Abstract
Fibromyalgia (FM) is a disease of the models of chronic pain characterized by the widespread muscular skeletal pain of the whole body. The patients of FM also complain various unidentified symptoms such as chronic headache, easy fatigability, hypersensitive gastrointestinal disorder, menstruation-related disorder, dizziness, tinnitus and urination disorder. Psycho-neurological symptoms include sleep disorder, nervousness, dejection, uneasiness and extensive strain. The onset and clinical course of FM involve genetic background and personal constitution as well as external factors such as mental and physical exhaustion or overload and an illness or physical traumatic event of some kind. Personality trait and distorted lifestyle and at times psychiatric disorders such as depression, bipolar disorder, anxiety disorders may be involved in the formation of the pathological condition of FM. The comorbidity of FM and mental disorder needs to be considered for understanding the condition of patient and treatment. It may be important to understand from the psychosomatic or psychiatric points of view that FM is not a single disease entity but a kind of spectrum disorder including heterogenic element. The enough and appropriate pharmacological approach to the pain is indispensable for treatment of FM, and also providing the treatment for the comorbidity of mental disorder is essential. As for the non-pharmacological approaches, receptive manner and consensual posture is necessary to support the long-term treatment of FM. To treat the problems of psychological stress and personality, psychological counseling and advanced psychotherapy such as cognitive behavioral therapy (CBT) based on the "personal growth model" may be more important. The cooperation with practitioners of psychosomatic medicine and the psychiatrist with knowledgeable skills will be likely to become most important for the treatment of comorbid mental disorders.
