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Báo cáo y học: "Psychological stress and fibromyalgia: a review of the evidence suggesting a neuroendocrine link"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Psychological stress and fibromyalgia: a review of the evidence suggesting a neuroendocrine link. | Arthritis Research Therapy Vol 6 No 3 Gupta and Silman Review Psychological stress and fibromyalgia a review of the evidence suggesting a neuroendocrine link Anindya Gupta and Alan J Silman ARC Epidemiology Unit School of Epidemiology and Health Sciences Manchester UK Corresponding author Anindya Gupta e-mail anindya.gupta@man.ac.uk Received 23 Dec 2003 Revisions requested 27 Jan 2004 Revisions received 3 Mar 2004 Accepted 18 Mar 2004 Published 7 Apr 2004 Arthritis Res Ther 2004 6 98-106 DOI 10.1186 ar1176 2004 BioMed Central Ltd Abstract The present review attempts to reconcile the dichotomy that exists in the literature in relation to fibromyalgia in that it is considered either a somatic response to psychological stress or a distinct organically based syndrome. Specifically the hypothesis explored is that the link between chronic stress and the subsequent development of fibromyalgia can be explained by one or more abnormalities in neuroendocrine function. There are several such abnormalities recognised that both occur as a result of chronic stress and are observed in fibromyalgia. Whether such abnormalities have an aetiologic role remains uncertain but should be testable by well-designed prospective studies. Keywords fibromyalgia hormone neurotransmitter psychological stress Introduction Fibromyalgia is the second most common diagnosis made in rheumatology clinics 1 yet its aetiology remains a source of controversy. It has been suggested that fibromyalgia is a functional psychological disorder and that the symptoms of fibromyalgia are simply due to somatisation of distress 2 . In support of this construct there is definite evidence from population-based studies that psychological distress particularly early-life trauma such as parental loss and abuse can predict the future development of chronic widespread pain and fibromyalgia 3 4 . However such observations leave unanswered the question of exactly how psychological factors translate into chronic physical pain.