Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.

Authors: Yunus MB (1)
Affiliations:
(1) Section of Rheumatology, The University of Illinois College of Medicine
Source: Semin Arthritis Rheum. 2008 Jun;37(6):339-52
DOI: 10.1016/j.semarthrit.2007.09.003 Publication date: 2008 Jun E-Publication date: Jan. 14, 2008 Availability: abstract Copyright: © 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
Language: English Countries: Not specified Location: Not specified Correspondence address: M.B. Yunus, MD,
Department of Medicine, University of Illinois College of Medicine at Peoria, One Illini Drive, Peoria, IL 61605.
Email : yunus@uic.edu

Keywords

Article abstract

OBJECTIVES:

To discuss the current terminologies used for fibromyalgia syndrome (FMS) and related overlapping conditions, to examine if central sensitivity syndromes (CSS) is the appropriate nosology for these disorders, and to explore the issue of disease versus illness.

METHODS:

A literature search was performed through PubMed, Web of Science, and ScienceDirect using a number of keywords, eg, functional somatic syndromes, somatoform disorders, medically unexplained symptoms, organic and nonorganic, and diseases and illness. Relevant articles were then reviewed and representative ones cited.

RESULTS:

Terminologies currently used for CSS conditions predominantly represent a psychosocial construct and are inappropriate. On the other hand, CSS seems to be the logical nosology based on a biopsychosocial model. Such terms as "medically unexplained symptoms," "somatization," "somatization disorder," and "functional somatic syndromes" in the context of CSS should be abandoned. Given current scientific knowledge, the concept of disease-illness dualism has no rational basis and impedes proper patient-physician communication, resulting in poor patient care. The concept of CSS is likely to promote research, education, and proper patient management.

CONCLUSION:

CSS seems to be a useful paradigm and an appropriate terminology for FMS and related conditions. The disease-illness, as well as organic/non-organic dichotomy, should be rejected.

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