Are there underlying psychosocial stressors?

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Are there underlying psychosocial stressors?

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Although many patients with FMS have a history of depression, only 15% to 20% are depressed at any given physician visit.6 Primary care physicians may be able to handle many FMS flares in a crisis intervention mode by addressing a patient’s divorce, death of a loved one, or job loss. The most common behavioral conditions associated with FMS are generalized anxiety disorder, PTSD, and mood disorders. 6,7 Anxiety may be related to a patient’s perception that he has a serious medical condition, psychosocial stressors, or discomfort at not feeling well. Anxious patients with FMS often have perfectionistic tendencies, tend to make lists, exhibit hypervigilance, and sleep poorly; however, they tend to hide their discomfort in social settings. Anxious patients are the most responsive to FMS-related interventions, counseling, biofeedback, reassurance, cognitive-behavioral therapy, and complementary regimens that promote relaxation. Most remain under the care of their primary care physician exc

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