Immune Patterns in Pain Patients DSM-IV
Condition: Somatoform Disorders; Fibromyalgia; Myofascial Pain Syndrome, Diffuse; Depression; Chronic Fatigue Syndrome
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes; Fatigue Syndrome, Chronic; Syndrome; Fatigue; Depression; Somatoform Disorders
Study type: Observational

Summary: 
      The purpose of this study is to define subgroups of patients with somatoform disorders due to
      DSM-IV by immunological, psychological and genetic characterization.
    

Detailed description: 
      Pain patients are defined as patients with a somatoform disorder due to DSM-IV, if chronic
      pain lasts for at least 6 months in several anatomical regions. Somatoform disorders (DSM-IV)
      have the presence of physical symptoms that suggest a general medical condition but that are
      not fully explained by a general medical condition, by the direct effects of a substance, or
      by another mental disorder. The symptoms must cause clinically significant distress or
      impairment in social, occupational, or other areas of functioning. The physical symptoms are
      not under voluntary control. Psychic factors exclusively or in combination with a medical
      disease factor influence onset, severity, exacerbation or maintenance of symptoms decisively.
      A subgroup of somatoform disorders, i.e., fibromyalgia, is a common nonarticular rheumatic
      syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation
      (trigger points). Muscle pain is typically aggravated by inactivity or exposure to cold. This
      condition is often associated with general symptoms, such as sleep disturbances, fatigue,
      stiffness, headaches, and occasionally depression. There is significant overlap between
      fibromyalgia and the chronic fatigue syndrome. Fibromyalgia may arise as a primary or
      secondary disease process. Interleukins IL-1ß, IL-6 und tumor necrosis factor-a have been
      detected in the skin of these patients. Blockade of the 5HT3 receptor has been reported to
      alleviate chronic pain in tendopathy, fibromyalgia and autoimmune diseases. However, only a
      subgroup of patients responds to this therapy. It is supposed that patients with somatoform
      disorders (DSM-IV) diagnosed according to clinical criteria consist of immunologically
      heterogenous groups. However, up to now, the immunologic and genetic background of patients
      with somatoform disorders classified via DSM-IV has not been systematically evaluated. The
      study concentrates on the psychometric characterization of patients with pain disorder
      focusing on depression, anxiety, coping behavior, psychic trauma, alexithymia and somatoform
      symptoms. The present study is performed to define subgroups of patients with somatoform
      disorders (DSM-IV) by immunological, pyschologic and genetic characterization which may
      benefit from potential 5HT3 receptor antagonists or anti-inflammatory therapy.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        chronic pain patients with a somatoform disorder due to DSM-IV
      
Biospecimen description: 
      Whole blood, serum, and white cells will be retained.
    
Keywords: humans; patients; somatoform disorders; fibromyalgia; myofascial pain syndrome diffuse; depression; chronic fatigue syndrome; inflammation; inflammatory response; biomarkers; cytokines; cell surface markers; functional polymorphisms