The Effect of Genetic and Other Factors on Fibromyalgia and Mood Concept

Abstract

Despite the lack of knowledge among doctors on the etiology of some illnesses, individuals have historically experienced the manifestations of many medical ailments. The term "idiopathic" is used by scientists to denote medical conditions that provide challenges in terms of diagnosis and lack a well-established etiological explanation. Fibromyalgia, chronic fatigue syndrome, and several types of epilepsy are classified as idiopathic conditions. One example of an ailment that falls under this category is fibromyalgia. It is plausible that some individuals may see this as "illusory" or, even more unfavorably, "subjective in nature". According to available statistics, fibromyalgia is a medically recognized disorder that impacts a significant number of individuals. The etiology of fibromyalgia remains elusive, yet individuals afflicted with this condition have some shared traits. The most prominent manifestation of fibromyalgia is a persistent and comprehensive medical condition. Furthermore, a significant majority of patients are likely to have varying degrees of fatigue. Fibromyalgia exhibits a higher prevalence in women compared to men, with the underlying causes for this disparity remaining unclear. Furthermore, there is evidence suggesting a familial pattern of inheritance, especially among first-degree relatives such as parents, children, and siblings.

Keywords: Idiopathic, Fibromyalgia, Fibromyalgia and Scientific Approaches, Areas Affected by Fibromyalgia, FM

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The Effect of Genetic and Other Factors on Fibromyalgia and Mood Concept
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Application Date : 2023 Article Publication Date: 2023 Article Type : Compilation article
Prof. Dr. Kürşat Şahin YILDIRIMER
St.Clemets University, Psychology, USA
Teaching Member /Turkey- United Kingdom
E-Mail: kursatsahinyildirimer@gmail.com
Orcid ID: 0000-0001-5896-2956
Summary
Individuals have had enduring medical issues for an
extended period, during which medical
professionals lacked comprehension of the etiology
of the ailment. The word "idiopathic" is used by
scientists to characterize illnesses that lack visible
manifestations and are devoid of established
etiology. Idiopathic illnesses include conditions
such as fibromyalgia, chronic fatigue syndrome, and
some forms of epilepsy. Fibromyalgia is a specific
medical ailment that may be classified inside this
particular category. This phenomenon has the
potential to be misinterpreted by some individuals
as being "illusory" or, even more concerning, as a
product of subjective perception. Based on
statistical data, fibromyalgia is a medically
recognized disorder that significantly impacts a
substantial number of individuals. Despite the lack
of a definitive explanation for fibromyalgia,
individuals afflicted with this condition exhibit
shared traits and symptoms. The primary
manifestation of fibromyalgia is enduring and
diffuse pain. Furthermore, a significant proportion
of patients may encounter varying degrees of
weariness, ranging from light to severe.
Fibromyalgia has a higher prevalence among
women compared to males, and its etiology remains
incompletely elucidated. Notably, there is a notable
familial aggregation of this condition, particularly
among those who have immediate biological
relationships, such as parents, offspring, and
siblings.

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Keyywords: Idiopathic, Fibromyalgia,
Fibromyalgia and Scientific Approaches, Areas
Affected by Fibromyalgia, FM
Abstract
Despite the lack of knowledge among doctors on the etiology of some illnesses, individuals
have historically experienced the manifestations of many medical ailments. The term
"idiopathic" is used by scientists to denote medical conditions that provide challenges in terms
of diagnosis and lack a well-established etiological explanation. Fibromyalgia, chronic fatigue
syndrome, and several types of epilepsy are classified as idiopathic conditions. One example
of an ailment that falls under this category is fibromyalgia. It is plausible that some individuals
may see this as "illusory" or, even more unfavorably, "subjective in nature". According to
available statistics, fibromyalgia is a medically recognized disorder that impacts a significant
number of individuals. The etiology of fibromyalgia remains elusive, yet individuals afflicted
with this condition have some shared traits. The most prominent manifestation of fibromyalgia
is a persistent and comprehensive medical condition. Furthermore, a significant majority of
patients are likely to have varying degrees of fatigue. Fibromyalgia exhibits a higher prevalence
in women compared to men, with the underlying causes for this disparity remaining unclear.
Furthermore, there is evidence suggesting a familial pattern of inheritance, especially among
first-degree relatives such as parents, children, and siblings.
Keywords: Idiopathic, Fibromyalgia, Fibromyalgia and Scientific Approaches, Areas Affected
by Fibromyalgia, FM
Introduction
The presence of fibromyalgia is sometimes a subject of contention due to the absence of a
singular, evident reason for the ailment, such as an infection, tumor, or congenital anomaly.
This factor contributes to the skepticism around the legitimacy of the disease. While the
etiology of fibromyalgia is believed to include genetic factors, current scientific investigations
have not yielded any identified genetic aberrations that may account for the diverse array of

