PubMed · 15776049
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Bjørn Klevmark. 2005-03-03. [Frequent urination].. https://pubmed.ncbi.nlm.nih.gov/15776049/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
The hypothesis that fibromyalgia (FM) should be classified as a somatoform disorder was assessed by reviewing current clinical studies. According to the ICD-10, somatic illness beliefs of the patient, high health care utilization, and frustrating patient-doctor relationships are diagnostic criteria of somatoform disorders. For the diagnosis of a somatoform pain disorder, a temporal association between the manifestation of pain and emotional or psychosocial conflicts and the exclusion of a depressive disorder are additionally required. Empirical studies demonstrate a higher lifetime and current prevalence of psychiatric disorders, childhood adversities, life events, and daily hassles and a higher health care utilization of FM patients. Studies also reveal that most patients believe that both somatic and psychosocial factors have caused their disorder. The patient-doctor relationship is characterized to be disappointing for both. Yet in all studies there were patients who did not fulfill the ICD-10 criteria of a somatoform (pain) disorder. A biopsychosocial model of FM differentiating between biological as well as psychosocial predisposing, triggering, and perpetuating factors in the pathogenesis of FM is presented as an alternative model. Hopefully the biopsychosocial model and the distinction of subgroups will enable more differentiated and tailored psychotherapeutic and pharmacological treatment strategies.
Fibromyalgia (FM) is continuing to be a challenging and confusing disorder for researchers and clinicians with its diverse symptoms, poorly understood etiology and pathophysiology. The use of multiple outcome variables reflecting the complexity of FM and co-morbid syndromes, makes it difficult to evaluate the efficacy or effectiveness of the treatment in clinical trials. Additionally researchers inevitably rely on patients' self-reported outcome data, which is prone to error and bias. In this paper, new researches in the field of FM and practical issues on methodology of pain assessment (visual analogue scales, paper or electronic diaries and compliance), core outcome domains in chronic pain assessment (IMMPACT recommendations), and advances in neuroimaging techniques like functional magnetic resonance imaging have been reviewed. Consequently, clinicians and researchers have various highly validated and adequate outcome domains to assess FM symptoms and new researches continue to add new valuable domains. Nevertheless the current problem is to conclude, which treatment works best for whom and which are the outcome domains suitable for FM patients or patients' subgroups with different prominent features. Standardised and appropriate core outcome domains for FM clinical trails will encourage more complete investigations, relevant outcome reporting and well-designed multicenter trials.