by Muhammed B Yunus, MD
February 4, 2008
[Note: In previous articles, Dr. Yunus, a leading researcher specialized in the neuroendocrine aspects of FM and overlapping conditions, has described central sensitivity syndromes (CSS) as involving neuroendocrine aberrations including central nervous system sensitization.]
Objectives: To discuss the current terminologies used for fibromyalgia syndrome (FMS) and related overlapping conditions, to examine if central sensitivity syndromes (CSS) is the appropriate nosology [classification] for these disorders, and to explore the issue of disease versus illness.
Methods: A literature search was performed through PubMed, Web of Science, and ScienceDirect using a number of keywords, e.g., functional somatic syndromes, somatoform disorders, medically unexplained symptoms, organic and nonorganic, and diseases and illness. Relevant articles were then reviewed and representative ones cited.
Results:
n Terminologies currently used for central sensitivity syndrome (CSS) conditions predominantly represent a psychosocial construct and are inappropriate.
n On the other hand, CSS seems to be the logical nosology based on a biopsychosocial model.
n Such terms as "medically unexplained symptoms," "somatization," "somatization disorder," and "functional somatic syndromes" in the context of CSS should be abandoned.
n Given current scientific knowledge, the concept of disease-illness dualism has no rational basis and impedes proper patient-physician communication, resulting in poor patient care. The concept of CSS is likely to promote research, education, and proper patient management.
Conclusion: CSS seems to be a useful paradigm and an appropriate terminology for FMS and related conditions. The disease-illness, as well as organic/non-organic dichotomy, should be rejected.
Source: Seminars in Arthritis and Rheumatism. 2008 Jan 11 [E-pub ahead of print] PMID: 18191990, by Yunus MB. Professor of Medicine, Section of Rheumatology, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA.
|