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symptoms seen in individuals with this disorder. Consequently, the etiology of fibromyalgia
remains elusive, and its characterization is mostly based on the presence of symptoms that lack
other credible explanations. In order to establish a diagnosis, medical practitioners are required
to exclude all alternative conditions, since there are now no available blood tests or imaging
tests that can definitively prove the presence of the disease. In spite of the prevailing conditions,
it is necessary for a patient to satisfy some diagnostic requirements prior to establishing a
conclusive diagnosis.
The user's text does not provide enough information to be rewritten in an academic manner.
Fibromyalgia is a medical disorder that exhibits a notable level of unpredictability, hence
adding to the general public's lack of confidence about this ailment. Individuals who are
afflicted with fibromyalgia may have extended periods of remission, followed by abrupt and
sometimes inexplicable exacerbations in their symptoms. This research aimed to investigate
the scientific perspectives about the potential relationship between emotional disturbances and
their potential to exacerbate certain conditions.
FINDINGS
Fibromyalgia is characterized by the presence of chronic pain
In the majority of instances, disorders that result in chronic pain may be attributed to organic
factors; nevertheless, it is important to note that this is not always applicable. Fibromyalgia, a
condition recognized as a disease by the World Health Organization in 1992 with its inclusion
in the International Classification of Diseases, Tenth Revision (ICD-10), is characterized by
the lack of a discernible biological cause and the existence of persistent pain (Bellato et al.,
2012). Fibromyalgia is distinguished by the lack of a definitive biological cause; however it is
accompanied by the presence of persistent pain. In a previous study conducted by Wolfe et al.
(1990), the American College of Rheumatology (ACR) had formulated diagnostic criteria
which included the need of experiencing widespread discomfort and pressure pain in a
minimum of 11 out of 18 sensitive spots. The concurrent presence of persistent pain and
emotional distress (referred to as psychological harm), psychopathological symptoms, and

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alterations in interpersonal, societal, and vocational functioning necessitates, in conjunction
with medical evaluation and diagnosis, a psychological evaluation of these co-occurring
conditions.
Due to the inherently subjective nature of pain perception, physical examinations possess a
restricted capacity in the differentiated evaluation of malingering. Psychological testing serves
as a valuable and significant adjunct to differential diagnosis. Several methods have been
created to serve the function mentioned above. However, it is important to note that some
instruments, like TOMM and MMPI, are specifically designed for psychological evaluation
and malingering assessment (Greene, 2011; Rogers, 2008; Rogers, Sewell, Martin, & Vitacco,
2003).
Psychological assessments related to chronic pain and fibromyalgia
Similarly, it is crucial to ascertain if individuals diagnosed with fibromyalgia and chronic pain
possess a valid biological etiology. Arce, Faria, Carballal, and Novo (2006, 2009) conducted a
study on the differential diagnosis of malingering, a crucial aspect in the field of forensic
examination (American Psychiatric Association, 2000). The investigation and dissemination
of information for use in forensic practice represents an additional area of scholarly inquiry.
Negative criteria refer to certain factors that render a protocol invalid or inapplicable. The
scales and indices mentioned have shown efficacy in accurately detecting genuine clinical
cases, since they have not been identified in pertinent malingering procedures (Arce et al.,
2006, 2009). The scales and indices under consideration include the Lie scale (L), Correction
scale (K), and Odecep's. Despite its origins as a modified version of the Mp, the results of this
research revealed substantial additional validity in the classification of chronic pain cases.
Operation and order
The participants were individuals diagnosed with fibromyalgia and chronic pain (without
fibromyalgia) who were receiving medical treatment in Mallorca, Spain. Their clinical records,
which spanned a minimum of six years, were available for analysis. Individuals who have been

