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Review
. 2023 Sep 29;5(3):e11179.
doi: 10.32872/cpe.11179. eCollection 2023 Sep.

Aetiological Understanding of Fibromyalgia, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and Classificatory Analogues: A Systematic Umbrella Review

Maria Kleinstäuber #  1 , Andreas Schröder #  2 , Sarah Daehler  1 , Karen Johanne Pallesen  3 , Charlotte U Rask  2   4 , Mathias Sanyer  1 , Omer Van den Bergh  5 , Marie Weinreich Petersen  2 , Judith G M Rosmalen  6
Affiliations
Review

Aetiological Understanding of Fibromyalgia, Irritable Bowel Syndrome, Chronic Fatigue Syndrome and Classificatory Analogues: A Systematic Umbrella Review

Maria Kleinstäuber et al. Clin Psychol Eur. .

Abstract

Background: This umbrella review systematically assesses the variety and relative dominance of current aetiological views within the scientific literature for the three most investigated symptom-defined functional somatic syndromes (FSS) and their classificatory analogues within psychiatry and psychology.

Method: An umbrella review of narrative and systematic reviews with and without meta-analyses based on a search of electronic databases (PubMed, Web of Science, Embase, PsychINFO) was conducted. Eligible reviews were published in English, focused on research of any kind of aetiological factors in adults diagnosed with fibromyalgia syndrome (FMS), irritable bowel syndrome (IBS), chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and somatic symptom disorder (SSD)/somatoform disorder (SFD).

Results: We included 452 reviews (132 systematic reviews including meta-analyses, 133 systematic reviews, 197 narrative reviews), of which 132 (29%) focused on two or more of the investigated health conditions simultaneously. Across diagnoses, biological factors were addressed in 90% (k = 405), psychological in 33% (k = 150), social in 12% (k = 54), and healthcare factors in 5% (k = 23) of the reviews. The methodological quality of the included systematic reviews (k = 255) was low (low/critically low: 41% [k = 104]; moderate: 49% [k = 126]; high quality: 10% [k = 25]). The high-quality systematic reviews suggest that deficient conditioned pain modulation, genetic factors, changes in the immune, endocrinological, gastrointestinal, cardiovascular, and nervous system, and psychosocial factors such as sexual abuse and pain catastrophizing increase the risk for FSS.

Conclusion: Only very few systematic reviews have used comprehensive, biopsychosocial disease models to guide the selection of aetiological factors in FSS research. Future research should strive for higher scientific standards and broaden its perspective on these health conditions.

Keywords: aetiology; chronic fatigue syndrome; fibromyalgia; functional somatic syndromes; irritable bowel syndrome; myalgic encephalomyelitis; systematic review.

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Conflict of interest statement

Omer Van den Bergh is a Subject Editor for Clinical Psychology in Europe but played no editorial role in this particular article or intervened in any form in the peer review process.

Figures

Figure 1
Figure 1. A-D. Frequency of Diagnosis-Specific (A-C) and Broad Reviews (i.e., Covering More Than One FSS Diagnosis and SSD) (D) Per Year of Publication Since 1990, Divided Into Narrative Reviews, Systematic Reviews Without and Systematic Reviews With Meta-Analyses
Note. Reviews focusing on somatic symptom disorder are summarised under reviews with a broad diagnostic concept. FMS = fibromyalgia syndrome; FSS = functional somatic syndrome; IBS = irritable bowel syndrome; CFS / ME = chronic fatigue syndrome / myalgic encephalomyelitis; SSD = somatic symptom disorder.
Figure 2
Figure 2. A-D. Frequency of Reviews (Regardless Investigated Diagnoses) Covering Biological (A), Psychological (B), Social (C) and Healthcare (D) Factors Per Year of Publication Since 1990, Divided Into Narrative Reviews, Systematic Reviews Without and Systematic Reviews With Meta-Analyses
Note. One review may cover several factors, and hence appear in more than one of the Figures A-D.
Figure 3
Figure 3. A-D. Aetiological Domains Covered in Diagnosis-Specific Reviews (A-C) and Reviews Applying a Broad Diagnostic Concept (D)
Note. One review may propose or investigate more than one aetiological factor. 'Multiple factor domains' indicates reviews that include two or more domains simultaneously. FMS = fibromyalgia syndrome; FSS = functional somatic syndrome; IBS = irritable bowel syndrome; CFS / ME = chronic fatigue syndrome / myalgic encephalomyelitis; SSD = somatic symptom disorder.
Figure 4
Figure 4. Frequency of Specific Investigated Biological and Psychosocial Factors in Systematic Reviews, Divided Into Reviews Addressing Irritable Bowel Syndrome, Fibromyalgia, Chronic Fatigue Syndrome, and Reviews Covering Somatic Symptom Disorder or More Than One of the Investigated Diagnoses Simultaneously
See this image and copyright information in PMC

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