Fibromyalgie aus psychosomatischer Sicht^[*]

Zusammenfassung

In den letzten Jahren weisen immer mehr wissenschaftliche Studienergebnisse darauf hin, dass psychosozialen Stressoren eine zentrale pathogenetische Bedeutung bei der Fibromyalgie zukommt. Frühe Stresserfahrungen können Ausreifung und spätere Funktion des Stresssystems lebenslang erheblich beeinträchtigen. Vor diesem Hintergrund wird der gegenwärtige Forschungsstand zur Bedeutung von Stress für die Ätiopathogenese der Fibromyalgie zusammengefasst. Sowohl psychologische als auch psychobiologische Konsequenzen werden dargestellt. Schließlich wird ein integratives bio-psychosoziales Pathogenesemodell entwickelt, das eine Reihe von Mosaiksteinen zusammenzufügen sucht. Dieses bietet die Möglichkeit zur Differenzierung pathogenetischer Subgruppen sowie eine klinische Orientierungshilfe, um für den einzelnen Patienten eine gezieltere Therapieplanung vorzunehmen.

Summary

In the last years evidence is growing that biological as well as psychosocial stress play a pathogenetic key-role in the pathogenesis of fibromyalgia. Early adverse childhood experiences can impair the function of the stress system all over the lifespan. Actual research evidence for the role of stress in the etiopathogenesis of fibromyalgia is summarised. Psychological as well as psychobiological consequences are outlined. Finally, an integrative model of fibromyalgia is proposed, which may put several pieces of a biopsychosocial puzzle together. This model offers an approach for the differentiation of subgroups and a clinical orientation for developing an adequate therapy for the individual patient.

Schlüsselwörter

Fibromyalgie - frühe Stresserfahrung - Missbrauch

Keywords

Fibromyalgia - stress - childhood adversities - abuse

^* gekürzte Fassung eines Buchbeitrags für »Sexueller Missbrauch, Misshandlung, Vernachlässigung. Erkennung und Therapie der Folgen früher Stresserfahrungen«, herausgegeben von Egle UT, Hoffmann SO, Joraschky P.

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