ABSTRACT
Chronic multi-symptom disorders are persisting conditions characterized by distressing or disabling symptoms in multiple organ systems and for which no physiological or anatomical cause is evident. Pain is a feature of most such disorders. Examples of such syndromes include irritable bowel, chronic fatigue, bromyalgia, multiple chemical sensitivity, interstitial cystitis, temporomandibular joint disorder, pelvic pain, and many other chronic pain conditions. The common denominator linking these disorders is a pattern. Each has a constellation of multiple symptoms that obvious pathophysiology cannot explain; emotionally distressing events exacerbate symptoms and strong resistance to conventional medical intervention. Multisymptom disorders are neither surrogate manifestations of psychological problems nor symptom exaggerations, and physiological markers exist in many cases. For example, irritable bowel syndrome patients and interstitial cystitis patients both demonstrate abnormalities of the epithelium. Patients with multi-symptom disorders appear to suffer more distress than patients with similar symptoms due to identiable organic disease. Such disorders compromise performance at work, prevent or limit recreation and travel, alter interpersonal relationships, and in general degrade quality of life. Some patients are partially or fully disabled by their condition.
