Tag: Central Sensitivity Syndrome

The impact of COVID-19 stress on pain and fatigue in people with and without a central sensitivity syndrome

Abstract:

Objectives: Stress may augment somatic symptoms in central sensitivity syndromes (CSS) such as fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. To test this hypothesis, we examined whether the association between COVID-19 stress and somatic symptom severity would be stronger in people with than without CSS and whether psychological flexibility would buffer the impact of this stress on symptom severity.

Methods: In a 2-sample, repeated cross-sectional design, we analysed questionnaire data from Dutch people with and without CSS, collected in two independent surveys: before the COVID-19 pandemic (2018; CSS: n = 194, non-CSS: n = 337) and at the peak of the pandemic (2020; CSS: n = 428, non-CSS: n = 1101). Somatic symptom severity, worry and stress due to the pandemic, and psychological flexibility were examined in regression analyses. Two stress operationalisations were analysed: stress levels during the peak of the pandemic, and a comparison of measurements in 2020 and 2018 (assuming higher stress levels in 2020).

Results: Higher worry and stress during the pandemic (standardized β = 0.14), the presence of a CSS (β = 0.40), and lower psychological flexibility (β = -0.33) were all (p < .0001) associated with more severe somatic symptoms, but the associations of each stress operationalisation with somatic symptoms was not particularly strong in people with CSS (β = -0.026, p = .27; β = -0.037, p = .22), and psychological flexibility (β = -0.025, p = .18; β = 0.076, p = .35) did not buffer this association.

Conclusions: Findings do not support the hypotheses that COVID-19 stress augments somatic symptoms, particularly in CSS, or that psychological flexibility buffers this impact. Rather, COVID-19-related stress appears to have an uncertain impact on somatic symptoms.

Source: Koppert TY, Jacobs JWG, Lumley MA, Geenen R. The impact of COVID-19 stress on pain and fatigue in people with and without a central sensitivity syndrome. J Psychosom Res. 2021 Oct 29;151:110655. doi: 10.1016/j.jpsychores.2021.110655. Epub ahead of print. PMID: 34739944. https://pubmed.ncbi.nlm.nih.gov/34739944/

Conditions, controversies and contradictions between Central Sensitivity Syndrome and Depressive Disorders

Abstract:

We present a description of the Central Sensitivity Syndrome (CSS) and some of its main components such as Multiple Chemical Sensitivity Syndrome, Chronic Fatigue Syndrome and Fibromyalgia. We review the changes in pain perception, describing the physiology and pathophysiology of the painful experience from the medulla horn to the CNS. We explain the theory of central sensitization as the basis to the syndrome. We refer to the differences between fibromyalgia and depressive disorders, is spite of their frequent presentation in comorbidity.

We state the main clinical and neurobiological differences. We point out the main psychoneuroimmunoendocrinologic differences such as adrenal activity (hypoactivity vs. hyperactivity, DST hypersuppressive response vs. DST non suppression, hypersensitivity of central glucocorticoid receptors vs. desensitization of these, among others), thyroid (probable reverse T3 vs. flat stimuli TSH response curve) and growth hormone secretion (probable increase vs. disruption of normal circadian rhythm) that makes CSS resemble PTSD. We describe differential changes in sleep patterns (alpha-delta intrusion vs. altered sleep time, REM latency, and stage 3/4) and immunological disturbances almost opposite in each pathological entity. We finally argue which medical specialty should treat these complex syndromes.

 

Source: Maresca T, Covini E, Mato AM. Conditions, controversies and contradictions between Central Sensitivity Syndrome and Depressive Disorders.Vertex. 2013 Sep-Oct;24(111):373-91. [Article in Spanish] https://www.ncbi.nlm.nih.gov/pubmed/24312923