Zusammenfassung
Das zunehmend bessere Verständnis des Phänomens Schmerz ist mit der Entwicklung zahlreicher
neuer medizinisch-somatischer sowie verhaltensmedizinischer Interventionen einhergegangen.
Die vorliegende Arbeit gibt einen Überblick über aktuelle ätiopathogenetische Erkenntnisse
des Fibromyalgie-Syndroms, die auf der Basis des „Dynamischen Prozessmodells der Fibromyalgie”
im Zusammenhang betrachtet werden. Neben zentralnervösen, autonomen und endokrinen
Einflussfaktoren auf die Ätiopathogenese der Fibromyalgie wird die Rolle von operanten
und kognitiven Lernprozessen bei der Aufrechterhaltung und Verstärkung der Erkrankung
aufgezeigt. Im 2. Teil der Arbeit werden verschiedene standardisierte psychologische
Therapieformen der Rheumatologie, wie Patientenschulung, Biofeedback, operant- und
kognitiv-verhaltenstherapeutische Schmerztherapie, vorgestellt. Erste Studien zu Indikationskriterien
der verschiedenen psychologischen Schmerztherapien weisen auf die Individualisierung
verhaltensmedizinischer Behandlungsstrategien hin. Metaanalysen weisen die Rolle und
die Bedeutsamkeit der psychologischen Schmerztherapie innerhalb eines interdisziplinären
Therapieansatzes nach und fordern einen stärkeren Einsatz dieser hocheffektiven psychologischen
Therapiemethoden in der rheumatologischen Langzeitbehandlung.
Abstract
Chronic pain is a complex perceptual construct that includes psychosocial and behavioral
as well as physiological parameters. The present article reviews the current understanding
of etiology and pathogenesis of the specific chronic pain syndrome of fibromyalgia.
An integrated dynamic processing model of the fibromyalgia syndrome (FMS) is described
incorporating its current understanding. The model integrates neurobiological factors
with the role of operant and cognitive behavioral learning principles. The dynamic
process model provides a heuristic explanation for the maintenance and reinforcement
of the symptoms and disability associated with FMS. The application and utility of
patient education, biofeedback, operant- and cognitive behavioral pain treatment are
described. Evidence that describes the potential of matching specific treatments to
patient characteristics is discussed. The results of meta-analyses demonstrate the
role and the relevance of the psychological pain treatment of FMS sufferers and suggest
interdisciplinary treatments that incorporate psychological treatments with information
and physical exercise are more effective than medical treatments alone.
Schlüsselwörter
Fibromyalgie - Schmerztherapie - Verhaltensmedizin
Key words
Fibromyalgia - pain therapy - behavioral therapy
Literatur
- 1
Ader R, Cohen N, Felten D.
Psychoneuroimmunology: interactions between the nervous system and the immune system.
Lancet.
1995;
345
99-103
- 2
Arnold L M, Keck P E Jr, Welge J A.
Antidepressant treatment of fibromyalgia. A meta-analysis and review.
Psychosomatics.
2000;
41
104-113
- 3
Arntz A, Dressen L, Merckelbach H.
Attention, not anxiety, influences pain.
Behavior Research and Therapy.
1991;
29
41-50
- 4 Astin J A, Meeker B, Bernhard G. et al .Use of complementary and alternative medicine
among rheumatology patients: result of a national survey. Proceedings of the 127th
Annual Meeting of the American Public Health Association Chicago, IL; 1999
- 5
Bandura A, O’Leary A, Barr T aylor C. et al .
Perceived self-efficacy and pain control: opioid and nonopioid mechanisms.
Journal of Personality and Social Psychology.
1987;
53
563-571
- 6
Bennett R M, Clark S R, Campell S M. et al .
Low levels of somatomedin C in patients with the fibromyalgia syndrome. A possible
link between sleep and muscle pain.
Arthritis & Rheumatism.
1992;
35
1113-1116
- 7
Bennett R M, Clark S R, Walzyk J.
