• Psychosomatic medicine · Jan 2005

    Comparative Study

    Abnormality in the self-monitoring mechanism in patients with fibromyalgia and somatoform pain disorder.

    • Matthias Karst, Niels Rahe-Meyer, Ayhan Gueduek, Ludwig Hoy, Mathias Borsutzky, and Torsten Passie.
    • Department of Anesthesiology, Pain Clinic, Hannover Medical School, D-30625 Hannover, Germany. karst.matthias@mh-hannover.de
    • Psychosom Med. 2005 Jan 1;67(1):111-5.

    BackgroundAuditory hallucinations and passivity experiences are associated with an abnormality in the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced sensations. It is unclear if chronic central pain disorders such as fibromyalgia and somatoform pain disorders also involve a defect of the self-monitoring mechanism.MethodsResponses to tactile stimulation were assessed in four groups of subjects (N = 40): patients with fibromyalgia, patients with somatoform pain disorder, patients with schizophrenia with auditory hallucinations and/or passivity experiences, and normal control subjects. The subjects were asked to rate the perception of a tactile sensation on their left and right hands. The tactile stimulation was either self-produced by movement of the subject's right or left hand or externally produced by the experimenter.ResultsNormal control subjects experienced self-produced stimuli as less intense than identical, externally produced tactile stimuli. In contrast, patients with fibromyalgia, patients with somatoform pain disorder, and patients with schizophrenia with auditory hallucinations and/or passivity experiences gave the same perceptual ratings for tactile stimuli produced by themselves as those produced by the experimenter (intergroup difference, p = .043; 95% confidence interval [CI], 0.16-0.68). Post hoc tests revealed that this significance was mainly caused by the fibromyalgia (p = .046; 95% CI, -1.66-0.13) and the somatoform pain disorder group (p = .033; 95% CI, -1.71-0.06).ConclusionsWe conclude that central pain disorders such as fibromyalgia and somatoform pain disorders interfere with the correct functioning of the self-monitoring mechanism that normally allows us to distinguish self-produced from externally produced tactile stimuli.

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