Fibromyalgia and its New Lessons for Neuropsychiatry

Fibromyalgia (FM) is a centralized pain state that until recently has been shrouded in mystery and questionable as a disease entity in the eyes of many physicians, who considered it purely psychogenic. Fibromyalgia is now thought of as a discrete diagnosis with a clustering of symptoms characterized by central nervous system pain amplification along with anergia, memory loss, disturbances of mood, and sleep disruption. The condition is present in approximately 2% to 8% of the population. We review the link between inflammatory mechanisms and FM from a neuropsychiatric perspective. Recent studies are pointing to a neuroinflammatory etiology that may open up more effective treatment strategies in the future. Better conceptualization of FM may also elucidate a neuropsychiatric understanding of how nociception, dysthymia, and suicidality co-develop and feed off one another.