A randomized, double-blind, placebo-controlled study of growth hormone in the treatment
of fibromyalgia.
American Journal of Medicine.
1998;
104
227-231
- 8
Born J, Brauninger W, Fehm-Wolfsdorf G. et al .
Dose-dependent influences on electrophysiological signs of attention in humans after
neuropeptide ACTH 4 - 10.
Exp Brain Res.
1987;
67
85-92
- 9
Born J, Fehm-Wolfsdorf G, Voigt K H. et al .
Cortisol effects on attentional processes in man as indicated by event-related potentials.
Physiol Behav.
1987;
39
83-87
- 10
Born J, Muth S, Fehm H L.
The significance of sleep onset and slow wave sleep for nocturnal release of growth
hormone (GH) and cortisol.
Psychoneuroendocrinology.
1988;
13
233-243
- 11
Bradley L A, McKendree-Smith N L, Alberts K R. et al .
Use of neuroimaging to understand abnormal pain sensitivity in fibromyalgia.
Curr Rheumatol Rep,.
2000;
2
141-8
- 12
Brown G K, Nicassio P M.
Development of a questionnaire for the assessment of active and passive coping strategies
in chronic pain patients.
Pain.
1987;
31
53-64
- 13
Burckhardt C S, Clark S R, O’Reilly C A. et al .
Pain-coping strategies of women with fibromyalgia: relationship to pain, fatigue,
and quality of life.
Journal of Musculoskeletal Pain.
1997;
5
5-21
- 14
Catley D, Kaell A T, Kirschbaum C. et al .
A naturalistic evaluation of cortisol secretion in persons with fibromyalgia and rheumatoid
arthritis.
Arthritis care and research.
2000;
13
51-61
- 15
Council J R, Ahern D K, Follick M J. et al .
Expectancies and functional impairment in chronic low back pain.
Pain.
1988;
33
323-340
- 16
Crisson J E, Keefe F J.
The relationship of locus of control to pain coping strategies and psychological distress
in chronic pain patients.
Pain.
1988;
35
147-154
- 17
Crofford L J.
The Hypothalamic-Pituitary-Adrenal Stress-Axis in the Fibromyalgia-syndrome.
J Musculoskelet Pain.
1996;
4
181-200
- 18
Crofford L J, Demitrack M A.
Evidence that abnormalities of central neurohormonal systems are key to understanding
fibromyalgia and chronic fatigue syndrome.
Rheum-Dis-Clin-North-Am.
1996;
22
267-284
- 19
Demjen S, Bakal D A.
Subjective distress accompanying headache attacks: Evidence for a cognitive shift.
Pain.
1986;
25
194-197
- 20
Demjen S, Bakal D A, Dunn B E.
Cognitive correlates of headache intensity and duration.
Headache.
1990;
30
423-427
- 21
Dolce J J, Doleys D M, Raczynski J M. et al .
The role of self-efficacy expectancies in the prediction of pain tolerance.
Pain.
1986;
27
261-272
- 22
Dolce J J.
Self-efficacy and disability beliefs in behavioral treatment of pain.
Behav Res Ther.
1987;
25
289-299
- 23
Ehlebracht-Konig I.
Qualitätsmanagement in der rheumatologischen Rehabilitation in einer Zeit der strukturellen
Veränderungen.
Z Rheumatol.
1998;
57
420-423
- 24
Eisenberg D M, Davis R B, Ettner S L. et al .
Trends in alternative medicine use in the United States, 1990 - 1997: Results of a
follow-up national survey.
JAMA.
1998;
280
1569-1575
- 25
Elam M, Johansson G, Wallin B G.
Do patients with primary fibromyalgia have an altered muscle sympathetic nerve activity?.
Pain.
1992;
48
371-375
- 26
Fehm-Wolfsdorf G, Born J.
Behavioral effects of neurohypophyseal peptides in healthy volunteers: 10 years of
research.
Peptides.
