Fibrositis: A Biographical Study of Fifty Civilian and Military Cases, from the Rheumatic Unit, St. Stephen's Hospital (London County Council), and a Military Hospital

Ellman, Philip; Savage, Oswald; Wittkower, E. C.; Rodger, T. Ferguson

doi:10.1136/ard.3.1.56

Cited by 38 publications

(11 citation statements)

References 4 publications

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“…Because of the generally elevated MMPI profiles of patients with fibrositis, we inferred that the fibrositis patients were more psychologically disturbed than patients with rheumatoid arthritis; these observations support the frequent clinical observation of psychologic disturbance in fibrositis patients (8,13). Because of the marked differences in psychologic test scores between the patients with fibrositis and those with rheumatoid arthritis, another disease with painful and debilitating effects, we suggest that the observed differences cannot simply be part of the patient's psychologic reaction to pain.…”

Section: Discussionsupporting

confidence: 56%

Fibrositis and psychologic disturbance

Payne

Leavitt

Garron

et al. 1982

Arthritis & Rheumatism

151

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Thirty patients with fibrositis and 2 control groups, one of rheumatoid arthritis patients and the other of arthritis patients with other than rheumatoid arthritis, were compared on the basis of the Minnesota Multiphasic Personality Inventory (MMPI) to assess the role of psychologic factors in fibrositis. Patients with fibrositis differed in both elevation and variability in their MMPI profiles, indicating that they were more psychologically disturbed than patients with rheumatoid or other types of arthritis. The fact that almost all of the fibrositis patients' MMPI scales were higher suggests that we might be dealing with a number of different psychologic disturbances that have stiffness and musculoskeletal pain as principal and common symptoms.Fibrositis is a controversial clinical diagnosis that was first recorded in 1904. Although the term was originally introduced by Gower to describe a vague pain pattern associated with the "inflammation of fibrous tissue," it is now a misnomer because the disease does not involve any signs of inflammation or other histopathology. Today, fibrositis describes a clinical syndrome of diffuse musculoskeletal pain and tenderness especially over certain "trigger points" (1). Patients who have fibrositis show no objective signs of inflammation and have unrestricted motion of the joints. In addition, fibrositis is often associated with chronic fatigue and poor sleep ( 2 ) .For many physicians, fibrositis is not an organic syndrome; it is either not recognized as a diagnosis ( 3 ) or is used to indicate that psychologic disturbance underlies the physical complaints. Physicians with a more organic bias (4) are less disturbed by the absence of objective laboratory findings since many patients have disease without physical signs (5). These physicians use the classification of fibrositis to distinguish these false-negative patients from those with psychogenic rheumatism (5-7).The most relevant papers on psychologic disturbance in patients with fibrositis were published more than 3 decades ago. In one of the more frequently quoted studies from that era, 70% of patients diagnosed as having fibrositis actually suffered from psychologic disorders (8).The purpose of the present study was to reexamine this issue, using standardized personality tests to assess personality differences and psychologic disturbance in patients with fibrositis. To ensure that identifiable psychologic disturbance is not simply a result of the long suffering and disability associated with illness, control data were also gathered on rheumatoid arthritis patients and another group of patients who had rheumatic diseases and who also experienced chronic pain and disability.

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Section: Discussionsupporting

confidence: 56%

Fibrositis and psychologic disturbance

Payne

Leavitt

Garron

et al. 1982

Arthritis & Rheumatism

151

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show abstract

“…In the absence of inflammation or degeneration and an association with depression and stress, Boland and Corr [51] labeled the condition as "psychogenic rheumatism." A similar view also was held by Ellman et al [52].…”

Section: Discussionsupporting

confidence: 50%

“…Nodules were mentioned, but Graham [54] referenced a study by Copeman and Pugh [55], who observed 500 soldiers in whom frequency of nodules were equal among those with and without fibrositis, although tender nodules/trigger points were much more frequent in those with fibrositis (30%) than in those without it (3%). Referring to a paper by Ellman et al [52] in 1942, Graham [54] correctly described pain characteristics as burning, piercing, gnawing, excruciating, and nagging long before Leavitt et al [56] described such descriptors assessed by the 1975 McGill Pain Questionnaire in a study that used rheumatoid arthritis as a control group. However, the overall concept of fibrositis remained a jumble of acute, chronic, and multiple regional pain conditions of diverse etiology.…”

Section: Discussionmentioning

confidence: 97%

History of fibromyalgia: Past to present

İnanıcı

Yunus

2004

Current Science Inc

107

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Fibromyalgia syndrome (FMS) is now a recognized clinical entity causing chronic and disabling pain. For several centuries, muscle pains have been known as rheumatism and then as muscular rheumatism. The term fibrositis was coined by Gowers in 1904 and was not changed to fibromyalgia until 1976. Smythe laid the foundation of modern FMS in 1972 by describing widespread pain and tender points. The first sleep electroencephalogram study was performed in 1975. The first controlled clinical study with validation of known symptoms and tender points was published in 1981. This same study also proposed the first data-based criteria. The important concept that FMS and other similar conditions are interconnected was proposed in 1984. The first American College of Rheumatology criteria were published in 1990 and neurohormonal mechanisms with central sensitization were developed in the 1990s. Serotonergic/norepinephric drugs were first shown to be effective in 1986.

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“…The first psychological studies of FM consistently found that up to 70% of patients manifested significant miscellaneous psychological disturbances [21]. The basic findings of these early investigators have been replicated and have shown that patients with FM have higher scores on the MMPI, for example, than patients with other rheumatic disorders and normal controls [22,23].…”

Section: Fibromyalgia and General Psychological Disturbancementioning

confidence: 96%

The role of psychiatric disorders in fibromyalgia

McBeth

Silman

2001

Curr Rheumatol Rep

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The cardinal features of fibromyalgia are chronic widespread pain in the presence of widespread tenderness as measured by multiple tender points. Despite extensive investigations, the etiology of this syndrome remains unclear. Increased rates of psychiatric disorders, particularly depressive, anxiety, and somatoform disorders, are apparent in clinic populations. Epidemiologic evidence suggests that this is also true for community subjects. Depression, generalized psychological distress, and other psychological factors have been shown to be associated with the onset and persistence of fibromyalgia symptoms. However, the bodily processes through which such factors may lead to the onset of fibromyalgia are unclear. Recent investigations have demonstrated altered stress system responsiveness, most notably the hypothalamic-pituitary-adrenal stress axis, in patients with fibromyalgia. These findings, and one promising avenue for investigating the interaction between psychological and biological factors in the onset of chronic pain syndromes including fibromyalgia, are discussed.

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Fibrositis: A Biographical Study of Fifty Civilian and Military Cases, from the Rheumatic Unit, St. Stephen's Hospital (London County Council), and a Military Hospital

Cited by 38 publications

References 4 publications

Fibrositis and psychologic disturbance

Fibrositis and psychologic disturbance

History of fibromyalgia: Past to present

The role of psychiatric disorders in fibromyalgia

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