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The role of life stress in fibromyalgia

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Abstract

This paper focuses on recent evidence of etiopathogenetic links between fibromyalgia and life stress. From an etiologic point of view, studies concerning the role of adverse life events, personality and lifestyle factors, post-traumatic stress, and negative childhood experiences are reviewed. From a pathogenetic point of view, neurobiologic links between stress and fibromyalgia symptoms, notably chronic pain and fatigue are highlighted. Finally, several method-ologic issues with regard to stress research on fibromyalgia, as well as the clinical relevance of the stress concept for fibromyalgia are discussed.

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References and Recommended Reading

  1. Yunus MB: The role of gender in fibromyalgia syndrome. Curr Rheumatol Rep 2001, 3:128–134.

    Article  PubMed  CAS  Google Scholar 

  2. Van Houdenhove B: Fibromyalgia: a challenge for modern medicine. Clin Rheumatol 2003, 22:1–5.

    Article  PubMed  Google Scholar 

  3. Bennett R: Fibromyalgia: present to future. Curr Pain Headache Rep 2004, 8:379–384. Well-informed and thoughtful update on essential aspects of fibro-myalgia, including a discussion on diagnostic controversies, mecha-nisms contributing to central senzitisation, the role of psychologic stressors, and genetic predispositon.

    PubMed  Google Scholar 

  4. Staud R, Cannon RC, Mauderli AP, et al.: Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain 2003, 102:87–95.

    Article  PubMed  Google Scholar 

  5. Van Houdenhove B, Egle U: Fibromyalgia: a stress disorder? Piecing the biopsychosocial puzzle together. Psychother Psychosom 2004, 73:267–275. The authors try to integrate different psychosocial and neurobiologic data about fibromyalgia by proposing a comprehensive biopsychosocial model that may be useful for clinical practice and future research.

    Article  PubMed  Google Scholar 

  6. Gold PW, Chrousos GP: Organisation of the stress system and its dysregulation in melancholic and atypical depression: high vs low CRH/NE states. Mol Psychiatry 2002, 7:254–275. Review with high didactic qualities on the functioning of the stress system and the mental/physical consequences of its hyper- and hypofunction.

    Article  PubMed  CAS  Google Scholar 

  7. Van Houdenhove B: Listening to CFS. Why we should pay more attention to the story of the patients. J Psychosom Res 2002, 52:495–499.

    Article  PubMed  Google Scholar 

  8. Williams DA, Brown SC, Clauw DJ, Gendreau RM: Self-reported symptoms before and after September 11 in patients with fibromyalgia. JAMA 2003, 289:1637–1638.

    Article  PubMed  Google Scholar 

  9. Raphael KG, Natelson BH, Janal MN, Nayak S: A community-based survey of fibromyalgia-like pain complaints follow-ing the World Trade Center terrorist attacks. Pain 2002, 100:131–139.

    Article  PubMed  Google Scholar 

  10. Heim C, Bierl C, Nisenbaum R, et al.: Regional prevalence of fatiguing illnesses in the United States before and after the terrorist attacks of September 11, 2001. Psychosom Med 2004, 66:672–678.

    Article  PubMed  Google Scholar 

  11. Poyhia R, Da Costa D, Fitzcharles MA: Previous experiences of women with fibromyalgia and inflammatory arthritis and non-painful controls. J Rheumatol 2001, 28:1888–1891.

    PubMed  CAS  Google Scholar 

  12. qVan Houdenhove B, Neerinckx E, Onghena P, et al.: Daily hassles reported by chronic fatigue syndrome and fibromyalgia syn-drome patients in tertiary care: a controlled quantitative and qualitative study. Psychother Psychosom 2002, 71:207–213.

    Article  PubMed  Google Scholar 

  13. Hatcher S, House A: Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study. Psychol Med 2003, 33:1185–1192.

    Article  PubMed  Google Scholar 

  14. Kivimäki M, Leino-Arjas P, Virtanen M, et al.: Work stress and incidence of newly diagnosed fibromyalgia. A prospective cohort study. J Psychosom Res 2004, 57:417–422. Impressive prospective investigation suggesting that various aspects of work stress may play an etiologic role in fibromyalgia.

    PubMed  Google Scholar 

  15. Wentz KAH, Lindberg C, Hallberg LRM: Psychological func-tioning in women with fibromyalgia: a grounded theory study. Health Care Women Int 2004, 25:702–729.

    Article  PubMed  Google Scholar 

  16. Van Houdenhove B, Neerinckx E, Onghena P, et al.: Premorbid "overactive" lifestyle in chronic fatigue syndrome and fibro-myalgia. An etiological factor or proof of good citizenschip? J Psychosom Res 2001, 51:571–576.

    Article  PubMed  Google Scholar 

  17. Cohen H, Neumann L, Haiman Y, et al.: Prevalence of post-traumatic stress disorder in fibromyalgia patients: overlap-ping syndromes or posttraumatic fibromyalgia syndrome?. Semin Arthritis Rheum 2002, 32:38–50.