1991;
12
1399-1406
- 27
Fehm-Wolfsdorf G, Nagel D.
Differential effects of glucocorticoids on human auditory perception.
Biol Psychol.
1996;
5 (42)
117-130
- 28
Fehm-Wolfsdorf G, Scheible E, Zenz H. et al .
Taste thresholds in man are differentially influenced by hydrocortisone and dexamethasone.
Psychoneuroendocrinol.
1989;
14
433-440
- 29
Fehm-Wolfsdorf G, Soherr U, Arndt R. et al .
Auditory reflex thresholds elevated by stress-induced cortisol secretion.
Psychoneuroendocrinol.
1993;
18
579-589
- 30
Fernandez E, Turk D C.
The utility of cognitive coping strategies for altering pain perception: A meta-analysis.
Pain.
1989;
38
123-135
- 31
Flor H, Behle D J, Birbaumer N.
Assessment of pain-related cognitions in chronic pain patients.
Beh Res Ther.
1993;
31
63-73
- 32 Flor H, Birbaumer N. Psychobiologie und interdisziplinäre Therapie chronischer
Wirbelsäulensyndrome. München; GSF, Forschungszentrum 1994: 22-45
- 33
Flor H, Birbaumer N.
Comparison of the efficacy of the electromyographic biofeedback, cognitive-behavioral
therapy, and conservative medical interventions in the treatment of chronic musculosceletal
pain.
J Consult Clin Psychol.
1993;
61
653-658
- 34
Flor H, Breitenstein C, Birbaumer N. et al .
A psychophysiological analysis of spouse solitousness towards pain behaviors, spouse
interaction and pain perception.
Behav Therapy.
1995;
26
255-272
- 35
Flor H, Fydrich T, Turk D C.
Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.
Pain.
1992;
21
195-202
- 36
Flor H, Kerns R D, Turk D C.
The role of spouse reinforcement, perceived pain, and activity levels of chronic pain
patients.
J Psychosom Res.
1987;
31
251-259
- 37
Flor H, Knost B, Birbaumer N.
The role of operant conditioning in chronic pain: an experimental investigation.
Pain.
2002;
95
111-118
- 38
Flor H, Turk D C.
Rheumatoid arthritis and back pain: predicting pain and disability from cognitive
variables.
J Behav Med.
1988;
11
251-265
- 39
Fordyce W E, Roberts A H, Sternbach R A.
The behavioral management of chronic pain: A response to critics.
Pain.
1985;
2
113-125
- 40 Fordyce W E. Behavioral methods in chronic pain and illness. St. Louis; Mosby 1976:
22-32
- 41
Fordyce W E.
Pain and Suffering.
Am Psychol.
1988;
43
276-283
- 42
Fordyce W E, Lansky D, Calsyn D A. et al .
Pain measurement and pain behavior.
Pain.
1984;
18
53-69
- 43
Gotzsche P C.
Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroidal
antiinflammatory drugs in rheumatoid arthritis.
Control Clinical Trials.
1989;
10
31-56
- 44
Gracely R H, Petzke F, Wolf J M. et al .
Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia.
Arthritis Rheum.
2002;
46
1333-1343
- 45
Graven-Nielsen T, Arendt-Nielsen L, Svensson P. et al .
Quantification of local and referred muscle pain in humans after sequential i. m.
injections of hypertonic saline.
Pain.
1997;
69
111-117
- 46
Griep E N, Boersma J W, de-Kloet E P.
Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome.
J Rheumatol.
1994;
21
2125-2130
- 47
Griep E N, Boersma J W, Lentjes E G. et al .
Function of the hypothalamic-pituitary-adrenal axis in patients with fibromyalgia
and low back pain.
J Rheumatol.
1998;
25
1374-1381
- 48
Heim C, Ehlert U, Hellhammer D H.
The potential role of hypocorticolism in the pathophysiology of stress-related bodily
disorders.
Psychoneuroendokrin.
