Beiner Eva, Hermes Michelle, Reichert Julian, Kleinke Kristian, Vock Stephanie, Löffler Annette, Ader Leonie, Sirazitdinov Andrei, Keil Sebastian, Schmidt Tim, Schick Anita, Löffler Martin, Hopp Michael, Ruckes Christian, Hesser Jürgen, Reininghaus Ulrich, Flor Herta, Eich Wolfgang, Friederich Hans-Christoph, Tesarz Jonas
Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany.
Department of Psychology, University of Siegen, Siegen, Germany.
Sci Rep. 2024 Dec 16;14(1):30471. doi: 10.1038/s41598-024-76635-z.
Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread musculoskeletal pain, fatigue and tenderness and closely associated with high levels of stress. FMS is therefore often considered a stress-related disease. A comparative study was conducted with 99 individuals diagnosed with FMS and a control group of 50 pain-free individuals. Stress indicators were classified into three categories: perceived stress assessed using the Perceived Stress Scale, and daily average salivary cortisol and hair cortisol concentrations as indicators of acute and chronic stress levels related to the hypothalamic-pituitary-adrenal axis. Analysis of variance and covariance were used to identify group differences and the influence of covariates age, sex, and body mass index. Correlational analyses further elucidated the relationship between stress indicators and clinical symptoms. Participants with FMS reported significantly higher perceived stress levels than controls (p < .001, η = 0.3), which were positively correlated with symptom burden (r = .41, p < .001). In contrast, there were no significant differences in the endocrinological stress indicators salivary and hair cortisol between the groups (p > .05), nor were these indicators associated with clinical symptoms. The study highlights the central role of perceived stress in FMS, whereas endocrinological indicators did not differentiate FMS from controls. This finding calls for a nuanced approach to clinical assessment and therapeutic interventions tailored to patients with FMS, emphasizing the management of perceived stressors.
纤维肌痛综合征（FMS）是一种慢性疾病，其特征为广泛的肌肉骨骼疼痛、疲劳和压痛，并与高水平的压力密切相关。因此，FMS常被认为是一种与压力相关的疾病。对99名被诊断为FMS的个体和50名无疼痛个体的对照组进行了一项比较研究。压力指标分为三类：使用感知压力量表评估的感知压力，以及作为与下丘脑-垂体-肾上腺轴相关的急性和慢性压力水平指标的每日平均唾液皮质醇和头发皮质醇浓度。使用方差分析和协方差分析来确定组间差异以及协变量年龄、性别和体重指数的影响。相关分析进一步阐明了压力指标与临床症状之间的关系。FMS患者报告的感知压力水平显著高于对照组（p <.001，η = 0.3），且与症状负担呈正相关（r =.41，p <.001）。相比之下，两组之间的内分泌压力指标唾液和头发皮质醇没有显著差异（p >.05），这些指标也与临床症状无关。该研究强调了感知压力在FMS中的核心作用，而内分泌指标并未区分FMS患者与对照组。这一发现呼吁对FMS患者的临床评估和治疗干预采取细致入微的方法，强调对感知压力源的管理。
