a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy.
b Laboratory of Panic and Respiration , Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ) , Rio de Janeiro , RJ , Brazil.
Int Rev Psychiatry. 2017 Oct;29(5):473-488. doi: 10.1080/09540261.2017.1320982. Epub 2017 Jul 6.
Fibromyalgia (FM) is a central sensitization syndrome characterized by chronic widespread pain. FM is often comorbid with psychiatric disorders, as well as psychological distress that worsens the quality-of-life of people affected. The aim was to collect current evidence about the management of FM from a psychosomatic perspective. The literature was synthesized and summarized in a narrative format. The literature search was carried out in PubMed; review articles, meta-analysis, overview, and guidelines published in the last 10 years written in English were included. Five main topics (Diagnostic criteria of FM; Pathogenesis of chronic widespread pain in FM; Early stress and trauma as predisposing factors for central sensitization; FM and Psychiatric comorbidity; Implications for treatment) were pointed out and discussed. Much evidence underlies the importance of considering and treating the comorbidity of FM with psychiatric disorders and psychological factors that affect pain management. Validation of FM as a central sensitization syndrome by a clinician facilitates therapeutic strategies that involve patients as active participants in the pain management process, likely leading to improved outcomes.
纤维肌痛(FM)是一种以慢性广泛性疼痛为特征的中枢敏化综合征。FM 常与精神障碍以及心理困扰同时发生,这会降低患者的生活质量。本研究旨在从身心医学的角度收集 FM 管理的最新证据。通过叙述性格式对文献进行了综合和总结。文献检索在 PubMed 中进行;纳入了过去 10 年中发表的综述文章、荟萃分析、概述和指南,语言为英文。本文指出并讨论了五个主要主题(FM 的诊断标准;FM 中慢性广泛性疼痛的发病机制;早期压力和创伤作为中枢敏化的诱发因素;FM 和精神共病;对治疗的影响)。大量证据表明,考虑 FM 与精神障碍和影响疼痛管理的心理因素的共病,并对其进行治疗非常重要。临床医生将 FM 确认为中枢敏化综合征,有助于实施治疗策略,让患者作为疼痛管理过程中的积极参与者,这可能会带来更好的结果。