2000;
25
1-35
- 49
Holsboer F, Grasser A, Friess E. et al .
Steroid effects on central neurons and implications for psychiatric and neurological
disorders.
Ann N Y Acad Sci.
1994;
746
345-359
- 50
Hrycaj P, Stratz T, Muller W.
Platelet 3H-imipramine uptake receptor density and serum serotonin levels in patients
with fibromyalgia/fibrositis syndrome.
J Rheumatol.
1993;
20
1986-1988
- 51
Jacobson N S, Follette W C, Revenstorf D.
Psychotherapy outcome research: methods for reporting variability and evaluating clinical
significance.
Behav Ther.
1984;
15
336-352
- 52
Jensen M P, Karoly P.
Control beliefs, coping efforts, and adjustment to chronic pain.
J Consult Clin Psychol.
1991;
59
431-438
- 53
Kaye R L, Hammond A H.
Understanding rheumatoid arthritis. Evaluation of a patient education program.
JAMA.
1978;
239
2466-2467
- 54
Kosek E, Ekholm J, Hansson P.
Sensory dysfunction in fibromyalgia patients with implications for pathogenetic mechanisms.
Pain.
1996;
68
375-383
- 55
Labus J S, Keefe F J, Jensen M P.
Self-reports of pain intensity and direct observations of pain behavior: when are
they correlated?.
Pain.
2003;
102
109-124
- 56
Lackner J M, Carosella A M, Feuerstein M.
Pain expectancies, pain and functioning self-efficacy expectancies as determinants
of disability in patients with chronic low back disorders.
Journal of Consulting and Clinical Psychology.
1996;
64
212-220
- 57
Langer H E.
Patientenschulung - ein Beitrag zur Verbesserung der Langzeitbehandlung der Patienten
mit Rheumatismus.
Z Rheumatol.
1995;
54
207-212
- 58
Langer H E, Birth U.
Patientenschulung bei chronischer Polyarthritis. 2. Organisation und Curriculum des
Patientenseminars fuer chronische Polyarthritis.
Z Rheumatol.
1987;
46
333-338
- 59
Langer H E, Birth U.
Patientenschulung bei chronischer Polyarthritis. 3. Ergebnisse einer prospektiven,
kontrollierten Effektivitätsstudie und Nebenwirkungen des Patientenseminars für Polyarthritispatienten.
Z Rheumatol.
1988;
47
43-51
- 60
Langer H E, Ehlebracht-Konig I, Mattussek S.
Qualitätssicherung in der rheumatologischen Patientenschulung.
Z Arztl Fortbild Qualitätssich.
2003;
97
357-363
- 61
Lindroth Y, Bauman A, Barnes C. et al .
A controlled evaluation of arthritis education.
Br J Rheumatol.
1989;
28
7-12
- 62
Linton S J.
Behavioral remediation of chronic pain: A status report.
Pain.
1986;
24
125-141
- 63
Litt M D.
Self-efficacy and perceived control: Cognitive mediators of pain tolerance.
Journal of Personality and Social Psychology.
1988;
54
149-160
- 64
Lorenz J, Grasedyck K, Bromm B.
Middle and long latency somatosensory evoked potentials after painful laser simulation
in patients with fibromyalgia syndrome.
Electroencephalogr Clin Neurophysiol.
1996;
100
165-168
- 65
Lorenz J.
Hyperalgesia or hypervigilance? An evoked potential approach to the study of fibromyalgia
syndrome.
Z Rheumatol.
1998;
57
19-22
- 66
Lorig K R.
Arthritis self-management: a patient education program.
Rehabil Nurs.
1982;
7
16-20
- 67
Lorig K, Holman H R.
Long-term outcomes of an arthritis self-management study: effects of reinforcement
efforts.
Soc Sci Med.
1989;
29
221-224
- 68
Lorig K R, Holman H.
Self-management education: history, definition, outcomes, and mechanisms.
Ann Behav Med.
