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The Biopsychiatry of Fibromyalgia Syndrome: Part 2 of 3

Understanding the Neuropsychiatry of Fibromyalgia

Activity Expiration

Please note: This activity has expired.

Fibromyalgia (FM) is a chronic widespread pain syndrome often associated with fatigue, sleep disturbance, functional impairment, and psychiatric co-morbidity. An estimated 6 million people in the United States and 2% of the worldwide population are affected by FM. Chronic widespread pain is the defining feature of FM. Patients have an increased sensitivity to pressure pain throughout the body. Emerging evidence suggests that an increased response to painful stimuli and enhanced pain experience from normally non-noxious stimuli reflect enhanced CNS processing of painful stimuli, characteristic of central sensitization. Pain derives partly from a generalized decrease in the pain perception threshold, reflecting discrimination of a nociceptive quality from a non-nociceptive quality. Since FM is primarily a CNS disorder, psychiatrists play an important role in detection and management. It has been well-documented that negative emotions such as depression and anxiety, and other negative psychological factors (e.g., loss of control, unpredictability in one’s environment), and certain cognitive aspects (e.g., negative beliefs and attributions, catastrophizing) are associated with the onset and persistence of FM symptoms. Furthermore, exposure to physical, emotional, or environmental stressors may trigger the initiation of symptoms. The primary objective of this activity is to provide psychiatrists and other clinicians with the most up-to-date information regarding major components of fibromyalgia syndrome.

This is a 3-Part Series:
Click here for Part 1.
Click here for Part 3.

Target Audience:
Psychiatrists and psychiatric specialists who treat and manage patients with fibromyalgia syndrome and comorbid psychiatric illnesses

Learning Objectives:
1. Review the classification criteria recommended by ACR to confirm a diagnosis of FM
2. Describe the relationship between neurobiological factors and psychological, cognitive and behavioral factors in the onset of FM and the manifestation of patient symptoms
3. List the primary outcomes used to assess therapeutic efficacy (VAS-pain scores, pain threshold), psychological function (depression, anxiety), quality of life, fatigue, and sleep
4. Identify the classes of medications used to treat FM symptoms, including their associated benefits and risks
5. Explain the importance of a multidisciplinary approach to patient treatment and disease management

Lesley M. Arnold, MD (Chair)
Professor of Psychiatry
Director, Women’s Health Research Program
University of Cincinnati College of Medicine
Cincinnati, OH

Daniel J. Clauw, MD
Professor of Anesthesiology and Medicine (Rheumatology)
Associate Dean for Clinical and Translational Research
Director, Chronic Pain and Fatigue Research Center
Director, Michigan Institute for Clinical and Health Research
The University of Michigan
Ann Arbor, MI

Release date: February 2009
Expiration date: February 2010
Estimated time to complete activity: 45 minutes

This activity is supported by an educational grant from Pfizer.

Accreditation Statement:
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Independent Medical Education, LLC. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation:
Postgraduate Institute for Medicine designates this educational activity for a maximum of 0.75 AMA PRA Category 1 Credits