The fibromyalgia (FM) syndrome as a manifestation of neuroticism?

After elucidating the components and theory of neuroticism (N)

as well as of psychosomatic complaints and their relationships

to personality dimensions and to psychosomatic diseases,

comparisons are performed between patients suffering from

fibromyalgia syndrome (FMS) or related pain diseases with

healthy subjects scoring high on personality dimensions

related to neuroticism. FMS and pain patients score high on

depression, anxiety, and experience of stress although

questionnaire scores on depression are higher in subjects not

exhibiting somatic features of the disease. High subjective

pain sensitivity and low thresholds for pain perception are

also common features in high N subjects and FMS patients. On

the endocrinological level cortisol responses to challenge

tests with CRH as well as prolactin responses to TRH are

higher in FMS patients than in high N healthy subjects

indicating an endocrinological difference. A common feature,

however, is the lack of adapatability in the two groups, since

neurotics are in particular characterized by a low capacity to

shift their behavior from one state to the other

(waking-sleeping, working-relaxing), to re-adapt to baseline

levels after endocrinological or physiological stress

responses, or to adjust to conditions of shift work. This is

reflected by chronobiological disturbances in FMS patients and

could also explain their maintainance of pain perception,

because they are incapable of correcting conditioned

pain-producing muscle tension.

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