{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T13:27:42Z","timestamp":1793798862221,"version":"4.6.1"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fibromyalgia remains a contested clinical entity, characterized by uncertainty regarding its definition, diagnostic boundaries, and underlying mechanisms. Over the past three decades, diagnostic frameworks have evolved from the 1990 American College of Rheumatology classification criteria, based on widespread pain and tender point examination, to symptom-based models emphasizing patient-reported outcomes, such as the 2010 and 2016 American College of Rheumatology criteria. While these developments have improved feasibility and expanded clinical recognition, they have remained confined to biomedical and neuropsychological domains. This narrative review examines the historical evolution, conceptual foundations, and methodological limitations of fibromyalgia diagnostic criteria, integrating evidence from classification systems, including the American College of Rheumatology frameworks and the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION)\u2013American Pain Society Pain Taxonomy. Across these models, fibromyalgia is operationalized through symptom aggregation, with limited incorporation of the social and contextual determinants of health. The analysis highlights epistemological tensions, including diagnostic inflation, the continuum of polysymptomatic distress, and debates regarding disease legitimacy. In response, emerging proposals advocate for a biopsychosocial diagnostic framework that integrates biological, psychological, and social dimensions into the diagnostic core. This review also evaluates alternative dual-framework approaches that separate biological diagnosis from psychosocial severity assessment.<\/jats:p>","DOI":"10.1093\/mr\/roag055","type":"journal-article","created":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T20:04:33Z","timestamp":1782590673000},"page":"876-891","source":"Crossref","is-referenced-by-count":0,"title":["Fibromyalgia diagnosis: From past paradigms to future directions\u2014The state of the art and ongoing controversies"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3983-5342","authenticated-orcid":false,"given":"Andr\u00e9","family":"Pontes-Silva","sequence":"first","affiliation":[{"name":"Postgraduate Program in Physical Education, NERD Research Group, Federal University of Maranh\u00e3o , S\u00e3o Lu\u00eds 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