PMID: 17393187

As far as I know, this is the first formal research article listed on PubMed to outline separate groups of Fibromyalgia.

1.  Inflammatory

2.  Depression

3.  Psychological problems

I have separated and color-coded their proposed subgroups and related comments in the article to make it easier to follow.

The subgroups in the article are not how we define the 4 Versions of Fibromyalgia at FibroFix, which may not be all-inclusive, but the Versions are tangible distinctions, and can be tested. 

We also recognize a cluster of symptoms that includes Depression, Procrastination, Anxiety / Panic, and Obsession / Compulsion. Again, these may not be all inclusive, but they do seem to appear as a cluster in many Fibros, but not all.  Generally, if these symptoms came on as a result of FMS, if they have one of them, they have the group.  We attribute the cluster to Seritonin Reuptake and successfully treat it with an SSRI. 

I have not made a direct association between the cluster of symptoms and any one particular Version of FMS.

1.  Overly Acidic

2.  Overly Alkali

3.  Thyroid / Temperature

4.   Physical Damage to Liver

I will withhold my final opinion until I read and consider the entire research article.  A survey of a very large number of Fibros is much needed.

Schmerz. 2007 Mar 29; [Epub ahead of print] 

[Subgroups of fibromyalgia.][Article in German]

Muller W, Schneider M, Joos T, Hsu HY, Stratz T.

Rheumatologische Forschungsabteilung, Park-Klinik Bad Sackingen, Weihermatten 1 , 79713, Bad Sackingen, Deutschland.

As has been shown by a number of working groups, primary fibromyalgia syndrome does not represent a single clinical entity.

It is possible to distinguish between

a subgroup with high pain sensitivity and no associated psychiatric condition,

a second subgroup characterized by depression and concomitant pain symptoms associated with fibromyalgia syndrome,

and a third group with somatoform pain disorder of the fibromyalgia type.

Bland inflammatory processes must be considered as the cause in the first group,

while depression is the underlying reason for the development of pain in the second group.

In the third group, serious previous or still existing psychological problems or also insufficient coping with illness symptoms must be regarded as the reason for pain chronification.

Group 1 benefits from a blocking of the 5-HT3 receptors by means of tropisetron, for example.

This not only affects pain chronification but also the inflammatory process itself.

Group 2 needs antidepressant treatment,

whereas the focus should be on psychotherapy is group 3.

Groups 1 and 2 will also profit from multimodal physical treatment programs;

to a certain extent this applies to group 3 as well.

So-called mixed types require a combination of therapeutic measures.

PMID: 17393187 [PubMed - as supplied by publisher]

Schmerz : "PAIN" a German medical journal. 

chronification: pain which occurs as sequence of a vicious cycle wherein untreated pain stimuli further evoke additional pain responses.

psychotherapy : an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living.

somatoform : any of a group of psychological disorders (as body dysmorphic disorder or hypochondriasis) marked by physical complaints for which no organic or physiological explanation is found and for which there is a strong likelihood that psychological factors are involved.

That's what it takes to beat a problem - the truth, communication, cooperation, motivation, determination, and the guts to try.

Anne Hillebrand   FibroFix  2004