Fibromyalgia: Proof of Physical Origins Vs. Two Danish Psychiatrists


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

 Guardian Liberty Voice

World Health Organization

Centers for Disease Control


Brain Physics

Washington Times

Web MD

Health Central

Personal email from Dr. Frank Rice

15 Responses to Fibromyalgia: Proof of Physical Origins Vs. Two Danish Psychiatrists

  1. MARTIN Patricia June 30, 2014 at 5:26 am

    I am FM for 10 years. Last year I broke my left leg and now I really suffer each day and fibro is permanent. I take tramium and now contramal. It is hard. I am searching about others medics. (Tramadol and form of opium). Pat

    • mand June 30, 2014 at 9:52 am

      The thing is, everyone finds different things are good – what works for me may be no use to you, but don’t rule out something that others say is useless because it may be the thing that helps you. It does need time spending on trial n error, but it’s worth it. I find celebration any improvement really helps, or it can be overwhelming.

      Having said that…

      I went through Amitriptyline and another of that family, which both helped but not enough, and now I’m on Duloxetine which makes a great difference. I think studies show Duloxetine is no good for most of us but it is for me. :) Also (non-prescription) glucosamine, cod liver oil, lately trying green-lipped mussel which if I remember right works well in combination wtih glucosamine. Every so often I try something else and they all seem to need weeks or months before you can tell – usually I only find out they make a difference when I come off them! For years I avoided “wasting” money on things that may not help, but now I look at it as money spent on research rather than money spent on treatment that ought to work; then when it turns up something good, that’s a bonus. Absolutely NOT money wasted because lower pain changes life right around!

      Also try to get on a pain management course if you haven’t already done one, and for me personally, Alexander technique has taught me a lot about the way I hold my body, parts that I didn’t know I was tensing, etc. Yoga I believe is similar for that. Fibromyalgia is a learning curve – and the learning has other benefits. Good luck with your own progress, Patricia. :)

  2. Lyla June 27, 2014 at 5:45 pm

    Do the bones of fibromyalgia patients crack constantly?

    • mand June 27, 2014 at 5:57 pm

      Mine do, but I don’t know if it’s an FM thing. I have tendon problems too and hypermobility, pretty sure it’s related to them. (though hypermobility is common among FM patients too).

  3. mand June 24, 2014 at 8:54 am

    @ Amanda – best of luck tomorrow! Glad you already have a pain specialist. :)

    I remembered another thing from the research: typically, FM patients are more hard-working and conscientious by nature, less likely to give up when it gets difficult, than average in the general population. (This is why learning to stop when we need to is such an important part of the FM learning curve.) When we feel guilty about not managing the workload we used to, this is nice to know.

    Maybe I shouldn’t have gone back to re-read all these comments, but it did prompt this statistic to emerge from my memory! ;)

  4. Amanda June 24, 2014 at 5:57 am

    @ mand – I have been struggling to get a diagnosis for the wide spread deep muscle pain/myofacial trigger points for almost 7 yrs now. There isn’t a doubt in my mind the FM is one part of it and I think you have hit the nail on the head with your advice! I too have done these things to prepare myself for the long awaited appointment I have tomorrow with the specialist my pain specialist has set up!!

  5. ruth ayling June 15, 2014 at 2:38 pm

    every thing your saying is true and most of all i wish doctors would try to understand more.

  6. mand June 2, 2014 at 6:00 am

    @ Taylor Carter – fibromyalgia is not an arthritis. I’m with you, I wouldn’t swallow any meds if I could avoid it. Topical products help (this is my personal experience only) when a fibromyalgia flare-up causes tension for hours which in turn causes muscle pain. The FM pain itself does not originate in the soft tissues. There are several kinds of pain and they fluctuate, after years of studying myself as scientifically as I can, I’ve worked out a few things that may make some of them worse, but mostly they are unpredictable. An activity which, on one occasion, causes two days’ pain after ten minutes doing it, on another occasion I may get away with and not “pay for” at all, even if I did it for an hour. All I really know is that if I push through when my body begins to say stop, even for a few minutes, I will pay later (I never know how badly).

    FM is neurological. This is why aspirin, ibuprofen, paracetamol, codeine etc rarely have any effect. There has been MRI evidence of altered brain activity since at least 2005. If trying to explain to someone who wants more than “It’s a bit like arthritis,” I say it’s to do with the way the nerves carry the pain messages to the brain. I’m no doctor but I have attended lectures by the top researchers in the FM field. One I remember saying: it should be diagnosed by neurology but handed over to rheumatology for management thereafter. I don’t know anywhere this happens in practice. But it isn’t diagnosed merely by excluding all the other similar conditions.

    But I have the brain fog which is one of the most common symptoms, so I can’t give you references. FM has turned me from an academic and later PA, freelance writer and highly involved mother, into a muddlehead who finds keeping up with the groceries and household finances is a full-time job – on a good day.

    @ nameisrequired – I would be more friendly, but you haven’t given your name – I suggest you research optimal pillow height if you’re waking stiff and sore every morning; look into recommendations for improving sleep; and drink more water. Check the seating you use at any desk or table, your driving position, and your sofa. Experiment until you’re fully familiar with the effect different foods have on your overall wellbeing. Keep a diary for a full year to see if weather and season make a difference. Notice if it’s better after a full night’s sleep, or better after a shorter night (as mine is). Notice if it’s worse after a more active day or a more sedentary one. Notice if it’s better after a day when you had a great time and worse after arguing. If these ideas don’t help at all, then see a doctor and I hope you already have the high level of communication skills and persistence required to be taken seriously for what is hard to describe but easy to dismiss: long-term “aches and pains”. However if you haven’t got something serious, consider relaxation techniques which may help you resent genuine patients less as well as helping your sleep.


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