Reviews
Fibromyalgia and post-traumatic stress disorder: different parts of an elephant?
M. Luís1, A.M. Pinto2, W. Häuser3, J.W. Jacobs4, A. Saraiva5, V. Giorgi6, P. Sarzi-Puttini7, M. Castelo-Branco8, R. Geenen9, J.A. Pereira Da Silva10
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Portugal. maryanaluys@gmail.com
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra; and Psychological Medicine Institute, Faculty of Medicine, University of Coimbra, Portugal.
- Department of Psychosomatic Medicine and Psychotherapie, Technical University Munich, Germany.
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands.
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.
- Department of Internal Medicine, Gruppo Ospedaliero Moncucco, Lugano, Switzerland.
- Department of Rheumatology, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan; and Department of Biomedical and Clinical Sciences, University of Milan, Italy.
- Instituto de Ciências Nucleares Aplicadas à Saúde (ICNAS), Coimbra, and Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.
- Department of Psychology, Utrecht University, Utrecht, the Netherlands.
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra; and Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Portugal.
CER18847
2025 Vol.43, N°6
PI 1146, PF 1160
Reviews
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PMID: 40576704 [PubMed]
Received: 21/04/2025
Accepted : 18/06/2025
In Press: 27/06/2025
Published: 27/06/2025
Abstract
Post-traumatic stress disorder (PTSD) and fibromyalgia (FM) are prevalent and debilitating conditions, conventionally delineated by distinct symptom profiles: PTSD is typified by intrusive thoughts and avoidance behaviours, while FM is essentially characterised by widespread pain, cognitive disturbances and fatigue. Despite these differences in definition, these disorders share a multitude of clinical features and risk factors, including persistent psychological distress. Furthermore, they often co-occur. Hyperactivity of the salience network, recognised as a key pathogenic feature of PTSD, has been recently suggested to also underlie FM, broadening the prevailing concept of central pain sensitisation. These observations prompt the hypothesis that these conditions have common vulnerability factors, characterised by a maladaptive response to stress perpetuated by a persistently heightened perception of threat and low ability to sooth the threats. This paper explores this hypothesis, by analysing the commonalities between FM and PTSD, in line with the FITSS model, and how this may, eventually, foster cross-fertilisation of knowledge stemming from both perspectives, to the benefit of patients.