2003;
26
1-7
- 69
Lorig K, Konkol L, Gonzalez V.
Arthritis patient education: a review of the literature.
Patient Educ Couns.
1987;
10
207-252
- 70
Lorig K R, Laurent D D, Deyo R A. et al .
Can a Back Pain E-mail Discussion Group improve health status and lower health care
costs? A randomized study.
Arch Intern Med.
2002;
162
792-796
- 71
Lorig K R, Mazonson P D, Holman H R.
Evidence suggesting that health education for self-management in patients with chronic
arthritis has sustained health benefits while reducing health care costs.
Arthritis Rheum.
1993;
36
439-446
- 72
Lorig K, Seleznick M, Lubeck D. et al .
The beneficial outcomes of the arthritis self-management course are not adequately
explained by behavior change.
Arthritis Rheum.
1989;
32
91-95
- 73
Lorish C D, Boutaugh M L.
Patient education in rheumatology.
Curr Opin Rheumatol.
1997;
9
106-111
- 74
Lorish C D, Parker J, Brown S.
Effective patient education. A quasi-experiment comparing an individualized strategy
with a routinized strategy.
Arthritis Rheum.
1985;
28
1289-1297
- 75
Lousberg R, Schmidt A JM, Groenman N H.
The relationship between spouse solicitousness and pain behavior: searching for more
experimental evidence.
Pain.
1992;
51
75-79
- 76
Maes M, Lin A, Bonaccorso S. et al .
Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress
disorder and patients with major depression, but not in patients with fibromyalgia.
Acta Psychiatric Scandinavia.
1998;
98
328-333
- 77
McCaul K D, Malott J M.
Distraction and coping with pain.
Psychol Bull.
1984;
95
516-533
- 78
McDermid A J, Rollman G B, McCain G A.
Generalized hypervigilance in fibromyalgia: evidence of perceptual amplification.
Pain.
1996;
66
133-144
- 79
Morris V, Cruwys S, Kidd A.
Increased capsaicin-induced secondary hyperalgesia as a marker of abnormal sensory
activity in patients with fibromyalgia.
Neurosci Lett.
1998;
250
205-207
- 80
Mountz J M, Bradley L A, Modell J G. et al .
Fibromyalgia in women. Abnormalities of regional blood flow in the thalamus and the
caudate nucleus are associated with low pain threshold levels.
Arthritis Rheum.
1995;
38
926-938
- 81
Neeck G, Riedel W.
Neuromediator and hormonal pertubations in fibromyalgia syndrome: results of chronic
stress?.
Baillière’s Clin Rheumatol.
1994;
8
763-775
- 82
Nicassio P M, Radojevic V, Weisman M H. et al .
A comparison of behavioral and educational interventions for fibromyalgia.
J Rheumatol.
1997;
24
2000-2007
- 83
Nielson W R, Walker C, McCain G A.
Cognitive behavioral treatment of fibromyalgia syndrome: preliminary findings.
J Rheumatol.
1992;
19
98-103
- 84
Nørregard J, Bulow P M, Lykkegaard J J. et al .
Muscle strength, working capacity and effort in patients with fibromyalgia.
Scand J Rehabil Med.
1997;
29
97-102
- 85
Novy D M, Nelson D V, Turk D C. et al .
Perspectives of chronic pain: an evaluative comparison of restrictive and comprehensive
models.
Psychological Bulletin.
1995;
118
238-247
- 86 Okifuji A, Turk D C. Fibromyalgia: Search for mechanism and effective treatment. Gatchel
RJ, Turk DC Psychosocial factors in pain: Critical perspectives New York; Guilford
Press 1999: 227-246
- 87
Papadopoulos I A, Georgiou P E, Katsimbri P P. et al .
Treatment of fibromyalgia with tropisetron, a 5HT3 serotonin antagonist: a pilot study.
Clin Rheumatol.
2000;
19
6-8
- 88
Paulsen J S, Altmaier E M.
The effects of perceived versus enacted social support on the discriminative cue function
of spouse for pain behaviors.
