Fewer Malingerers in Patients with Fibromyalgia?

[barbc56]

There's been some high quality research out of Israel about Fibromyalgia. While this study is almost nine years old it made a statement that absolutely astonished me. The bolded part of the abstract is what caught my attention. Even if the study is junk science, I would like to see the references they use for the statement.

As well as bolding I have broken up the abstract for easier reading,

Abstract
A total of 25-50% of fibromyalgia patients (FM) report the occurrence of physical trauma that preceded the
onset of their symptoms by several weeks to several months. Yet, there is still no agreement among experts
as to whether physical trauma can cause FM. The severity of the injury varies, but is usually milder than that
seen in patients with post-traumatic stress syndrome. Road accidents, and, in particular, whiplash injuries, or
accumulated injury inherent in some occupations have been described as causes of fibromyalgia.

The only two prospective studies that assessed the incidence of fibromyalgia syndrome following accidents, such as whiplash injuries, were conducted by Israeli researchers and they reported opposite results. Possible mechanisms for the development of the syndrome following trauma have not been elucidated sufficiently to date. Stressful conditions are also known to contribute to the appearance of the syndrome. In most likelihood, there is no significant difference between idiopathic fibromyalgia and post traumatic fibromyalgia in terms of clinical course, symptom severity and prognosis, although some investigators have reported a worse prognosis in post-traumatic cases.

In Israel, there is an increase in the number of suits filed against private insurance companies and the National Insurance system for post-traumatic fibromyalgia. According to the literature, it is probable that the number of cases that involve malingering or secondary gain is low. The ongoing controversy among medical experts as to whether there is an association between FS and physical trauma has made it very difficult, in the absence of guidelines and objective tools, for the legal and administrative systems to deal with this difficult issue.

I'm not focusing on the quality of the study per se, but if others want to that's fine with me.

Edit. Now I'm not sure I'm reading the statement correctly. Are they interchanging Post Traumatic Syndrome with Post Trauma Fibromyalgia having fewer malingerers? Both?

 

[Esther12]

I'm coming down with a migraine, so may be missing something obvious, but aren't they just saying that few cases of FM involve malingering or secondary gain? I've no idea of the research in this area, but don't see an obvious reason for that to grab your attention.

 

[barbc56]

I think what surprised me is the fact that FM and ME/CFS are often misdiagnosed as the other or seen as the same condition, so fall under the biopsychosocial/mus category. FM is sometimes considered a form of me/cfs, though I think this is changing. So to read that the authors state there're few malingerers or secondary gains in FM is interesting and I am curious what references the authors used as the conclusions in studies and the literature are more the opposite than not as well as the recommendation of cbt/get.

Don't know if that makes sense. It's weird what can grab your attention.

 

[Esther12]

Don't know if that makes sense. It's weird what can grab your attention.

It was my impression that in papers from the late 90s on there was generally an emphasis on patients not being deliberately deceptive, but being victims of their own distorted understanding, which may be influence by social factors like disability benefits.

I'm not sure there was ever much evidence for any of the speculation on this stuff. You're right that it could be interesting if there was strong supporting evidence though.