Digital archive of theses discussed at the University of Pisa


Thesis etd-06182017-221108

Thesis type
Tesi di specializzazione (5 anni)
Thesis title
Posttraumatic stress disorder (PTSD),posttraumatic stress spectrum and adult autism subthreshold spectrum in 70 patients with fibromyalgia
Course of study
relatore Prof.ssa Dell'Osso, Liliana
  • posttraumatic stress spectrum
  • fibromyalgia
  • PTSD
  • adult autism subthreshold spectrum
Graduation session start date
Release date
Fibromyalgia is a chronic disease characterized by widespread musculoskeletal pain, often accompanied by fatigue, cognitive disorders and psychiatric symptoms. Patients report asthenia, sleep disorders, anxiety, depression, problems of concentration and memory, tenderness, increased sensitivity to pain with allodynia and hyperalgesia, stiffness throughout the body, without evidence of structural abnormality in muscles and ligaments or joints. Fibromyalgia is related to a more serious disability in daily activities in comparison with other rheumatic diseases. Despite many studies, the pathogenesis of pain in the fibromialgic syndrome was not fully understood, and a growing interest has been focused on the role of psychiatric comorbidity. The fibromyalgic patients can report multiple mental disorders, including the major depressive disorder, bipolar disorder, panic disorder and social phobia, returning prevalence rates respectively of 62%, 11%, 29% and 19%. The Post-Traumatic Stress Disorder (PTSD) is a psychopathological condition resulting in the exposure of the subject to a traumatic event of objective and significant severity lasting on life threatening or serious injury for the subject himself or for a loved one. According to the recent definition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA 2013) regarding the exposure to trauma, the event can be experienced by the subject in first person as well as he can be a direct or indirect witness of an event regarding close family members or friends; the event can finally be the result of repeated exposures (for example, for professional reasons) to consequences of a trauma. The clinical frame of the disease is characterized by the onset and persistence, one month after the trigger event, of symptoms belonging to four core clusters: re- experiencing (for example in the form of nightmares, flashbacks, recurring and intrusive memories, physiological reactions as a result of stimuli associated with the trauma); avoidance behavior towards feelings, thoughts, people, places linked to the event; negative alterations in cognition and mood (including distorted sense of guilt, persistently negative beliefs about themselves or the world in general, reduction of interest, loss of ability to feel positive emotions) and, finally, persistent alterations of arousal and reactivity (hypervigilance, alarm responses, alteration in the circadian rhythm, concentration problems, reckless and self-destructive behavior).
The aim of this thesis was to investigate the rates of PTSD, both full and partial, according to the criteria of the DSM-5, in a sample of patients followed for fibromyalgia at the Rheumatology outpatient Unit of the University of Pisa. The secondary objective of this study was to explore the Adult Autism Subthreshold Spectrum symptomatology, and the presence of any correlation between symptoms of Post-Traumatic Stress Spectrum and Adult Autism Subthreshold Spectrum, in this sample of fibromyalgic patients.