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diagnosed with chronic pain have a clinical record that indicates the absence of inflammation
and the presence of objective musculoskeletal disease, so providing evidence for an organic
cause. The comparison was made between the diagnosis of fibromyalgia, as per the established
diagnostic criteria of the disorder (Wolfe et al., 1990; Wolfe et al., 2010), and the assessments
made by rheumatologists who were unaware of the original diagnosis.
An individual's experience of emotional disturbance may sometimes precipitate a flare, hence
potentially leading to the perception that the pain is of psychological origin rather than physical.
In some instances, symptoms may be induced by a physical injury or premenstrual syndrome
(PMS), leading to the misattribution of an individual's emotional reaction as the primary cause,
rather than the presence of "phantom" pain.
The aforementioned perspective is further heightened when an individual has brain fog, a
symptom often associated with fibromyalgia that manifests as a diminished emotional or
cognitive reaction. This perception is further reinforced when individuals encounter cognitive
impairment often referred to as "brain fog."
Being With Someone with Fibromyalgia
Individuals diagnosed with fibromyalgia often have a significant obstacle in their everyday
lives, namely the difficulty of effectively communicating the nature of their ailment to their
loved ones, who sometimes struggle to comprehend its intricacies. This illness is characterized
by a state of indeterminacy, and the efficacy of treatment in addressing this specific ailment is
variable.
The first step in managing fibromyalgia while cohabitating with an individual afflicted by the
condition is acknowledging and embracing the illness, particularly its inherent unpredictability.
The provision of assistance by family and friends may be regarded as a very advantageous
component of the therapeutic approach for persons afflicted with fibromyalgia. Numerous
healthcare practitioners, including rheumatologists, pain specialists, general practitioners, and

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mental health experts, possess considerable expertise in managing patients who articulate
persistent and diffuse bodily discomfort, sometimes referred to as chronic broad pain. This
particular kind of pain is often linked to a diverse range of accompanying symptoms, including
disrupted sleep patterns, feelings of exhaustion, and depressive symptoms. The understanding
of fibromyalgia (FM) is challenging due to its multifaceted symptomatology, which contributes
to the complexity surrounding this condition.
In the last thirty years, there has been a discernible rise in the quantity of scientific research
focused on FM. The observed expansion may be attributed to the rise in consciousness and
collective engagement of diverse stakeholders, including individuals afflicted with the ailment,
patient support organizations, medical practitioners, researchers, and the pharmaceutical
sector. By adopting this particular definition of FM, it is anticipated that further investigation
will be prompted, so facilitating a more comprehensive comprehension of the fundamental
pathophysiological mechanisms involved. Consequently, this enhanced understanding is
expected to culminate in advancements in therapeutic interventions for FM. In addition to the
humanitarian objectives of study and therapy, the interest in fibromyalgia (FM) may be
influenced by several other factors, including the legitimization of symptoms and illness for
patients, the effect on academic pursuits, the economic benefits for pharmaceutical
corporations, and the legal interests involved.
There exists a viewpoint suggesting that some conflicts within the field of FM are not primarily
driven by genuine scientific and therapeutic advancements, but rather by the competing belief
systems of medical and psychiatric specializations, the vested interests of self-help groups, and
financial motivations. In the course of these discussions, there are discernible and fervent
perspectives about the essence of fibromyalgia (FM) and treatment suggestions that diverge
from conventional medical practices. The following are commonly held misunderstandings
about FM.
Accuracy of symptoms

