April 2, 2003

Self-reported Symptoms Before and After September 11 in Patients With Fibromyalgia

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(13):1637-1638. doi:10.1001/jama.289.13.1638

To the Editor: A newspaper story reported that by October 1, 2001, three weeks following the terrorist attacks on the United States, physicians in Washington, DC, were "inundated" by complaints of worsening pain in patients already diagnosed with chronic pain conditions.1 This report claimed that the increase in pain was "clearly triggered by stress over the attacks" and insomnia. Subsequent studies have reported an increase in insomnia immediately after the attacks,2 decreased parasympathetic tone in some individuals,3 and symptoms of posttraumatic stress disorder.4

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