Abstract: Abnormality in the Self-monitoring Mechanism in Patients With Fibromyalgia and Somatoform Pain Disorder

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Psychosom Med. 2005 Jan-Feb;67(1):111-5.

Karst M, Rahe-Meyer N, Gueduek A, Hoy L, Borsutzky M, Passie T.

Hannover Medical School, Department of Anesthesiology, Pain Clinic, D-30625 Hannover, Germany. karst.matthias@mh-hannover.de.

Background: Auditory hallucinations and passivity experiences are associated with an abnormality in the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced sensations. It is unclear if chronic central pain disorders such as fibromyalgia and somatoform pain disorders also involve a defect of the self-monitoring mechanism.

Methods: Responses to tactile stimulation were assessed in four groups of subjects (N = 40): patients with fibromyalgia, patients with somatoform pain disorder, patients with schizophrenia with auditory hallucinations and/or passivity experiences, and normal control subjects. The subjects were asked to rate the perception of a tactile sensation on their left and right hands. The tactile stimulation was either self-produced by movement of the subject’s right or left hand or externally produced by the experimenter.

Results: Normal control subjects experienced self-produced stimuli as less intense than identical, externally produced tactile stimuli. In contrast, patients with fibromyalgia, patients with somatoform pain disorder, and patients with schizophrenia with auditory hallucinations and/or passivity experiences gave the same perceptual ratings for tactile stimuli produced by themselves as those produced by the experimenter (intergroup difference, p = .043; 95% confidence interval [CI], 0.16-0.68). Post hoc tests revealed that this significance was mainly caused by the fibromyalgia (p = .046; 95% CI, -1.66–0.13) and the somatoform pain disorder group (p = .033; 95% CI, -1.71–0.06).

Conclusions: We conclude that central pain disorders such as fibromyalgia and somatoform pain disorders interfere with the correct functioning of the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced tactile stimuli.

PMID: 15673632 [PubMed – in process]

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2 thoughts on “Abstract: Abnormality in the Self-monitoring Mechanism in Patients With Fibromyalgia and Somatoform Pain Disorder”

  1. MamaR says:

    I was DX with Fibromyalgia and Myofascial Pain Syndrome in the late 1980’s. I was younger then and managed to continue my life by pushing through the pain and symptoms that comes along with both with very little medication. I finally had to stop (very reluctantly) stop in 1999 due to so much pain and lack of concentration.

    I am now 56 yrs old and for the last three to five yrs I find myself in more pain and now have Osteoporosis and Osteoarthritis, along with so many internal problems (IBS, Interstitial Cystitis, digestive disorder), but I still can’t tolerate any strong medications. I am on Klonopin (1 mg@ bedtime), Flexeril (1mg @ bedtime), Flextra (twice a day as needed.)

    I find living a normal life impossible due to the pain, mental confusion, and fatigue. I am now at the point of almost being homebound due to being unable to function.

    I just returned from my family doctor that I have only seen tree times and he tells me that I am suffering from Somatoform Pain Disorder. I am sitting here trying to decide where to go from here. I am scheduled to see a new rheumatologist within two months. Do you have anything that can help enlighten me AS to where I should really start with this? I am so confused!

    Mari

  2. MamaR says:

    I was DX with Fibromyalgia and Myofascial Pain Syndrome in the late 1980’s. I was younger then and managed to continue my life by pushing through the pain and symptoms that comes along with both with very little medication. I finally had to stop (very reluctantly) working in 1999 due to so much pain and lack of concentration.

    I am now 56 yrs old and for the last three to five yrs I find myself in more pain and now have Osteoporosis and Osteoarthritis, along with so many internal problems (IBS, Interstitial Cystitis, digestive disorder), but I still can’t tolerate any strong medications. I am on Klonopin (1 mg@ bedtime), Flexeril (10mg @ bedtime), Flextra (twice a day as needed.)

    I find living a normal life impossible due to the pain, mental confusion, and fatigue. I am now at the point of almost being homebound due to being unable to function.

    I just returned from my family doctor that I have only seen tree times and he tells me that I am suffering from Somatoform Pain Disorder. I am sitting here trying to decide where to go from here. I am scheduled to see a new rheumatologist within two months. Do you have anything that can help enlighten me AS to where I should really start with this? I am so confused!

    Mari

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