The Evolution of Fibromyalgia, Its Concepts, and Criteria, 2021, Wolfe & Rasker

Abstract
Fibromyalgia developed in the 1950s from a substrate of difficult to explain regional and widespread pain mixed with symptoms of psychosocial distress. Controversies regarding psychological issues were common. Multiple criteria arose to define the disorder, but each identified a different set of patients.

The identification of widespread pain as a criterion changed the nature of the disorder by effectively eliminating regional pain as a component condition. The easy-to-measure and relatively reliable widespread pain criterion then came to define the disorder.

In the primary care community, diagnostic criteria were largely ignored, and a substantial fraction of diagnosed patients with lower pain scores, particularly women and those with high non-pain symptom scores, were diagnosed. Non-pain symptoms were added back to the fibromyalgia definition and criteria in 2010. Recognition grew that fibromyalgia fit the description of a functional somatic disorder.

The idea of fibromyalgia as a primary pain disorder with a neurobiological basis contended with fibromyalgia as a broader biopsychosocial disorder. It is increasingly recognized that fibromyalgia represents a dimensional, non-binary condition and that features of fibromyalgia extend to persons who do not satisfy the criteria. Severity assessments are now available but rarely used. The course of fibromyalgia is not well studied, and improvement and remission criteria have not been successfully defined.

The future of fibromyalgia as a discrete disorder remains uncertain as features of fibromyalgia are increasingly observed in patients with multiple different medical conditions.

Open access full text
https://www.cureus.com/articles/78424-the-evolution-of-fibromyalgia-its-concepts-and-criteria

 

The article states:

Highlighting that the distinction can be contentious, as an example, Fink et al. point out that, “… very active patient groups that aggressively spread misinformation on the social media. … [Can have] have some impact on research. The Institute of Medicine in the US report on CFS/ME avoids including any studies on psychological factors or treatment by stating that this is a medical condition and not a psychiatric one” [62].​

Reference 62 points to a paper by Fink from 2007, so this doesn't seem like where that comment on the IOM report came from. I also don't think that the IOM report excluded studies on psychological factors or treatments and suspect this is merely Fink's opinion.

 

Thought about posting the following comment:

Wolfe & Rasker quote Fink in the following way:

“very active patient groups that aggressively spread misinformation on the social media. … [Can have] have some impact on research. The Institute of Medicine in the US report on CFS/ME avoids including any studies on psychological factors or treatment by stating that this is a medical condition and not a psychiatric one.”​

This is a peculiar statement. The 2015 Institute of Medicine (IOM) report on ME/CFS conducted a comprehensive literature review as it was asked to define diagnostic criteria for the illness. One obvious explanation why the IOM report didn’t include studies on psychological treatments, is that it didn’t evaluate the treatment of ME/CFS, psychological or not. The quote by Fink, therefore, seems to misrepresent the scope and content of the IOM report on ME/CFS.

It is also unclear where this quote comes from. The reference provided points to a paper by Fink and colleagues published in 2007, several years before the IOM report was published so this must surely be an error.

 

Way to find out that pain is one of the most common medical symptom. Groundbreaking stuff right there. What progress we have made since the 1950's, truly a marvel.

 

Anything written by Frederick Wolfe is suspect, in my opinion. He has a long history of being against diagnosis of FM. His tone is quite anti-patient.