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According to a rheumatologist or pain expert, it has been reported by another healthcare
practitioner that they remarked, "Fibromyalgia does not exist." The discourse around the
existence of FM prompts an inquiry into the conceptualization and delineation of existence.
Providing a comprehensive and adequate definition of a disease proves to be very challenging.
The scope of diseases that may be identified evolves with time, primarily influenced by
advancements in diagnostic capabilities, as well as variations in societal and economic factors.
The aforementioned ailment is often referred to as osteoporosis. In 1994, the World Health
Organization (WHO) reclassified a condition that was previously seen as an unavoidable
outcome of the aging process, asserting that it should be recognized as a disease. Subsequently,
it has been acknowledged as an independent pathological condition. Once a condition is
approved, a variety of advantages become accessible. The benefits include the confirmation of
sickness and suffering, with potential financial advantages such as payment for treatment
expenses. If the criteria for being classified as a disease include obtaining official recognition
from the World Health Organization (WHO), then fibromyalgia (FM) fulfills this need. On the
contrary, if the establishment of a specific cause and underlying mechanisms is deemed
necessary for the characterization of a medical condition, fibromyalgia (FM) would not meet
the criteria to be classified as a disease.
The World Health Organization (WHO) use the word "disorder" consistently in its
categorization of mental illnesses, so circumventing the inherent issues associated with
terminology usage. The current prominence of the biological paradigm in modern medical
practice may provide insight into the hesitancy shown by some medical practitioners when it
comes to attributing the diagnostic designation of fibromyalgia to their patients. This
conceptual framework delineates a disease as a pathological state that might arise from the
introduction of exogenous pathogens or from a disruption in the normal physiological
processes of organs and bodily systems. Biomarkers are assigned a significant function and are
deemed crucial in this context. The diagnosis of fibromyalgia requires a comprehensive
evaluation of a constellation of symptoms that collectively characterize the condition, as
determined by expert consensus and supported by clinical investigations. The diagnosis of an

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illness often relies on objective evidence, like laboratory tests, imaging studies, or pathology
findings. However, it is important to note that the diagnosis of fibromyalgia (FM) cannot be
solely established by objective data. Similar to the majority of mental diseases, the diagnosis
of FM requires a comprehensive assessment of the individual's FM-related medical
background. The identification of functional musculoskeletal dysfunction (FM) may be
established when a patient's symptoms satisfy certain criteria, and the presence of a somatic
ailment that can sufficiently account for the patient's symptoms is ruled out.
Fibromyalgia (FM) is not a binary syndrome that exhibits a dichotomous presence or absence
at a certain moment; instead, it is a disorder that exists along a continuum, like to other medical
conditions such as diabetes, hypertension, and depression. The frequency of the syndrome is
contingent upon the criteria used to delineate the presence of a pathological condition, which
may fluctuate in magnitude over the course of time. Individuals who have been diagnosed with
fibromyalgia do not constitute a distinct subgroup, but rather fibromyalgia reflects the
culmination of a continuous range of polysymptomatic discomfort, including both physical and
psychological symptom load, that is prevalent among the general population. The concept of
FM represents the terminus of a continuum.
The development of a categorization system that is applicable in both primary care and clinical
settings has significant importance in the realm of specialist pain treatment. One of the
categories that can be identified is chronic primary pain, which is characterized by the presence
of persistent or recurring pain in one or more anatomical locations for a duration exceeding
three months. This type of pain is often accompanied by notable emotional distress or
significant impairment in functional abilities, leading to interference with and limitations in
engaging in daily activities. The phenomenon of social roles is not well explained by any other
chronic pain condition. Chronic primary pain may be categorized as a kind of neuropathic pain.
The emergence of this novel phenomenological characterization of chronic pain has arisen in
response to a dearth of comprehension about the etiology of many forms of chronic pain. The
word "primary pain" was used because of its widespread acceptance, particularly from a non-

