Chronic episodic disorders in women

Many of the chronic episodic disorders, such as major depression, migraine headache, irritable bowel, and fibromyalgia, are comorbid in a bidirectional manner. This comorbidity can lead to difficulties in diagnosis and may complicate treatment. The commonalities of these disorders have been referred to as affective spectrum disorders, the stress-related syndromes, or central sensitivity syndrome. These comorbid chronic episodic disorders have important commonalities, including an increased prevalence in women, an absence of classic anatomic pathology in the tissues, a lack of objective findings on physical examination, and a lack of specific abnormal findings by routine laboratory and radiologic tests. Patients with these disorders typically are treated by various medical specialists that fail to comprehensively target treatment to address the underlying similar pathophysiology of hypothalamic-pituitary-axis hyperactivity and central serotonin dysfunction. Attention by psychiatrists to the related physical and psychiatric symptoms that their patients endure may result in improved treatment and functioning of the individual.