Lately, there has been some buzz about two Danish psychiatrists who, back in 2010, decided to classify a group of diseases including fibromyalgia into one disease “umbrella” called “bodily distress syndrome.” Along with fibromyalgia, other diseases such as chronic pain, chronic fatigue syndrome and irritable bowel syndrome, among others, were also lumped into this new “syndrome.” That Danish study from 2010 was entitled One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. Bodily distress syndrome is classified as a mental disorder. This Danish definition of what two Danish psychiatrists consider to be a psychiatric problem has caused some confusion here in the United States.
The 2010 study performed by the two Danish psychiatrists had some buzz around it recently because last year, a Danish woman suffering from a disease covered under “bodily distress syndrome,” Karina Hansen, was forcibly removed from her home and placed into a hospital where she is being reportedly held against her will and is not allowed to see her parents.
This case in Denmark, and the fact that other Danish psychiatrists have now accepted “bodily distress syndrome” as an actual disease, has raised questions among some interested parties in the United States as to whether fibromyalgia could be grouped into one disease here. Despite the fact that the “syndrome” was only discussed in one small paper from 2010 and despite the fact that there are studies and data to prove fibromyalgia is a real physical illness along with proof of it having real physical origins, there are some psychiatrists who still claim it is a mental condition.
To be clear, no major organizations such as the CDC or the World Health Organization have labeled fibromyalgia a mental disorder or mental illness. It is not included in the WHO’s classification of mental disorders. In fact, the WHO defines fibromyalgia as a “soft tissue” or “rheumatic” disease. The World Health Organization website states:
Fibromyalgia is included in the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) published by WHO in 1992 as follows: M79 Other soft tissue disorders, not elsewhere classified, M79.0 Rheumatism, unspecified, Fibromyalgia, Fibrositis.
Despite the fact that the WHO does not classify fibromyalgia as a mental disorder, and has no plans to re-label it as such, there has been some confusion about whether they do now or may in the future classify it as a mental condition. This confusion prompted the WHO to send out the following Tweet recently to clarify the matter:
Fibromyalgia, ME/CFS are not included as Mental & Behavioural Disorders in ICD-10, there is no proposal to do so for ICD-11
The Centers for Disease Control (CDC) also reports that Fibromyalgia is a disorder that causes physical pain and often occurs with conjunction with other physical diseases:
Fibromyalgia often co-occurs (up to 25-65%) with other rheumatic conditions such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS).
Nowhere in any WHO or CDC published documents does it state that fibromyalgia is definitely “all in the head,” “a mental health condition” or “psychological.”
In addition to these major organizations recognizing fibromyalgia as a physical, not mental, ailment, there have recently been many studies and papers that are finding multiple possible causes of fibromyalgia such as a vitamin D deficiency, extra nerve fibers in the hands, rheumatism, physical trauma, viral infections and other causes.
While the two Danish psychiatrists may believe that fibromyalgia is a mental condition, and there are perhaps some psychiatrists in the United States who might wish to classify it that way because it could perhaps bring them more business, fibromyalgia is discussed and classified by the WHO as a physical, and not a mental condition. While the exact physical etiology for every patient suffering from fibromyalgia is unknown at this this time, some research has shown definite physical causes and ongoing research continues to uncover new information. This proof of physical origins of the condition is growing at a fast pace.
Dr. Frank Rice, who conducted the peer reviewed, published research study proving that a majority of fibromyalgia patients had extra nerve fibers in their hands, is doing ongoing research which continues to yield physical causes centering on the nerves in the body and how those nerves relay information.
Dr. Rice states that his study results had a very high level of significance, and that particular study proved that fibromyalgia pain originates from too many of a specific type of nerve fiber in the skin. Speaking about his study, he states:
The results were so profound that they achieved an especially high level of significance. The standard for significance in scientific studies is what is referred to as a “p value of 0.05” which means that there is only a 5% possibility that the results could be explained by chance. Our results were a p value of 0.0001 which means a 0.01% likelihood of occurring by chance.
Additionally, Dr. Rice is involved in further research that he feels confident will pave the way toward more meaningful physical diagnoses and better treatment approaches. At this time it appears that the proof and data supports the classification as fibromyalgia as a concern stemming from physical origins and not as a mental disorder.
An Editorial By: Rebecca Savastio
Personal email from Dr. Frank Rice