Concepts of illness in populations as applied to fibromyalgia (FM) syndromes: a biopsychosocial perspective

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Chronic widespread musculoskeletal pains have been recorded since

antiquity. However, critical medical and experimental research

on these conditions have been performed mainly within the past

one or two decades. Controversy exists regarding many aspects

of these common problems, including: classification and

nosology; causation mechanisms; course and outcomes, as well

as management strategies. Fibromyalgia syndrome (FMS) is not a

disease. Neither a defined pathology nor specific etiological

mechanisms have been documented. Instead, FMS may be

considered a dysfunctional disorder. Constellations of

typical, although diverse, manifestations have been identified

as well as predisposing factors. Under such circumstances, a

new biopsychosocial paradigm of person-centered dynamics,

rather than an agent per se or the environment, is fundamental

to understanding the complex multifactorial interactions in

FMS. Conceptual models of etiology and research methodology to

investigate such complex, multifactorial mechanisms are not

yet well-developed. More effective research approaches and

improved management of persons with FMS is expected to result

from such new conceptual constructs.

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