Fibromyalgia: Geenen R

Geenen R, van Middendorp H. · No affiliation provided · Patient Educ Couns. · Pubmed #16426801 No free full text.

This publication has no abstract.

Adler GK, Geenen R. · Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA. · Rheum Dis Clin North Am. · Pubmed #15639063 No free full text.

Abstract: In general, there seems to be a reduction in some neuroendocrine and autonomic nervous system (ANS) responses to applied stresses in individuals who have fibromyalgia. This article presents an overview and discussion of these findings with respect to the role of the ANS and the neuroendocrine system in the response to stress, with emphasis on the hypothalamic-pituitary-adrenal axis and the possible implication to fibromyalgia.

Geenen R, Janssens EL, Jacobs JW, van Staveren W. · Department of Health Psychology, Utrecht University, Utrecht, The Netherlands. · J Rheumatol. · Pubmed #15088308 No free full text.

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Geenen R, Jacobs JW, Bijlsma JW. · Department of Health Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands. · Rheum Dis Clin North Am. · Pubmed #12122926 No free full text.

Abstract: Fibromyalgia-like symptoms such as muscle pain and tenderness, exhaustion, reduced exercise capacity, and cold intolerance, resemble symptoms associated with endocrine dysfunction like hypothyroidism, and adrenal or growth hormone insufficiency. To investigate the potential of management of endocrine abnormalities for relieve of symptoms of patients with fibromyalgia, we reviewed experimental and clinical studies of endocrine functioning and endocrine treatment. Serum GH, androgen, and 24-hour urinary cortisol levels of patients with fibromyalgia tend to be in the lower part of the normal range, while serum levels of thyroid hormone, female sex hormones, prolactin, and melatonin are normal. With exception of GH, these conclusions are based on studies in small samples. With respect to dynamic responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis, the dexamethasone suppression test and stimulation with ACTH show normal results, while patients show marked ACTH hypersecretion in response to severe acute stressors, perhaps indicative of chronic CRH hyposecretion. This finding and slightly altered responsiveness of growth hormone, thyroid hormone, and prolactin in pharmacologic stimulation tests suggest a central rather than peripheral origin of endocrine deviations. Because hormone level deviations were not severe, occurred in subgroups of patients only, and few controlled clinical trials were performed, there is--unless future research shows otherwise--little support for hormone supplementation as a general therapy in the common patient with fibromyalgia. In patients with clinically overt hormone deficiency, hormonal supplementation is an option. In patients with hormone levels that are in the lower part of the normal range, interventions aimed at pain, fatigue, sleep or mood disturbance, and physical deconditioning may indirectly improve endocrine functioning.

van Middendorp H, Lumley MA, Jacobs JW, van Doornen LJ, Bijlsma JW, Geenen R. · Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. · J Psychosom Res. · Pubmed #18222129 No free full text.

Abstract: OBJECTIVE: Disturbances in emotional functioning may contribute to psychological and physical symptoms in patients with fibromyalgia. This study examined emotions and emotion-regulation strategies in women with fibromyalgia and in controls, and how these variables relate to symptoms of fibromyalgia. METHODS: We compared 403 women with fibromyalgia to 196 control women using self-report questionnaires. RESULTS: Negative emotions and the use of emotional-avoidance strategies were elevated, and positive emotions were reduced, in fibromyalgia patients; the alexithymia scale "difficulty identifying feelings" showed a large deviation from normal. Emotional-approach measures were not deviant. In the fibromyalgia sample, emotional-avoidance strategies were highly correlated with more mental distress and were modestly correlated with more pain and fatigue, while emotional-approach strategies were only minimally related to better functioning. We tested two interaction models. The intense experiencing of emotions was related to more pain only in patients who lack the ability to process or describe emotions. Although fibromyalgia patients showed deficits in the experiencing of positive affect, positive affect did not buffer the association between pain and negative affect. CONCLUSION: This study demonstrates increased negative emotions and decreased positive emotions, as well as increased emotional-avoidance strategies, in women with fibromyalgia. Research should test whether interventions that reduce emotional avoidance lead to health improvements in women with fibromyalgia.

Näring GW, van Lankveld W, Geenen R. · Radboud University Nijmegen, Department of Clinical Psychology, Behavioral Science Institute, The Netherlands. · Clin Exp Rheumatol. · Pubmed #18173922 No free full text.

