E. Neerinckx

Daily Hassles Reported by Chronic Fatigue Syndrome and Fibromyalgia Patients in Tertiary Care: A Controlled Quantitative and Qualitative Study

Background: This study aimed at providing insight in the frequency, emotional impact and nature of daily hassles, experienced by patients suffering from chronic fatigue syndrome (CFS) and/or fibromyalgia (FM), compared with patients with a chronic organic disease. Methods: One hundred and seventy-seven CFS/FM patients, 26 multiple sclerosis (MS) and 26 rheumatoid arthritis (RA) patients were investigated within 2–6 months after diagnosis. All patients completed a self-report questionnaire assessing daily hassles and associated distress, a visual analogue scale assessing fatigue and pain and a depression and anxiety questionnaire. Results: CFS/FM patients show a higher frequency of hassles, higher emotional impact and higher fatigue, pain, depression and anxiety levels compared with MS/RA patients. Three hassle themes dominate in the CFS/FM group: dissatisfaction with oneself, insecurity and a lack of social recognition. In contrast, hassles reported by MS/RA patients show a much larger diversity and are not focused on person-dependent problems. Conclusions: Patients recently diagnosed as suffering from CFS and/or FM are highly preoccupied and distressed by daily hassles that have a severe impact on their self-image, as well as their personal, social and professional functioning. An optimal therapeutic approach of CFS and FM should take account of this heavy psychosocial burden, which might refer to core themes of these patients’ illness experience.

What Happens to the Fibromyalgia Concept

Fibromyalgia (FM) has always been a controversial syndrome. In early discussions, researchers were divided into two camps, usually defined as believers and nonbelievers. Believers were those researchers who thought this syndrome was a particular disease entity resulting in a condition of significant disability; non-believers considered this syndrome to be a chimera of an (for one or another reason) interested coalition of patients and medical doctors. During the past years, the confrontations between these groups have regularly been quite heated. However, a new element seems to have entered the discussion. The tenacity of some researchers who developed the concept seems to have weakened. Meanwhile, hypotheses quickly change. This paper aims to describe the recent evolution by means of a review of the most recent literature (1995–1998).

Tender points or tender patients? The value of the psychiatric in-depth interview for assessing and understanding psychopathological aspects of fibromyalgia

SummaryAlthough the aetiology of fibromyalgia is still unexplained, evidence favouring the role of psychopathology is accumulating, at least in a subgroup of patients; however, the exact aetiological significance of psychopathology in this syndrome is difficult to assess. Various assessment strategies have both strengths and weaknesses. Two case reports are presented which illustrate the value of the psychiatric in-depth interview (including psychodynamic-biographical history taking) for assessing and understanding psychological/psychiatric aspects of fibromyalgia.

Het fibromyalgiesyndroom: een kritisch literatuuroverzicht

Internationale interesse voor fibromyalgie ontwikkelde zich vanuit een artikel van Smythe en Moldofsky in 1977 (65). Voor het eerst werd toen fibromyalgie – of fibrositis, zoals het toen werd genoemd – gedefinieerd als een klinisch syndroom in termen van een klacht, met name diffuse pijn, en een symptoom, namelijk multipele actieve gevoelige punten of zogenaamde “tender points”.