Pain.
1995;
60
103-110
- 89
Qiao Z G, Vaeroy H, Morkrid L.
Electrodermal and microcirculatory activity in patients with fibromyalgia during baseline,
acustic stimulation and cold pressure tests.
J Rheumatol.
1991;
18
1383-1389
- 90
Ramos-Remus C, Salcedo-Rocha A L, Prieto-Parra R E. et al .
How important is patient education?.
Baillieres Best Pract Res Clin Rheumatol.
2000;
14
689-703
- 91
Reul J M, HM, Bilang-Bleuel A. et al .
New mode of hypothalamic-pituitary-adrenocortical axis regulation: significance for
stress-related disorders.
Z Rheumatol.
2000;
59
II/22-II25
- 92
Riedel W, Layka H, Neeck G.
Secretory pattern of GH, TSH, thyroid hormones, ACTH, cortisol, FSH, and LH in patients
with fibromyalgia syndrome following systemic injection of the relevant hypothalamic-releasing
hormones.
Z Rheumatol.
1998;
57
81-87
- 93
Romano J M, Turner J A, Friedman L S. et al .
Sequential Analysis of Chronic Pain Behaviors and Spouse Responses.
J Consult Clin Psychol.
1992;
60
777-782
- 94
Rossy L A, Buckelew S P, Dorr N. et al .
A meta-analysis of fibromyalgia treatment interventions.
Ann Behav Med.
1999;
21
180-191
- 95
Russel I J.
Neurochemical pathogenesis of fibromyalgia.
Zeitschrift für Rheumatologie.
1998;
57
63-66
- 96
Schmidt A JM.
Cognitive factors in the performance level of chronic low back pain patients.
J Psychosom Res.
1985;
29
183-189
- 97
Sinclair V G, Wallston K A.
Predictors of improvement in a cognitive-behavioral intervention for women with rheumatoid
arthritis.
Ann Behav Med.
2001;
23
291-297
- 98
Smith A J.
The analgesic effects of selective serotonin reuptake inhibitors.
J Psychopharmacol.
1998;
12
407-413
- 99
Snow-Turek A L, Norris M P, Tan G.
Active and passive coping strategies in chronic pain patients.
Pain.
1996;
64
455-462
- 100
Sorensen J, Graven-Nielson T, Henriksson K G. et al .
Hyperexcitability in fibromyalgia.
J Rheumatol.
1998;
25
152-155
- 101
Sullivan M JL, Stanish W, Waite H. et al .
Catastrophizing, pain, and disability in patients with soft-tissue injuries.
Pain.
1998;
77
253-260
- 102
Svebak S, Anjia R, Karstad S I.
Task-induced electromyographic activation in fibromyalgia subjects and controls.
Scandinavien J Rheumatol.
1993;
22
124-130
- 103
Thieme K, Gromnica-Ihle E, Flor H.
Operant behavioral treatment of fibromyalgia: A controlled study.
Arthritis Rheum/Arthritis Care Res.
2003;
49
314-320
- 104
Thieme K. et al .
Das SLE - Patientenschulungsprogramm - Programminhalt und erste Evaluationsergebnisse.
Akt Rheum.
1997;
22 : 3
1-7
- 105
Thieme K for the group „SLE-patient education programme” .
Evaluation of the SLE- patient education programme (1).
Arthritis Rheum.
1997;
40 (9) (Suppl): 71
- 106
Thieme K for the group SLE-patient education programme” .
Evaluation of the SLE- patient education programme (2).
Arthritis Rheum.
1998;
41 (9) (Suppl): 89
- 107 Thieme K, Turk D C, Flor H. Comorbid depression and anxiety in fibromyalgia syndrome:
Relationship to somatic and psychosocial variables (submitted for publication).
- 108 Thieme K, Turk D C, Flor H. Indication criteria for the operant and for the cognitive-behavioral
pain treatment in fibromyalgia (submitted for publication).
