Fibromyalgia and chronic pain: are we asking about (and auditing) psychological trauma or traumatic events?

[摘要] Childhood adversity or childhood trauma has been, and continues to be, connected to poor quality of health and life. A growing body of evidence points to millions of people across the world experiencing events in their childhood that are detrimental to their physical and mental development.As a GP, I have grown to be interested in this subject and the role that primary care may have to play in mitigating the impact of this adversity. What I do know is that on an everyday basis patients tell me of the trauma they have experienced in their lives, be that as a child or as an adult.CURRENT MANAGEMENT OF CHRONIC PAIN This is a complex intergenerational problem that will require many streams of solutions. Fibromyalgia and chronic pain are common diagnoses found and coded in primary care. In the UK approximately 28 million people are thought to be affected by chronic pain (CP).1 CP is a complex problem across the world, costs the UK economy millions of pounds a year, and detrimentally impacts the quality of lives. Primary care manages the vast majority of patients with chronic pain whether or not there is a specific diagnosis, or it has an unknown origin. Only a small percentage of patients are referred to a secondary care pain clinic.One paper has reported that 22% of GP consultations are regarding chronic pain.2 Childhood adversities are common across the world; the average number that people experience before the age of 18 is 2.5–2.9 different types of trauma.3 Negative experiences in childhood include physical abuse, emotional neglect and abuse, sexual abuse, and family dysfunction, as well as living with those with poor parental mental health or incarceration. These have been linked to chronic health conditions, including chronic pain, in adulthood.

[学科分类] 卫生学