Fibromyalgia and Related Syndromes Characterised by Stress Intolerance and Pain Hypersensitivity: Do We Need a New Nosology?

Patients with functional somatic syndromes such as fibromyalgia (FM) and chronic fatigue syndrome (CFS) are frequently seen in primary care as well as in various medical specialties. Despite a controversy between ‘lumpers’ and ‘splitters’ regarding these syndromes, many authors assume that FM and CFS patients show more communalities than differences. Stress system dysfunctioning and associated abnormal pain processing seem to link these syndromes from a pathophysiological point of view. Consequently, we propose to rename FM and CFS as ‘stress intolerance and pain hypersensitivity (SIPH) syndromes’. Furthermore, we make a plea for developing specific treatment settings for SIPH patients. Finally, we outline future research perspectives on the interaction between life stress, personality/lifestyle factors, and stress system/pain processing disturbances in the aetio-pathogenesis of SIPH and other functional somatic syndromes.