Reclaim the Diagnosis of Somatoform Disorder and Neurasthenia

The clinical concept of sensitive-trigger points was introduced in 1977, when the existence of certain anatomical locations with excessive sensitivity to pain was described, but it was not until 1981 when Yunun et al. first introduced the term fibromyalgia. In 1990 the American College of Rheumatology, ACR published diagnostic criteria based on the presence of chronic widespread pain (more than 3 months) and (in at least 3 of the 4 body quadrants), along with 11 or more 18 specific tender points. In 1992 the World Health Organization (WHO) officially recognizes and defines fibromyalgia as a painful joint condition not widespread, affecting predominantly muscle areas and rachis, and having an exaggerated sensitivity to multiple predetermined points.

Somatoform Disorder
Somatoform Disorder

Over time the content of the disease has stopped focusing on the symptoms of the musculoskeletal system, and in 2010 the ACR proposes new criteria that no longer require palpation of tender points and evaluating the patient based on number of painful regions (Widespread Pain Index [WPI]) and a severity scale (symptom severity Score [SS-Score]) of fatigue, restless sleep and cognitive symptoms. The term neurasthenia (“nervous exhaustion”) was used by Beard in 1869 to refer to a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood. Over the years the term neurasthenia has been abandoned as a regular medical diagnosis and has been replaced by chronic fatigue syndrome.


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