Is fibromyalgia a psychosomatic disorder?

[KMiller]

I believe there is compelling evidence that fibromyalgia may be a psychosomatic disorder. Currently there is no scientific consensus as to a cause. It remains a medically unexplained syndrome that despite great efforts continues to elude us with regards to etiology.

The first-line treatments for fibromyalgia are psychiatric medications - tricyclic antidepressants and anticonvulsants. There are also two other psychiatric medications, Cymbalta, an SNRI, and Lyrica, an anticonvulsant. Neurontin (gabapentin) is a very common treatment, as is amitryptiline. All of these medications are neurologically active with no known effect in the rest of the body.

Many doctors are skeptical of the disorder entirely: because there is no known cause, it is difficult to diagnose the disorder. Diagnosis is done entirely on case history and current symptoms - symptoms which have no clear cause. In fact, one of the diagnostic criteria for fibromyalgia is that we don't know what is causing the pain. This in and of itself makes evidence-based practitioners skeptical of the validity of the diagnosis.

No genetic information can be obtained on the syndrome because we know of no physical causes, so we can't do trait analysis. For this reason it's virtually impossible to link the disorder to other disorders, as is being discussed in another thread.

There is no doubt that there exists an empirically validated syndrome referred to as fibromyalgia - I'm not questioning that. There is, however, some evidence that this disease is psychiatric in origin.

[sarey]

One word.
No.

I have M.E & like FM, there is no "specific" known cause, just speculations & ideas on what could be the cause, however, it is VERY real, & is NOT psychosomatic, as is FM, I find it extremely insulting and upsetting that people believe otherwise. There is evidence that both M.E & FM are medical illnesses, in fact, M.E can be life threatening. FM is very real & not psychosomatic.

If it is a condition without a cause, then it is not psychosomatic, as psychosomatic is a cause.

[KMiller]

My, what a well reasoned and thought out argument you have made there.

You will surely convince everyone.

[sarey]

Edited, happy now?

[KMiller]

Perhaps you should learn to read more carefully.

Originally Posted by KMiller

There is no doubt that there exists an empirically validated syndrome referred to as fibromyalgia - I'm not questioning that.

I think maybe you are confused as to what psychosomatic means?

Also, it's not a matter of there being no "specific" known cause, it's a matter of there being "absolutely no known cause at all period despite years of research." There are a whole mess of conflicting hypotheses, none of which have any real empirical support.




Edit: for the record, CFS actually even responds to cognitive behavioral therapy. Regarding it being life threatening, the mortality rate of CFS is not higher than the general population, and the deaths associated with it are typically suicides. It, too, is likely psychosomatic.

[sarey]

Well, I've said my part, I don't think it is psychosomatic, & people who have this dreadful, disabling medical illness will more than likely be very upset with people who believe it is, I know I was.

[KMiller]

You do not understand what "psychosomatic" means. Though to be fair, I'm giving you a lot of credit by asking if it's psychosomatic, because it may well be just a somatoform disorder. I'm conceding that real-life stressors might exacerbate real symptoms, instead of it being entirely psychological in nature, which it may well be.

[sarey]

You don't seem to be understanding my answer. I know what it means thank you very much, I've been told myself before my diagnosis, and continue to be told, that it is psychosomatic & it is in my head. It is not a psychiatric disorder, it is a medical disorder.

[KMiller]

"Psychosomatic" does not mean it is all in your head. Again, you do not understand what psychosomatic means.

But it's awfully ballsy to say it's a medical disorder and not psychiatric, when there is no known medical cause, and it only seems to respond to psychiatric treatment. Especially CFS, seeing as it actually responds well to cognitive behavioral therapy without any kind of medical intervention at all.

[sarey]

CBT works on the stress management and emotions, as stress makes M.E worse.
M.E is a medical condition, and it is life threatening, and there is scientific evidence that it is so.
A girl has died from M.E, and there is evidence of significant reduce in blood volume, and multiple things wrong in the system entirely.

[KMiller]

Originally Posted by sarey

CBT works on the stress management and emotions, as stress makes M.E worse.
M.E is a medical condition, and it is life threatening, and there is scientific evidence that it is so.

CBT causes actual symptom reduction in CFS, not just stress management.

CFS is a medically unexplained syndrome. There is scientific evidence that it is not life threatening, and most of the deaths associated with it are suicides or due to unrelated medical conditions.

There is no consensus on any kind of medical cause.

The only thing that there is any consensus on is that there are a cluster of symptoms that, when they occur without any known cause, comprise a syndrome which we call CFS. There's no evidence that there is a medical cause. There is also a lack of evidence showing discriminant validity from the purely psychological somatoform disorder.

[sarey]

Seriously, I'm not in the mood for someone like you. It has been proven to be a medical condition, & it has killed someone, & it can cause death & can be life threatening, It's a shame you're so ignorant but that's your choice. Have a nice day. Well, or not. =)

[KMiller]

Originally Posted by sarey

Seriously, I'm not in the mood for someone like you.

Someone who has reasoned a conclusion based on evidence?

Originally Posted by sarey

It has been proven to be a medical condition,

No it hasn't. Proven by whom? Cite a source.

Originally Posted by sarey

& it has killed someone,

Allegedly. Most of the associated deaths are suicides or unrelated. There are a few that are medically unexplained, but they can't be associated with the CFS. Cite a source.

Originally Posted by sarey

& it can cause death & can be life threatening,

So you've said. Where are you getting this information?

It's a shame you're so ignorant but that's your choice.

One of us appears to be ignorant, but it's not the guy who is actively researching this as we speak.

Originally Posted by sarey

Have a nice day. Well, or not. =)

It's past midnight, but hopefully I'll go to bed soon, I work in the morning. Thanks for your well wishes! I hope you're doing well too. =]

[sarey]

Okie dokie, here is my source;
http://www.hfme.org/methemedicalfacts.htm

I've researched this heavily as I have it thank you.

Go have a nice read & look around.

Byedebye now. Arrogance. Urgh. They say it's bliss, & it really isn't for those who are on the receiving end. Tut.

[KMiller]

I looked around. I noticed a distinct lack of proposed causes. There is a camp that believes the "epidemics" are caused by mass hysterias - something not entirely unheard of in the psychiatric community. I'm still poking around but this is a pretty one-sided website. It's hard to find websites that argue the other viewpoint, mainly because people with CFS are remarkably vocal about their desire for the disorder to have a physical cause. A lot of this website falls into the "epidemic" camp, which associates the condition with a "viral attack on the brain" but to date we have never found a "CFS virus." Are they proposing that any virus can cause CFS? I honestly don't know.

If we ever do find a real cause, my opinion on the matter will immediately reverse. So far, no dice, though I admit you've shown that there is some compelling research going on.

Which viral infection do you believe precipitated the onset your CFS?


At any rate we've gotten thoroughly off track here - we're supposed to be discussing fibromyalgia, something which you have failed to address entirely.