Psychiatric Aspects of Chronic Fatigue Syndrome and Fibromyalgia

  title={Psychiatric Aspects of Chronic Fatigue Syndrome and Fibromyalgia},
  author={Boudewijn van Houdenhove and Stefan Kempke and Patrick Luyten},
  journal={Current Psychiatry Reports},
Chronic fatigue syndrome and/or fibromyalgia (CFS/FM) consists of highly overlapping, medically unexplained symptoms, including long-lasting fatigue, effort intolerance, cognitive dysfunction, and widespread pain and tenderness. CFS/FM often seems to be triggered by infections and physical trauma, but depression, sleep disturbances, and personality may also be involved. Moreover, dysregulation of the stress system, the immune system, and central pain mechanisms may determine the pathophysiology… 

The interface between chronic fatigue syndrome and depression: A psychobiological and neurophysiological conundrum

Comorbid personality disorders in chronic fatigue syndrome patients: a marker of psychopathological severity.

According to these results, PDs may be frequent in CFS patients and this comorbidity is associated with a complex clinical profile, secondary to more severe psychiatric symptoms.

Immune Consequences of Early Life Stress: Relationship to Chronic Pain Syndromes

A clinician’s approach to the patient and choice of interventions may be dramatically altered when working with the understanding that a shared biological etiopathology can produce either a chronic pain syndrome or a psychiatric disorder or, perhaps more commonly, a presentation with features of both these conditions.

The Neuropsychiatric and Neuropsychological Features of Chronic Fatigue Syndrome: Revisiting the Enigma

A comprehensive and updated review of the key neuropsychiatric and neuropsychological complaints associated with chronic fatigue syndrome is provided in an effort to understand the significance of cognitive impairment in CFS.

The Role of Perfectionism in Chronic Fatigue Syndrome

A working model of chronic fatigue is presented suggesting that self-critical or maladaptive perfectionism is one of the key factors that may contribute to chronic stress and subsequent neurobiological alterations in at least a subgroup of CFS patients.

syndrome de fatigue chronique : une nouvelle maladie ? hronic fatigue syndrome : A new disorder ?

The new American concept of Systemic Disease Exertion Intolerance proposed in 2015 simplifies the diagnostic approach and breaks with the past and terminologies (CFS and myalgic encephalomyelitis) and is a strong signal to intensify the recognition and management of patients with CFS and stimulate research.

Potentially traumatic events, post-traumatic stress disorder and post-traumatic stress spectrum in patients with fibromyalgia.

It is shown that fibromyalgic patients with PTSD report more potentially traumatic events, avoidance symptoms, numbing, arousal, maladaptive coping and personality characteristics compared to patients with partial or without PTSD; these results could indicate that loss and/or trauma events represent a risk factor for the development of symptoms of FM in genetically predisposed individuals.

Self-critical perfectionism predicts lower cortisol response to experimental stress in patients with chronic fatigue syndrome.

It is suggested that self-critical perfectionism is associated with loss of resilience of the neurobiological stress response system in CFS.



Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors.

Further research should clarify the aim and outcome of different treatment strategies in CFS/FM, as well as the underlying mechanisms of change, including those facilitating neurobiological recovery.

Fibromyalgia and related syndromes characterised by stress intolerance and pain hypersensitivity: Do we need a new nosology?

This work proposes to rename FM and CFS as 'stress intolerance and pain hypersensitivity (SIPH) syndromes', and makes a plea for developing specific treatment settings for SIPH patients.

Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants

Chronic fatigue syndrome (CFS) is characterized by chronic, medically unexplained fatigue associated with effort- and stress-intolerance, widespread pain, and impairment in sleep and concentration.

Chronic fatigue syndrome: is there a role for non-antidepressant pharmacotherapy?

Pharmacotherapy can currently not be considered first-line treatment in CFS and should always be used in a context of self-management and rehabilitation, as well as the complex relationships between CFS, stress and depression.

Heart rate variability as a biomarker of fibromyalgia syndrome.

  • R. Staud
  • Medicine, Psychology
    Future rheumatology
  • 2008
Heart rate variability (HRV) analysis of FM patients can be used to assess ANS dysfunction, specifically related to sympathovagal balance, which has provided evidence for nonabating sympathetic hyperactivity in this chronic pain population.

A Comparison of Patients With Chronic Fatigue Syndrome in Two “Ideologically” Contrasting Clinics

It is concluded that CFS patients attending the 2 clinics could not be distinguished along dualistic biological/psychosocial lines, but those reporting sudden illness onset and making somatic attributions were more likely to be represented in the biologically-oriented clinic.

Stress, depression and fibromyalgia.

The hypothesis that chronic stress/depression may contribute to a dysregulation of neuro-endocrine, immune and central pain mechanisms in FM is put forward.

The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study

We have developed a conceptual framework and a set of research guidelines for use in studies of the chronic fatigue syndrome. The guidelines cover the clinical and laboratory evaluation of persons

A systematic review of chronic fatigue syndrome: don't assume it's depression.

Genetic, immunologic, infectious, metabolic, and neurologic etiologies were suggested to explain CFS and a biopsychosocial model was suggested for evaluating, managing, and differentiating CFS from depression.