One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders

Fink, Per; Schröder, Andreas

doi:10.1016/j.jpsychores.2010.02.004

Cited by 267 publications

(205 citation statements)

References 55 publications

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“…But it is not seen that way in the broader medical community and literature, where it is looked upon as a type of functional somatic syndrome. Danish investigators characterize fibromyalgia as a bodily distress syndrome, along with chronic fatigue syndrome, irritable bowel syndrome, and similar disorders, because they share a common set of symptoms (6). Somatic symptoms may be assessed with the Patient Health Questionnaire-15 (PHQ-15), a well-validated and widely used measure of somatic symptom severity (7).…”

mentioning

confidence: 99%

What Is Fibromyalgia, How Is It Diagnosed, and What Does It Really Mean?

Wolfe

Walitt

Haüser

2014

Arthritis Care & Research

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Prior to the 1970s and 1980s, fibromyalgia represented an amorphous set of symptoms and definitions-local, regional, or widespread pain with or without other symptoms, including, for some, the idea of "psychogenic rheumatism" (1). The American College of Rheumatology (ACR) 1990 criteria de facto established and redefined fibromyalgia to require the presence of widespread pain and multiple (Ն11) tender points (2). The 2 criteria items were measures of pain, and their diagnostic cutoff levels were determined by comparing patients with fibromyalgia to those without it. But who were the original patients with fibromyalgia and what were they like, this group that constituted the gold standard?We know now that they were chosen in part by individual physician tolerance of the presence and severity of somatic symptoms, and by the degree of patient distress. The subsequent idea that the 1990 criteria were just about pain was not correct: the criteria implied substantial, if unmeasured, symptomatic distress. In clinical practice after the 1990 criteria were adopted, it was symptoms that made the clinician think of fibromyalgia-and the tender point examination that sometimes followed.Tender points, the "semi-objective" physical finding, were elusive. Most physicians did not know how to carry out the tender point examination and generally skipped it. When performed, it was most often done incorrectly. The cervical tender points were almost impossible to assess correctly; body habitus and behavioral characters interfered with criteria-provided instructions, and no one really used (or understood) the recommended 4 kg of force. When physicians began the tender point examination, the patient's interview had already provided clues as to what the examination results might be. It is fair to say that the examination may have been influenced by physician beliefs as well as by the contributions of patients. The fibromyalgia examination provided an approximate estimate of tender points-easy at the extremes of tenderness, but much more uncertain in the important middle. Fibromyalgia diagnosis often depended on physician referral, behavioral and emotional characteristics of patients, and the skill, interest, and beliefs of the physicians. Different physicians could and often did come up with different results. In the absence of careful training, the easy assumption that the examination was reliable was usually an untested and dubious assumption.The 2010 ACR criteria approached the fibromyalgia identification problem differently (3). Using the 1990 ACR criteria as the gold standard, fibromyalgia criteria were constructed that excluded tender points, but included a count of pain locations and the physician's rating of the most discriminative symptoms. In these criteria, musculoskeletal pain accounted for about 50% of the criteria score, while the other 50% came from fatigue, sleep, cognitive problems, and an estimate of the overall degree of somatic symptom severity. The relative contributions were not fixed, and it was possible for patie...

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confidence: 99%

What Is Fibromyalgia, How Is It Diagnosed, and What Does It Really Mean?

Wolfe

Walitt

Haüser

2014

Arthritis Care & Research

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“…Several studies show that the 2 Besides IBS, other conditions subsumed under this label are food intolerance, CFS/ME, burnout, fibromyalgia (FM), somatoform disorder (SD), vertigo, hypochondria, whiplash and non-cardiac chest pain (NCCP). 3 The latest results from Fink's group showed an overlap of symptoms and symptom patterns among a huge sample of patients and resulted in the development of the term BDD which refers to symptom experiences, is aetiology-neutral, leaves out behavioural dimensions and does not reinforce a mind-body dualism (Fink and Schrøder 2010).…”

Section: Symptomatic Experiences In the Clinicmentioning

confidence: 99%

What is called symptom?

Eriksen

Risør

2013

Med Health Care and Philos

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“…Results showed that the complete overlap of these diagnostic categories was 95% (95% CI 93.1-96.0; kappa 0.86, p<0.001). [9] However, there are lots of studies indicating that existence of this overlap does not vary when only dominant symptoms of these single syndromes are taken into account as well. Aaron et al [10] exhibited that number of tender points within different segments of body which is one of the main diagnostic criteria for FMS according to the American College of Rheumatology (ACR) was reported not to change as a function of FMS, CFS and temporomandibular disorders.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore the ongoing diagnostic imprecision necessitates an urgent clarification and validation of whether these distinct symptom groups are indeed members of the same category of FSS. [8][9][10][11][12][13][14] Therefore, the aim of the present study is to illuminate whether two distinct phenomena, however characterized by chronic pain, namely FMS and FBSS can be evaluated under the unique title of FSS, regarding their familial, symptomatological and psy-chological features. With this purpose, these groups will be compared with one another and individuals with and without chronic medical illness, in terms of symptomatological constructs such as intensity, frequency, age of onset, duration, painful areas, fear of pain, and pain coping styles; familial constructs such as family history of chronic illness, psychopathology and pain; and psychological constructs such as pain coping styles, fear of pain, alexithymia, symptom interpretation, somatosensory amplification and depression.…”

Section: Introductionmentioning

confidence: 99%