New insights into culture driven disorders.
Rheumatologists frequently encounter patients whose illnesses lack face-value; that is, they lack the typical objective features of pathology that rheumatologists traditionally rely on for diagnosis and developing effective treatment approaches: namely fibromyalgia, chronic fatigue syndrome, Gulf War syndrome, chronic whiplash, chronic low back pain, etc. In this article, we examine this group of illnesses as culture-driven disorders to emphasize the central importance of various societal constraints in the ultimate presentation of patients with these illnesses. We will examine them by first understanding the purpose they serve, the underlying factors that compel societal institutions to sanctify these disorders as diseases, and how research is beginning to examine the behaviour that captures and packages these symptoms to produce their clinical presentation. With this research understanding, rheumatologists may be able to offer patients more useful action plans, but likely changes in societal approaches to the expressions of distress and changes in disability and compensation systems will also be required.
Aceves-Avila
Francisco Javier
FJ
Hospital General Regional No. 46, Instituto Mexicano del Seguro Social, Unidad de Investigación en Enfermedades Crónico-Degenerativas SC, Guadalajara, Jalisco, Mexico. fjaceves@megared.net.mx
Ferrari
Robert
R
Ramos-Remus
Cesar
C
D003466:Cultural Characteristics; D006801:Humans; D008960:Models, Psychological; D011364:Professional Practice; D012219:Rheumatology / Q000379:methods*; D013577:Syndrome