Zeitschrift für Rheumatologie
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Review Multicenter Study Clinical Trial
Primary fibromyalgia syndrome: a critical evaluation of recent criteria developments.
Although nonspecific musculoskeletal aching of nonarticular origin has been described in European literature since the 17th century under such names as muscular rheumatism, the fibrositis syndrome with generalized musculoskeletal aches or stiffness, fatigue, poor sleep, and multiple tender points as a characteristic rheumatologic entity was not described until the 1960s. Smythe first suggested criteria for this condition based on clinical experience in the 1970s. ⋯ Since then other criteria have been published, and in 1989 criteria studies on fibromyalgia with appropriate design and controls were reported. This article critically evaluates current criteria developments in fibromyalgia.
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Pain intensity and sensory dimensions of pain experience were studied in four samples totalling 346 patients with rheumatoid arthritis. 35%-61% of these patients suffer from severe pain. Arthritic pain is not automatically associated with emotional disorder. However, we met significant correlations of pain intensity with depression, trait anxiety, and state anxiety. ⋯ Within the greater part of the patients severe pain is accompanied by considerable emotional suffering. The question of whether pain intensity is the cause of or the result from depression cannot be answered. However, predicting pain intensity from depression scores is much easier than predicting depression from pain intensity.