A “functional somatic symptom” is a symptom without an adequate medical explanation. When you have several of those linked together they called “functional somatic syndrome”. A group of symptoms without an adequate medical explanation – Sound familiar? It should. Because if you have Fibromyalgia or Chronic Fatigue Syndrome then that’s exactly what you have. This term also applies to IBS (something you also likely have if you live with Fibromyalgia or CFS). So you could end up with multiple functional somatic syndromes.
The source of these syndromes is currently assumed to be a combination of things including biology, psychology and social / environmental factors. In other words, they just don’t know, so it’s probably caused by a little bit of everything. You’ve got just the right genes mixed with just the right psychological chemicals, mixed with just the right actions and environment. You can’t fix the problem by fixing only one of those issues, you’ve got to tackle them all. This is why most of those you talk to who have had any luck treating their Fibromyalgia or CFS have done so by tackling it from every angle.
A recent study sought to tackle the issue of functional somatic syndromes (FSS) and their impact on life, comparing those who suffer from FSS (CFS, Fibromyalgia, IBS) to those who suffer from medical diagnoses with similar symptoms (MS, RA, IBD), as well as a control group. The study used questionnaires to compare
- Quality of Life
- Mental Component Summary (vitality, social function, role emotional,and mental health)
- Physical Component Summary (physical function, role physical, bodily pain, and general health)
- Work Participation
89,585 people provided information for the study. Participants with both an FSS and a medical diagnosis were excluded. The control group was made up of participants that reported neither an FSS or a medical diagnosis. 11% of those who provided information reported at least one FSS, and 2.7% reported at least 1 of the listed medical diagnoses.
Fibromyalgia patients were compared directly to patients with Rheumatoid Arthritis; CFS patients were compared to patients with MS; IBS patients were compared to patients with IBD. These comparisons were made based on symptom similarity. Overall Quality of Life scores were lower in each of the FSS groups than the medical diagnoses groups they were compared to; however, once the scores were adjusted for mood disorders the differences were not statistically significant.
Physical Component Summaries were statistically lower in those with FSS as compared to those with medical diagnoses (even when mood disorders were considered).
Overall:
- CFS patients reported lower mental component summaries than MS patients.
- Fibro pateints reported lower mental component summaries and physical component summaries than RA patients.
- There was no clinical difference between IBS patients and IBD patients.
- Fibromyalgia, RA, and IBD patients worked fewer hours on average than controls. CFS and IBS patients worked about the same hours as controls.
- Work participation was overall about the same between controls, FSS, and medical diagnosis patients.
- Fibromyalgia and medical diagnosis patients reported a higher number of sick days than other participants.
- After adjusting for mental disorders, IBS patients worked fewer hours/week than IBD patients and CFS patients reported fewer sick days than MS patients.
Not surprisingly, both FSS and medical diagnosis patients report lower Quality of Life than controls. What is in some ways surprising is that patients with FSS report a lower Quality of Life and in some cases lower work participation than patients with medical diagnoses.
Why do patients with #Fibro, CFS have lower quality of life than RA and MS? Share on XThis study doesn’t address why the differences may occur, but I have a few thoughts (as I’m sure you do).
1. Unlike medical diagnoses, CFS, Fibromyalgia, and IBS do not have clear treatments. Not having a clear treatment, as well as being diagnosed with something that not even understood by the medical community would likely lead to a higher rate of mood disorders and a lower quality of life.
2. If the diagnosis came with a clear treatment that actually improved the symptoms, quality of life would likely increase (as has been seen in those with medical diagnoses).
3. The lack of clear treatment options means the patient is more likely to feel sick more often, leading to more sick days, less social involvement, and more pain.
Is it possible that if our diagnoses were better understood, they would be better treated, and we would feel better overall? Yes. I think it is.
Related Posts:
- Can Mindfulness Based Stress Reduction Help Fibromyalgia?
- Why are Doctors Reluctant to Treat Fibromyalgia Patients
- The Patient’s Playbook for Chronic Illness
- 3 Steps to Choosing the Right Doctor
Reference:
Joustra, M. L., Janssens, K. A., Bültmann, U., & Rosmalen, J. G. (2015). Functional limitations in functional somatic syndromes and well-defined medical diseases. Results from the general population cohort LifeLines. Journal Of Psychosomatic Research, doi:10.1016/j.jpsychores.2015.05.004
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