Article

[Etiology and pathophysiology of fibromyalgia syndrome].

Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
Der Schmerz (Impact Factor: 1.02). 06/2012; 26(3):259-67.
Source: PubMed

ABSTRACT

The scheduled update to the German S3 guidelines on fibromyalgia syndrome (FMS) by the Association of the Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften", AWMF; registration number 041/004) was planned starting in March 2011.
The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy ("Deutsche Interdisziplinären Vereinigung für Schmerztherapie", DIVS), 9 scientific medical societies and 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields. Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Centre for Evidence-Based Medicine.
Current data do not identify distinct etiologic or pathophysiological factors mediating development of FMS. The development of FMS is associated with inflammatory rheumatic diseases (EL2b), with gene polymorphisms of the 5-hydroxytryptamine (HT)(2) receptor (EL3a), lifestyle factors (smoking, obesity, lack of physical activity; EL2b), physical and sexual abuse in childhood and adulthood (EL3a).
FMS is most likely the result of various pathogenetic factors and pathophysiological mechanisms. The English full-text version of this article is available at SpringerLink (under "Supplemental").

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Available from: Winfried Häuser
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    • "FMS opinion leaders reported two guidelines. Three of these met our inclusion criteria: the 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome [10], the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) on the definition, pathophysiology, diagnosis, and treatment of fibromyalgia syndrome [11] [12] [13] [14] [15] [16] [17] [18] [19], and the Israeli guidelines for the diagnosis and treatment of fibromyalgia syndrome [20]. The reasons for excluding other hits were as follows: duplications (í µí±› = 19), not commissioned by a scientific society (í µí±› = 2) [21] [22]. "
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    ABSTRACT: Objectives. Fibromyalgia syndrome (FMS), characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences. Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted. Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified) preliminary American College of Rheumatology (ACR) 2010 diagnostic criteria. Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.
    Full-text · Article · Nov 2013 · Evidence-based Complementary and Alternative Medicine
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    • "The prevalence of FMS, according to the modified diagnostic ACR 2010 criteria, in the general German population was 2.1% [38]. A biopsychosocial model of interacting variables in the predisposition , triggering, and perpetuating of FMS has been suggested [33]. Among psychosocial variables, major negative life events and traumatic experiences may play a role in the predisposition to FMS. "
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    ABSTRACT: A link between fibromyalgia syndrome (FMS) and posttraumatic stress disorder (PTSD) has been suggested because both conditions share some similar symptoms. The temporal relationships between traumatic experiences and the onset of PTSD and FMS symptoms have not been studied until now. All consecutive FMS patients in 8 study centres of different specialties were assessed from February 1 to July 31, 2012. Data on duration of chronic widespread pain (CWP) were based on patients' self-reports. Potential traumatic experiences and year of most burdensome traumatic experience were assessed by the trauma list of the Munich Composite International Diagnostic Interview. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV symptom criteria by the Posttraumatic Diagnostic Scale. Age- and sex-matched persons of a general population sample were selected for controls. Three hundred ninety-five of 529 patients screened for eligibility were analysed (93.9% women, mean age 52.3years, mean duration since chronic widespread pain 12.8years); 45.3% of FMS patients and 3.0% of population controls met the criteria for PTSD. Most burdensome traumatic experience and PTSD symptoms antedated the onset of CWP in 66.5% of patients. In 29.5% of patients, most burdensome traumatic experience and PTSD symptoms followed the onset of CWP. In 4.0% of patients' most burdensome traumatic experience, PTSD and FMS symptoms occurred in the same year. FMS and PTSD are linked in several ways: PTSD is a potential risk factor of FMS and vice versa. FMS and PTSD are comorbid conditions because they are associated with common antecedent traumatic experiences.
    Full-text · Article · Apr 2013 · Pain
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    • "The prevalence of FMS, according to the modified diagnostic ACR 2010 criteria, in the general German population was 2.1% [38]. A biopsychosocial model of interacting variables in the predisposition , triggering, and perpetuating of FMS has been suggested [33]. Among psychosocial variables, major negative life events and traumatic experiences may play a role in the predisposition to FMS. "

    Full-text · Article · Apr 2013 · Pain
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