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expert standpoint. The presence of allodynia and spontaneous pain has provided evidence for
dysfunction in pain modulation, indicating that fibromyalgia (FM) may be classified as a pain
disorder characterized by heightened pain sensitivity and diminished pain inhibitory
mechanisms.
The notion that fibromyalgia is only a distressing ailment is a subject of ongoing scholarly
discussion. In their seminal work dating back to 1989, Turk and Flor astutely observed that
fibromyalgia (FM) had a broader scope beyond the mere presence of persistent widespread
pain and sensitive spots. The concept of vulnerabilities might be likened to the "sedimentation
rate" of physical and psychological suffering. The diagnostic criteria for sleep and exhaustion
place almost equal emphasis on both symptoms, with depression being considered a secondary
manifestation. The co-occurrence of symptoms seen in individuals diagnosed with
fibromyalgia prompts inquiry into the potential shared etiology of these diverse manifestations.
Patients may also attribute different levels of severity to the concomitant symptoms of
fibromyalgia.
Depression covered up with fibromyalgia
Fibromyalgia is a medical condition that is distinguished by the presence of chronic and diffuse
somatoform pain.
Certain specialists in the field of psychosomatic medicine have recently adopted the diagnostic
label "persistent somatoform pain disorder" (ICD-10 F45.4) due to the absence of a well-
defined pathology and the observed association between symptoms of fibromyalgia and
various psychological and physiological disturbances. Indeed, a significant proportion, ranging
from sixty to eighty percent, of individuals diagnosed with fibromyalgia (FM) experience the
beginning or worsening of FM symptoms due to psychosocial stress and emotional problems.
The disease known as fibromyalgia is characterized by physical symptoms
There has been ongoing discourse over the potential classification of fibromyalgia (FM) as a
somatic symptom disorder (SSD). The fifth edition of the Diagnostic and Statistical Manual of

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Mental Disorders (DSM-5) has undergone revisions by the American Psychiatric Association
(APA), which include the replacement of the "pain disorder" category with a new classification
termed "Somatic Symptom Disorder" (SSD). Recent scholarly articles propose that
fibromyalgia ought to be classified as a somatic symptom disorder (SSD). However, research
revealed that a mere 26% of persons diagnosed with fibromyalgia satisfied the criteria for
somatic symptom disorder (SSD). In this particular study, there was insufficient evidence to
support the construct validity or clinical utility of the diagnostic label.
CONCLUSION
The pathophysiological characteristics of fibromyalgia (FM) that have been subject to
significant investigation mostly revolve around central sensitization. Central sensitization
refers to the augmentation of pain intensity and other sensory mechanisms inside the brain.
This phenomenon is characterized by a concurrent augmentation in the functional connectivity
to brain regions associated with pain promotion and a reduction in connectivity to brain regions
associated with pain inhibition. Additionally, alterations in neurotransmitter levels within the
central nervous system (CNS) and variations in the dimensions and morphology of different
brain structures are observed. Nevertheless, FM is neither the only entity nor is it unique in
undergoing these transformations. The results pertaining to central nervous system (CNS)
alterations, which are used to substantiate the concept of pain centralization, also provide
credence to other ideas centered on the CNS. Several ideas have been proposed to explain
various phenomena, including the effects of personality characteristics, such as pain
catastrophizing. Other explanations focus on the failure of the sympathetic nervous system, the
evolutionary stress response, and the activation of homeostatic brain programs.
RESTRICTION
The research is limited to scientific research that has been previously conducted around the
world and reported in the literature.
NOTIFICATIONS

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Evaluation: Evaluated by internal and external consultants.
Conflict of Interest: The authors declared no conflict of interest regarding this article.
Financial Support: The authors did not report any financial support related to this article.
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