The Journal of clinical psychiatry
-
Fibromyalgia is a common condition associated with abnormal central pain processing, chronic widespread musculoskeletal pain, tenderness at various points on the body, fatigue, and sleep abnormalities. Individuals with fibromyalgia often have comorbid anxiety, depression, and/or other pain syndromes. Multiple pharmacologic agents have demonstrated efficacy in alleviating some fibromyalgic symptoms, but pharmacology is only one piece of the puzzle in the successful management of fibromyalgia. Thorough medical and psychiatric evaluations are necessary after confirming a diagnosis of fibromyalgia, and a multidisciplinary treatment strategy including patient education, aerobic exercise, and cognitive-behavioral therapy as well as pharmacotherapy has been shown to be effective in alleviating fibromyalgic symptoms.
-
Chronic widespread pain is associated with several medical and psychiatric disorders including, but not limited to, chronic fatigue syndrome, fibromyalgia, mood disorders, hepatitis, endocrine disorders such as hypothyroidism, and rheumatologic disorders such as rheumatoid arthritis. Careful and comprehensive differential diagnosis must be performed to ensure a correct diagnosis before an appropriate treatment can be selected. Fibromyalgia, in particular, is challenging to diagnose and treat because it shares many characteristics with other disorders and is commonly concurrent with major mood disorders. A comprehensive disease management strategy including patient education, pharmacotherapy, cognitive-behavioral therapy, and aerobic and other forms of exercise can be beneficial for many patients with fibromyalgia.