No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
New Results from Psychosomatic Research and from Studies of the Consequences of severe Stress
ResearchGate has not been able to resolve any citations for this publication.
Fibromyalgia syndrome as a psychosomatic disorder – Diagnosis and therapy according to current evidence-based guidelines
Objectives: The classification and therapy of patients with chronic widespread pain without
evidence of somatic factors as an explanation is currently a matter of debate. The diagnostic
label “fibromyalgia syndrome”(FMS) has been rejected by some representatives of general and
psychosomatic medicine.
Methods: A summary is given of the main recommendations from current evidence-based
guidelines on FMS and nonspecific/functional/somatoform bodily complaints.
Results: The criteria of FMS and of persistent somatoformpain disorder or chronic pain disorder
with somatic and psychological factors partly overlap. They include differential clinical characteristics
of personswith chronicwidespread pain butwithout sufficiently explaining somatic factors.
Not all patients diagnosed with FMS meet the criteria of a persistent somatoform pain disorder.
FMS is a functional disorder, inwhich inmost patients psychosocial factors play an important role
in both the etiology and course of illness. FMS can be diagnosed by looking at the history of a
typical symptom cluster and excluding somatic differential diagnoses (without a tender point
examination) using the modified 2010 diagnostic criteria of the American College of Rheumatology.
Various levels of severity of FMS can be distinguished from a psychosomatic point of view,
ranging from slight (single functional syndrome) to severe (meeting the criteria ofmultiple functional
syndromes) forms of chronic pain disorder with somatic and psychological factors, of persistent
somatoformpain disorder or of a somatization disorder. The diagnosis of FMS as a functional
syndrome/stress-associated disorder should be explicitly communicated to the patient. A
therapy within collaborative care adapted to the severity should be provided. For long-termmanagement,
nonpharmacological therapies such as aerobic exercise are recommended. In more
severe cases, psychotherapy of comorbid mental disorders should be conducted.
Conclusions: The coordinated recommendations of both guidelines can synthesize general
medical, somatic, and psychosocial perspectives, and can promote graduated care of patients
diagnosed with FMS.