Abstract: OBJECTIVE: Trauma and dissociation tend to be interrelated. The objective of this study was to examine the frequency of traumatic experiences and somatoform dissociation in patients with fibromyalgia syndrome (FMS) or rheumatoid arthritis (RA), two conditions that are both characterized by pain and disability. METHODS: Patients with a diagnosis of FMS (2 male, 26 female; mean age 42 +/- 11 years) or RA (5 male, 46 female; mean age 46 +/- 10 years) completed the Fibromyalgia Impact Questionnaire (FIQ), the Somatoform Dissociation Questionnaire (SDQ), and the Traumatic Experience Checklist (TEC). RESULTS: Patients with FMS reported significantly higher levels of various forms of traumatization and dissociation than patients with RA. In patients with FMS, but not in patients with RA, there was a significant correlation between traumatization and dissociative symptoms. A possible dissociative disorder was indicated in 10% of the patients with FMS and 2% of the patients with RA. CONCLUSION: Traumatization experiences are frequent in FMS, but as compared to conversion disorder or dissociative identity disorder only a small subgroup of patients with FMS or RA shows the combination of traumatization and somatoform dissociation. The observation of somatoform dissociation calls for a broad treatment approach with a special role of the psychologist or psychiatrist.

Prins MA, Woertman L, Kool MB, Geenen R. · Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. · Clin Exp Rheumatol. · Pubmed #17181925 No free full text.

Abstract: OBJECTIVE: To examine sexual functioning at the specific phases of the sexual response cycle among women with fibromyalgia. METHODS: The Questionnaire for screening Sexual Dysfunctions - Short Form (QSD-SF) was filled out by 63 premenopausal, heterosexual women with fibromyalgia (age: 21-54 years) who were recruited at meetings of regional patient associations. RESULTS: The women with fibromyalgia did not differ from healthy women of an age reference group with respect to functioning in the excitement and the orgasm phases, but reported more problems with sexual desire and satisfaction, more pain in their body, and insensitivity (but not pain) in their genitals before, during or after having sex. Mental distress, but not pain, was a significant predictor of virtually all aspects of sexual dysfunction. CONCLUSION: Our study generates the hypothesis that the psychological but not the physiological aspect of the sexual response cycle is more disturbed than normal in fibromyalgia. This finding needs confirmation in a more representative population.

Geenen R, Jacobs JW. · Department of Health Psychology, Utrecht University, Utrecht, the Netherlands. · Curr Opin Anaesthesiol. · Pubmed #17019142 No free full text.

Abstract: Fibromyalgia is characterized by chronic widespread pain and the presence of tender points, often accompanied by several non-specific symptoms, such as fatigue, depressive mood, and sleep disturbances. The apparent overlap between fibromyalgia and other syndromes, such as chronic fatigue and irritable bowel, is not sufficient cause to consider all these syndromes as manifestations of a single syndrome. Fibromyalgia is a multifaceted problem. Central afferent pain amplification and perhaps also impaired descending pain inhibition are supposed to underlie widespread pain. Neuroendocrine perturbations, sleep disturbances, health beliefs, mood disorder, and physical deconditioning play a role in the modulation and perseverance of pain and other symptoms. It is extremely difficult to mitigate chronic generalized pain and to deal with other symptoms in fibromyalgia. A uniform intervention strategy is missing. Essential in the tailored management of fibromyalgia are an enhancement of functional capacities and quality of life, and the symptomatic treatment of individual symptoms such as pain, distress, and sleep disturbances. Rather than analysing monotherapy per se, the objective in future evaluations should be to try to find the combined pharmacological or non-pharmacological treatment of choice for specific subgroups of patients.

Kool MB, Woertman L, Prins MA, Van Middendorp H, Geenen R. · Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. · J Sex Marital Ther. · Pubmed #16959664 No free full text.

Abstract: To examine the predictive potential of relationship variables on sexual functioning in women with fibromyalgia, we instructed 63 women (age 21-54 years) to fill out several questionnaires. Low relationship satisfaction was the strongest and most-frequent predictor of problematic sexual functioning. In addition, more fatigue and--only after taking account of relationship satisfaction--more active engagement (i.e., involvement) of the spouse were associated with reduced sexual functioning and satisfaction. Our study suggests that for women with fibromyalgia, relationship satisfaction is good for sexual functioning. Although having an involved spouse is good for the relationship, it may be bad for sexual functioning.

Jacobs JW, Geenen R. · University Medical Centre, Utrecht, The Netherlands. · West J Med. · Pubmed #11694476 links to  free full text

This publication has no abstract.