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Sociosomatics and Illness in CFS

Loma Linda University, School of Medicine, Department of Neurology, Loma Linda, CA 92354

In her discussion of "chronic fatigue syndrome" and issues involving the work place, I was surprised that Dr. Norma Ware didn’t interview employers for her study (1). She might have gotten a quite different perspective. Anecdotally, patients with "CFS" idealize their motivation and efforts, fitting themselves with halos. In short, I don’t consider self-report to be valid or useful in patients with somatoform disorders.

Furthermore, to use terms like "CFS sufferers" and "debilitating condition" in a medical paper is a bit maudlin, unless one is discussing this from a psychiatric point of view. Along with others, I have found that persons with this and similar diagnoses (such as fibromyalgia) can be highly energetic, particularly when it comes to litigation, compensation, and disability. There may also be emotional rewards within the family structure or via friends, and I find Dr. Ware’s definition of "secondary gain" to be rather narrow.

REFERENCES

1. Ware NC. Sociosomatics and illness course in chronic fatigue syndrome. Psychosom Med 1998; 60: 394–401.[Abstract/Free Full Text]

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