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Central Sensitivity Syndromes: A New Paradigm and Group Nosology for Fibromyalgia and Overlapping Conditions, and the Related Issue of Disease versus Illness – Source: Seminars in Arthritis and Rheumatism, Jan 11, 2008

  [ 328 votes ]   [ 2 Comments ]
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.


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.

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Article Comments Post a Comment

Central Sensitivity Syndromes
Posted by: miastella
Feb 6, 2008
"Syndromes" while prehaps accurate still makes these illnesses seem un-concrete. I prefer "disorder" because at least it suggests that something solid is amiss.
Reply Reply

Posted by: Svette_Palme
Feb 14, 2008
Yes, I like it very much. I have been searching and researching my condition from this angle and it seems to fit what I am experiencing. "Sensory processing disorder" is another way I think of it ; adding the "Central" to the title may be helpfull, but I need a little more information as to what the "Central" part indicates. In medical terms, "central" indicates [Medline Dictionary]: a: "comprising the brain and spinal cord" b: "originating within the central nervous system : caused by factors originating in the central nervous system" c: "affecting or involving the trunk of the body and especially the abdomen" I have found that the BRAIN aspect is left out of research into Fibro type disorders, and the CNS and spinal cord [calcium channels, etc] are the focus , whereas I would like to see a title that indicates the brain as the key to the problem. For sure, terms implying involvement of a psychosocial disorder should be rejected - I have had enough of that misunderstanding!!
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