189 people were participated in the study. Together with childhood trauma scale (CTQ-28) and dissociation scale (DIS-Q) applied three groups; the name, age, sex, marital status, occupation, education, economic status, place of residence, family history of psychiatric disorders were questioned as socio-demographic data. Results: Total mean CTQ score of groups with SD and FMS was significantly higher than the control group (p = 0.008). When we compared to the groups in terms of the CTQ subscales scale; Emotional neglect mean score of the patients with SD and FMS were significantly higher than the control group (p <0.001). In spite of that, the average emotional neglect is similar in patients with FMS and SD (p> 0.05). The average of patients with SD in terms of emotional abuse was significantly higher than the average of the control group (p = 0.029). There was not difference among other groups, and in terms of averages emotional abuse, SD and FMS are similar (p> 0.05). According to average physical neglect terms, the average of patients with FMS was significantly higher than the average of the control group (p = 0.046), but statistically significant difference was not found between average physical neglect terms of patients with SD and average physical neglect of the patients with FMS and the control group. In this sense, SD and FMS is similar (p> 0.05). The average scores of all subscales of the CTQ in all groups were found higher than cut-off point determined at scale of Turkish validity and reliability study (except for mean emotional neglect score of control group). Significant differences were detected among the groups in terms of mean DIS-Q (somatization disorder, fibromyalgia, control) (p = 0.004). When the differences were examined in detail, average DIS-Q of patients with FMS was significantly higher than the average of patients with somatization disorder and control group (p=0.05 and 0.003, respectively). Conclusion:. We detected the similar to SD and FMS in terms of whole childhood trauma, emotional neglect, emotional abuse, physical neglect, DIS-Q average was higher for SD and FMS and it was significantly higher in FMS. Due to the childhood trauma the likeness of the traumatic experience, the SD, FMS even dissociative disorders should be considered as interfered, the different clinical manifestation of the same disease, caused by trauma and associated with neurobiological, psychological and somatic consequence. Our study about the etiology and comorbid psychiatric conditions has also strengthened this thesis and we thought that it will be lead on the work to be performed in this area.