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Somatoforme Schmerzstörung, Fibromyalgie und chronisches Müdigkeitssyndrom aus psychosomatischer Sicht

Psychosomatic aspects of somatoform pain disorder, fibromyalgia and chronic fatigue syndrome

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Zusammenfassung

Forschungsergebnisse deuten bei somatoformer Schmerzstörung, Fibromyalgie und chronischem Müdigkeitssyndrom auf gemeinsame ätiopathogenetische Grundlagen hin. Replizierbare Befunde belegen ein Ungleichgewicht des autonomen Nervensystems mit erhöhtem Sympathikotonus, das früh im Leben der Betroffenen erfasst werden kann. Nachgewiesen wurden ferner eine Störung der zentralen Sensibilisierung als Grundlage von chronischen Schmerzen und die Evidenz, dass psychopathologische Störungen eine wichtige Rolle spielen, was eine vertiefte Analyse erfordert. Ätiopathogenetische Gemeinsamkeiten finden sich auch bei anderen somatoformen Störungen. Forschungsergebnisse zeigen zudem auf, dass die Wahrnehmung und Verarbeitung von Beschwerden und funktionellen Auswirkungen wesentlich durch das Persönlichkeitsmerkmal Neurotizismus geprägt werden. Die auf möglichst umfassenden Informationen basierende genaue Einzelfallanalyse ist hinsichtlich der Indikation für therapeutische Interventionen und Festlegung der Funktionsfähigkeit der Betroffenen zwingend. Bei den hier diskutierten gesundheitlichen Störungen bestehen phänomenologische Gemeinsamkeiten, die durch forschungsmäßig belegte gemeinsame pathophysiologische Mechanismen erklärt werden können. Aufgrund aller Erkenntnisse ergeben sich Hinweise auf mögliche relevante Beeinträchtigung der Funktionsfähigkeit der Individuen, die unter solchen gesundheitlichen Störungen leiden.

Abstract

Research has shown common etiopathogenetic mechanisms between somatoform pain disorder, fibromyalgia and chronic fatigue syndrome. Based on reproducible research results the following have been demonstrated: imbalance of the autonomic nervous system with enhanced tonus of the sympathetic nervous system that can be detected early in life, disorders of central sensitization as a basis for chronic pain and evidence that psychopathological disorders play an important role, which require detailed analysis. In addition, neuroticism as a personality trait considerably influences symptom perception and coping with complaints eventually leading to functional disability. Similar etiopathogenetic mechanisms may play an important role in other somatoform disorders. A detailed analysis of individual cases on the basis of the comprehensive information is mandatory with respect to therapeutic actions and assessment of functional ability. The phenomenological similarities between syndromes discussed here can be explained by common pathophysiological mechanisms. The research results indicate possible relevant interference with the functioning ability of individuals who suffer from such disorders.

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  1. Schulthess Klinik, Lengghalde 2, 8008, Zürich, Schweiz

    B. Radanov

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Radanov, B. Somatoforme Schmerzstörung, Fibromyalgie und chronisches Müdigkeitssyndrom aus psychosomatischer Sicht. Manuelle Medizin 54, 296–302 (2016). https://doi.org/10.1007/s00337-016-0175-y

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