Fibromyalgia in an active duty military sample across the deployment cycle: An evaluation of prevalence, incidence, and the role of psychosocial predictors in onset and comorbidity




Sramek, Kristin Nicole

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Research problem: Fibromyalgia incidence, prevalence, psychosocial risk, and comorbidity have yet to be evaluated in active duty military personnel. Methods: A sample of 4,119 U.S. Army personnel were evaluated before a military deployment and 1,902 were re-evaluated at a post-deployment follow-up time point. Fibromyalgia rates were compared (1a) at the pre-deployment time point among those who had previously deployed at least once versus those who had never previously deployed and (1b) among the follow-up subsample in pre-deployment versus post-deployment. Additionally, (2) psychosocial predictors of fibromyalgia incidence were evaluated prospectively, and (3) comorbidity of moderate to severe insomnia and moderate to severe depression were evaluated among the fibromyalgia incident group compared to the rest of the follow-up subsample.
Results: Of the 3,934 cases with complete data at pre-deployment, 2,527 had previously deployed and 1,407 had not. Previous deployment was significantly related to fibromyalgia prevalence among the entire pre-deployment sample, OR 4.228, 95% CI [2.410, 7.418]. The prevalence of fibromyalgia was 4% (104/2,527) among those who had previously deployed compared to 1% (14/1,407) among those with no previous deployment experience. Among the follow-up subsample (N = 1,836), the prevalence rate of fibromyalgia post-deployment was (7.84%) compared to (2.23%) at pre-deployment. Fibromyalgia incidence in post-deployment was 6.74% (121/1,795) where pre-deployment reports of pain, moderate to severe insomnia, and age demonstrated the strongest prospective direct effects. Among the fibromyalgia incident group, 64.5% met criteria for both moderate to severe insomnia and moderate to severe depression, another 19.0% met criteria for insomnia, and another 5.8% met criteria for depression. Conclusion: This study demonstrated increased prevalence of fibromyalgia among U.S. military personnel who deployed to a military combat theater and increased risk for fibromyalgia incidence among those with insomnia. Targeting insomnia, as both a preventative measure and treatment, may benefit those at risk for fibromyalgia and those with the condition.


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active duty military, army, chronic multisymptom illness, chronic pain, deployment, fibromyalgia