    Article  PubMed  Google Scholar 

  18. Sherman JJ, Turk DC, Okifuji A: Prevalence and impact of posttraumatic stress disorder-like symptoms on patients with fibromyalgia syndrome. Clin J Pain 2000, 16:127–134.

    Article  PubMed  CAS  Google Scholar 

  19. Raphael KG, Janal MN, Nayak S: Comorbidity of fibromyalgia and posttraumatic stress disorder symptoms in a community sample of women. Pain Med 2004, 5:33–41.

    Article  PubMed  Google Scholar 

  20. Van Houdenhove B: Letter to the editor. Semin Arthritis Rheum 2003, 33:134–135.

    Article  PubMed  Google Scholar 

  21. Mc Lean S, Clauw DJ: Predicting chronic symptoms after an acute "stressor" — lessons learned from 3 medical conditions. Med Hypotheses 2004, 63:653–658.

    Article  Google Scholar 

  22. Zautra AJ, Fasman R, Reich JW, et al.: Fibromyalgia: evidence for deficits in positive affect regulation. Psychosom Med 2005, 67:147–155.

    Article  PubMed  Google Scholar 

  23. Sharp TJ, Harvey AG: Chronic pain and posttraumatic stress disorder: mutual maintainance? Clin Psychol Rev 2001, 21:857–877.

    Article  PubMed  CAS  Google Scholar 

  24. Roy-Byrne P, Smith WR, Goldberg J, et al.: Post-traumatic stress disorder among patients with chronic pain and chronic fatigue. Psychol Med 2004, 34:363–368.

    Article  PubMed  CAS  Google Scholar 

  25. Van Houdenhove B, Neerinckx E, Onghena P, et al.: Victimiza-tion in chronic fatigue syndrome and fibromyalgia in tertiary care: a controlled study on prevalence and characteristics. Psychosomatics 2001, 42:21–28. First controlled study confirming the high prevalence of childhood (and often lifelong) victimization in patients with the chronic wide-spread pain/fatigue symptom cluster.

    Article  PubMed  Google Scholar 

  26. Imbierowicz K, Egle UT: Childhood adversities in patients with fibromyalgia and somatoform pain disorder. Eur J Pain 2003, 7:113–119.

    Article  PubMed  Google Scholar 

  27. Nickel R, Egle UT: Coping with conflict as a pathogenetic link between psychosocial malversaties in childhood and psychic disorders in adulthood. Z Psychosom Med Psychother 2001, 47:332–347.

    Article  PubMed  CAS  Google Scholar 

  28. Raphael KG, Widom CS, Lange G: Childhood victimization and pain in adulthood: a prospective investigation. Pain 2001, 92:283–293.

    Article  PubMed  CAS  Google Scholar 

  29. Van Houdenhove B, Egle UT: Comment on Raphael et al. Pain 2002, 96:215–216.

    Article  PubMed  Google Scholar 

  30. Van Praag H: The debit balance of present day stress research. World J Biol Psychiatry 2004, 5:155–160.

    Article  PubMed  Google Scholar 

  31. Bolger N, Davis A, Rafaeli E: Diary methods: capturing life as it is lived. Annu Rev Psychol 2003, 54:579–616.

    Article  PubMed  Google Scholar 

  32. Feiler S, Müller KG, Müller A, et al.: Using interaction graphs for analysing the therapy process. Psychother Psychosom 2005, 74:93–99.

    Article  PubMed  CAS  Google Scholar 

  33. Cleare AJ: Stress and fibromyalgia — what is the link? J Psychosom Res 2004, 57:423–425. Interesting methodologic commentary on the Kivimäki et al. [14 ] study highlighting many methodologic pitfalls in the field of psycho-somatic medicine.

    Article  PubMed  Google Scholar 

  34. Zurowski M, Shapiro C: Stress, fibromyalgia, and sleep. J Psycho-som Res 2004, 57:415–416.

    Article  Google Scholar 

  35. Raphael KG, Chandler HK, Ciccone DS: Is childhood abuse a risk factor for chronic pain in adulthood? Curr Pain Headache Rep 2004, 8:99–110.

    PubMed  Google Scholar 

  36. Kendall-Tackett K, Becker-Blease K: The importance of retro-spective findings in child maltreatment research. Child Abuse Negl 2004, 28:723–727.

    Article  PubMed  Google Scholar 

  37. Hardt J, Rutter M: Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatr 2004, 45:260–273.

    Article  Google Scholar 

  38. Okifuji A, Turk DC: Stress and psychophysiological dysregula-tion in patients with fibromyalgia syndrome. Appl Psychophysiol Biofeedback 2002, 27:129–141.

    Article  PubMed  Google Scholar 

  39. Gupta A, Silman AJ: Psychological stress and fibromyalgia: a review of the evidence suggesting a neuroendocrinological link. Arthritis Res Ther 2004, 6:98–106.

    Article  PubMed  CAS  Google Scholar 

  40. Adler GK, Geenen R: Hypothalamic-pituitary-adrenal and autonomic nervous system functioning in fibromyalgia. Rheum Dis Clin N Am 2005, 31:187–202.