- 109
Turk D C, Flor H.
Primary fibromyalgia > tender points: toward a multiaxial taxonomy.
J Rheumatol.
1989;
16
80-86
- 110
Turk D C, Okifuji A, Sinclair J D. et al .
Pain, disability and physical functioning of patients with fibromyalgia.
J Rheumatol.
1996;
23
1255-1262
- 111
Turk D C, Okifuji A, Sinclair J D. et al .
Interdisciplinary treatment for fibromyalgia syndrome: clinical and statistical significance.
Arthritis Care Res.
1998;
11
186-195
- 112
Vaeroy H, Helle R, Forre O. et al .
Elevated CSF levels of substance P and high incidence of Raynaud phenomenon in patients
with fibromyalgia: new features for diagnosis.
Pain.
1988;
32
21-26
- 113
Vaeroy H, Qiao Z G, Morkrid L. et al .
Altered sympathetic nervous system response in patients with fibromyalgia.
J Rheumatol.
1989;
16
1460-1465
- 114
van Denderen J C, Boersma J W, Zeinstra P. et al .
Physiological effects of exhaustive physical exercise in primary fibromyalgia syndrome
(PFS): is PFS a disorder of neuroendocrine reactivity?.
Scandinavien J Rheumatol.
1992;
21
35-37
- 115
Vignos P J, Parker W T, Thompson H M.
Evaluation of a clinic education program for patients with rheumatoid arthritis.
J Rheumatol.
1976;
3
155-165
- 116
Vlayen J WS, Van Eek H, Groenman N H. et al .
Dimensions and components of observed chronic pain behavior.
Pain.
1987;
31
65-75
- 117
Vlaeyen J WS, Pernot D, Kole-Snijders A MJ. et al .
Assessment of the components of observed chronic pain behavior: the Checklist for
Interpersonal Pain Behavior (CHIP).
Pain.
1990;
43
337-347
- 118
Wolfe F, Anderson J, Harkness D. et al .
A prospective, longitudinal, multicenter study of service utilization and costs in
fibromyalgia.
Arthritis Rheum.
1997;
40
1560-1570
- 119
Wolfe F, Russell I J, Vipraio G. et al .
Serotonin levels, pain threshold and fibromyalgia symptoms in the general population.
J Rheumatol.
1997;
243
555-559
- 120
Wolfe F, Zhao S, Lane N.
Preference for nonsteroidal antiinflammatory drugs over acetaminophen by rheumatic
disease patients: a survey of 1,799 patients with osteoarthritis, rheumatoid arthritis
and fibromyalgia.
Arthritis Rheum.
2000;
43
378-385
- 121
Woolf C J, Mannion R J.
Neuropathic pain: aetiology, symptoms, mechanisms, and management.
Lancet.
1999;
353
1959-1964
- 122
Wüst S, Federenko I, Hellhammer D H. et al .
Genetic factors, perceived chronic stress and the free cortisol response to awakening.
Psychoendocrinol.
2000;
25
707-720
- 123
Zautra A J, Hoffman J M, Matt K S. et al .
An examination of individual differences in the relationship between interpersonal
stress and disease activity among women with rheumatoid arthritis.
Arthritis Care Res.
1998;
11 (4)
271-279
- 124
Zidar J, Backman E, Bengtsson A. et al .
Quantitative EMG and muscle tension in painful muscles in fibromyalgia.
Pain.
1990;
40
249-254
- 125
Zink A, Huscher D, Listing J.
Die Kerndokumentation der Regionalen Rheumazentren als Instrument für klinische Epidemiologie
und Qualitätsmessung in der Rheumatologie.
Z Arztl Fortbild Qualitätssich.
2003;
97
399-405
Dipl.-Psych. Dr. Kati Thieme
Department of Anesthesiology, University of Washington
1959 NE Pacific Street
BOX 356540
Seattle, Washington 98195-6540
USA
eMail: Thiemek@u.washington.edu
