Chronic Fatigue, Fibromyalgia, and Chemical Sensitivity: Overlapping Disorders

Ziem, Grace; Donnay, Albert

doi:10.1001/archinte.1995.00430170109016

Cited by 18 publications

(4 citation statements)

References 2 publications

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“…The lower prevalence of multiple chemical sensitivity (11%–24%) reported by fatigued twins probably reflects the difference between the frequency of a symptom (hypersensitivity) and a more well‐defined syndrome (multiple chemical sensitivity). Alternately, as some have argued, multiple chemical sensitivity may often be unrecognized by affected individuals or treating physicians leading to an underestimation of this disorder among fatigued individuals 30 …”

Section: Discussionmentioning

confidence: 99%

Comorbid Clinical Conditions in Chronic Fatigue. A Co-Twin Control Study

Aaron¹,

Herrell

Ashton³

et al. 2001

J Gen Intern Med

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OBJECTIVES: Chronically fatiguing illness, defined as fatigue for at least 6 months, has been associated with various physical health conditions. Our objective was to determine whether there is a significant relationship between chronically fatiguing illness and 10 clinical conditions that frequently appear to be associated with fatigue, adjusting for the potentially confounding effects of psychiatric illness. DESIGN: A co‐twin control study controlling for genetic and many environmental factors by comparing chronically fatigued twins with their nonfatigued co‐twins. SETTING: A nationally distributed volunteer twin registry. PARTICIPANTS: The study included 127 twin pairs in which one member of the pair experienced fatigue of at least 6 months' duration and the co‐twin was healthy and denied chronic fatigue. Fatigued twins were classified into 3 levels using increasingly stringent diagnostic criteria. MEASUREMENTS AND MAIN RESULTS: Twins reported on a history of fibromyalgia, irritable bowel syndrome, multiple chemical sensitivities, temporomandibular disorder, interstitial cystitis, postconcussion syndrome, tension headache, chronic low back pain, chronic pelvic pain (women), and chronic nonbacterial prostatitis (men). The prevalence of these comorbid clinical conditions was significantly higher in the fatigued twins compared to their nonfatigued co‐twins. Most notably, compared to their nonfatigued co‐twins, the chronically fatigued twins had higher rates of fibromyalgia (>70% vs <10%) and irritable bowel syndrome (>50% vs <5%). The strongest associations were observed between chronic fatigue and fibromyalgia (odds ratios >20), irritable bowel syndrome, chronic pelvic pain, multiple chemical sensitivities, and temporomandibular disorder (all with odds ratios ≥4). Regression analysis suggested that the number of comorbid clinical conditions associated with chronic fatigue could not be attributed solely to psychiatric illness. CONCLUSIONS: Chronically fatiguing illnesses were associated with high rates of many other clinical conditions. Thus, patients with chronic fatigue may present a complex clinical picture that poses diagnostic and management challenges. Nonetheless, clinicians should assess such patients for the presence of comorbid clinical conditions. Future research should provide a better understanding of the temporal relationship of the onset of fatigue and these conditions, and develop strategies for early intervention.

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Section: Discussionmentioning

confidence: 99%

Comorbid Clinical Conditions in Chronic Fatigue. A Co-Twin Control Study

Aaron¹,

Herrell

Ashton³

et al. 2001

J Gen Intern Med

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“…Simon found significantly lower guishable in as many as 67% of all cases (56). Given these problems, and the TAI/CD26 cell activation among MCS (45,61 (63) and in patients with chemical sensitivity (42,64,65). One of our patients developed new onset of Raynaud's phenomenon (a vasospastic disorder), which we observed to be triggered by doubleblinded finger contact with carbonless copy paper (the probable cause of her chemical sensitivity).…”

Section: Introductionmentioning

confidence: 78%

Profile of Patients with Chemical Injury and Sensitivity

Ziem¹,

McTamney²

1997

Environmental Health Perspectives

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“…Because of this, this review will focus on research in two related conditions that have well‐established definitions, fibromyalgia (FM) and chronic fatigue syndrome (CFS). Several studies have been performed establishing that considerable clinical overlap exists between MCS, FM, and CFS, in that approximately one‐half of the individuals who meet criteria for one of these conditions will also meet criteria for one or both of the others 7–11. In addition, many other systemic and regional syndromes fall within this spectrum.…”

Section: Introductionmentioning

confidence: 99%

Potential Mechanisms in Chemical Intolerance and Related Conditions

Clauw

2001

Annals of the New York Academy of Sciences

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The symptom of chemical intolerance may occur in isolation, but often occurs in conjunction with other chronic symptoms such as pain, fatigue, memory disturbances, etc. This frequent clustering of symptoms in individuals has led to the definition of several chronic multisymptom syndromes, such as multiple chemical sensitivity, fibromyalgia, chronic fatigue syndrome, and Gulf War illnesses. The aggregate research into these syndromes has suggested some unifying mechanisms that contribute to symptomatology. Multiple lines of evidence suggest that there is aberrant function of numerous efferent neural pathways, such as the autonomic nervous system and hypothalamic‐pituitary axes, in subsets of individuals with these conditions. There is perhaps the greatest evidence for abnormal sensory processing in these syndromes, with a low “unpleasantness threshold” for multiple types of sensory stimuli. Psychological and behavioral factors are known to play a significant role in initiating or perpetuating symptoms in some persons with these illnesses. In the field of pain research, the interrelationship between physiologic and psychologic factors in symptom expression has been well studied. Using both established and novel methodologies, studies have suggested that psychologic factors such as hypervigilance and expectancy are playing a relatively minor role in most individuals with fibromyalgia and that clear evidence exists of physiologic amplification of sensory stimuli. These studies need to be extended to more sensory tasks and to larger numbers of subjects with related conditions. It is of note, though, that existing data on this spectrum of illnesses would suggest that there may be greater psychologic contributions to symptomatology if an illness is defined in part by behavior (e.g., avoidance of chemical exposures) rather than on the basis of symptoms alone.

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Chronic Fatigue, Fibromyalgia, and Chemical Sensitivity: Overlapping Disorders

Cited by 18 publications

References 2 publications

Comorbid Clinical Conditions in Chronic Fatigue. A Co-Twin Control Study

Comorbid Clinical Conditions in Chronic Fatigue. A Co-Twin Control Study

Profile of Patients with Chemical Injury and Sensitivity

Potential Mechanisms in Chemical Intolerance and Related Conditions

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