A DATABASE FOR FIBROMYALGIA

Fibromyalgia syndrome (FMS) is a multidimensional disorder characteriz ed by chronic pain, hyperalgesia, fatigue, sleep disturbance, and emot ional distress. There recently has been intense investigation into FMS but, like the oft-quoted analogy with the blind men and the elephant, we currently know more about the components of FMS than we know about the ''beast'' as a whole. The essential element of FMS is pain. Indee d, FMS appears to represent a change in homeostasis of an individual's total integrated pain system. This system has internal characteristic s, comprising anatomical, physiologic, and psychologic domains, unique to the individual. External influences, such as cultural, ethnic, and other societal factors, bring further generic inputs into that person 's homeostatic mechanisms. FMS is a complicated reaction of the whole person and reflects powerful and variable physiologic responses linkin g mind and body. The dimensions of FMS include aberrations at several levels-the nociceptor, the central nervous system, the psyche, and the society with which the individual interacts. All these factors play a role in FMS. The aim of this article is to examine which of these var iables one can collect, measure and use to assess, study, or follow pa tients with FMS. The different dimensions of FMS are reviewed, and ite ms that may relate to a database are examined. Emphasis is placed on i nstruments or assessments that have been commonly used or are deemed t o be useful in FMS. New instruments to assess aspects of FMS are appea ring all the time, and one needs to remain flexible in choice of asses sing instrument. Only a selection of psychologic instruments, for inst ance, is provided. It is stressed that each item is only one component of the whole and for any one assessment one selected component may be valid, while for another, a different component may be more appropria te.