Schritte zu einer symptombasierten Diagnose des Fibromyalgiesyndroms

Abstract

Following the exclusion of inflammatory rheumatoid, endocrinological and neurological diseases, a symptom-based clinical diagnosis of FMS can be based on of the key symptoms of chronic widespread musculoskeletal pain, as well as chronic fatigue.

Identification of symptom and functional domains that fibromyalgia patients would like to see improved: a cluster analysis

“…Nevertheless, given that the chosen clinical features stem from those documented as having a substantial negative impact on daily life, based on focus groups [22], the same selection of clinical features would likely be made if patients were simply asked about the most problematic clinical features they experience. Our findings document and quantify that pain is the most prominent clinical feature for FM patients, with fatigue being the next most problematic symptom; this confirms the findings of other studies [20,47,48]. …”

“…Our use of cluster analysis to identify clinical features clusters is in contrast to other studies which used the same technique to identify patient clusters [15-20]. While these two approaches can provide complementary information that can aid in our understanding of FM, clinical features clusters may provide a more clinically relevant approach since current management goals are clinical features-driven.…”

“…Cluster analysis has also been applied to FM in several studies [15-20]. While some of these studies categorized patients through the use of objective quantitative sensory testing [15] and psychophysiologic response patterns [18], others identified subgroups based on the presence and severity of physical and/or affective clinical features [16,19,20].…”

“…While some of these studies categorized patients through the use of objective quantitative sensory testing [15] and psychophysiologic response patterns [18], others identified subgroups based on the presence and severity of physical and/or affective clinical features [16,19,20]. In contrast to these studies, which have used cluster analysis to identify patient clusters (i.e., groups of patients with similar characteristics), we have attempted to identify clusters of clinical features that are meaningful to FM patients and correspond to their treatment priority goals in the context of desired improvement.…”

Effekte einer kognitiv-behavioralen Patientenschulung auf das Fibromyalgiesyndrom

“…Als Hauptsymptome werden Muskelund Gliederschmerzen in mehreren Kör-perregionen sowie Müdigkeit und nicht erholsamer Schlaf angegeben [5]. Häuser et al [9] erhoben mit dem Gießener Beschwerdebogen (GBB-24) und der deutschen Version der Regionalen Schmerzskala (Regional Pain Scale, RPS) die Symptome bei 665 Fibromyalgiesyndrompatienten. Dabei fielen Nacken-oder Schulterschmerzen, Gelenk-oder Gliederschmerzen, Kreuz-oder Rückenschmer-zen, rasche Erschöpfbarkeit und Müdig-keit im Vergleich zur allgemeinen Bevöl-kerung deutlich stärker aus.…”