    Article  Google Scholar 

  41. Crofford LJ, Young EA, Engleberg C, et al.: Basal circadian and pulsatile ACTH and cortisol secretion in patients with fibro-myalgia and/or chronic fatigue syndrome. Brain Behav Immun 2004, 18:314–325.

    Article  PubMed  CAS  Google Scholar 

  42. Miller GE, Cohen S, Ritchey AK: Chronic psychological stress and regulation of pro-inflammatory cytokines: a glucocorti-coid resistance model. Health Psychol 2002, 21:531–541.

    Article  PubMed  Google Scholar 

  43. Clauw D, Chrousos GP: Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and poten-tial pathogenenic mechanisms. Neuroimmunomodulation 1997, 4:143–153. Paper with great heuristic value, arguing for an etiopathogenetic understanding of chronic widespread pain and fatigue based on stress system dysregulation.

    Google Scholar 

  44. Glass JM, Lyden AK, Petzke F, et al.: The effect of brief exercise cessation on pain, fatigue, and mood symptom development in healthy, fit individuals. J Psychosom Res 2004, 57:391–398. Very original study demonstrating that stress response hypoactivity may precede symptom development in fibromyalgia/CFS.

    PubMed  Google Scholar 

  45. Van Houdenhove B: Premorbid ’overactive’ lifestyle and stress-related pain / fatigue syndromes. J Psychosom Res 2005, In press.

  46. Cleare AJ: The neuroendocrinology of chronic fatigue syndrome. Endocrinol Rev 2003, 24:236–252.

    CAS  Google Scholar 

  47. Cleare AJ: The HPA axis and the genesis of chronic fatigue syndrome. Trends Endocrinol Metab 2004, 15:55–59.

    Article  PubMed  CAS  Google Scholar 

  48. Raison CL, Miller AH: When not enough is too much: the role of insufficient glucocorticoid signaling in the pathology of stress-related disorders. Am J Psychiatry 2003, 160:1554–1565. Comprehensive review of research data on the potential pathogenic effects of insufficient glucocorticoid bioavailibility or reduced gluco-corticoid receptor sensitivity on bodily function.

    Article  PubMed  Google Scholar 

  49. McEwen BS: Protective and damaging effects of stress mediators. New Engl J Med 1998, 338:171–179. Seminal paper proposing a new, heuristically very important neuro-biologic perspective on stress and stress-related disorders, including chronic pain and fatigue syndromes.

    Article  PubMed  CAS  Google Scholar 

  50. Eriksen HR, Ursin H: Subjective health complaints, sensitisa-tion, and sustained cognitive activation (stress). J Psychosom Res 2004, 56:445–448.

    Article  PubMed  CAS  Google Scholar 

  51. Watkins LR, Maier SF: Immune regulation of central nervous system functions: from sickness responses to pathological pain. J Intern Med 2005, 257:139–155. New perspectives on the role of (potentially stress-related) immune activation and cytokine production in pathologic pain and reduced cognition, as part of the sickness response.

    Article  PubMed  CAS  Google Scholar 

  52. Moffit TE, Caspi A, Rutter M: Strategy for investigating inter-actions between measured genes and measured environ-ments. Arch Gen Psychiatry 2005, 62:473–481.

    Article  Google Scholar 

  53. Southwick SM, Vythilingam M, Charney DS: The psychobiol-ogy of depression and resilience to stress: implications for prevention and treatment. Ann Rev Clin Psychol 2005, 1:255–291.

    Article  Google Scholar 

  54. Ledeboer A, Sloane EM, Milligan ED, et al.: Minocycline attenuates mechanical allodynia and proinfammatory cyto-kine expression in rat models of pain facilitation. Pain 2005, 115:71–83.

    Article  PubMed  CAS  Google Scholar 

  55. Crofford LJ, Rowbotham MC, Mease PJ, et al.: Pregabalin for the treatment of fibromyalgia syndrome: results of a ran-domized, double-blind, placebo-controlled trial. Arthritis Rheum 2005, 52:1264–1273.

    Article  PubMed  CAS  Google Scholar 

  56. Boisset-Pioro MH, Esdaile EM, Fitzcharles MA: Sexual and physical abuse in women with fibromyalgia syndrome. Arthritis Rheum 1995, 38:235–241.

    Article  PubMed  CAS  Google Scholar 

  57. Alexander RW, Bradley LA, Alarcon GS, et al.: Sexual and physical abuse in women with fibromyalgia: association with outpatient health care utilization and pain medication usage. Arthritis Care Res 1998, 11:102–105.

    Article  PubMed  CAS  Google Scholar 

  58. Taylor ML, Trotter DR, Csuka ME: The prevalence of sexual abuse in women with fibromyalgia. Arthritis Rheum 1995, 38:229–234.

    Article  PubMed  CAS  Google Scholar 

  59. Goldberg RT, Pachas WN, Keith D: Relationship between traumatic events in childhood and chronic pain. Disabil Rehabil 1999, 21:23–30.

    Article  PubMed  CAS  Google Scholar 

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Van Houdenhove, B., Egle, U. & Luyten, P. The role of life stress in fibromyalgia. Curr Rheumatol Rep 7, 365–370 (2005). https://doi.org/10.1007/s11926-005-0021-z

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