Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
To the Editor: The book review by Dr Ehrlich1 portrays individuals with chronic fatigue syndrome
(CFS) as victims of sensationalist media propaganda and medical charlatanism.
We find such a portrayal very disturbing, since individuals who have CFS are
actually victims of a medical establishment that has failed them.
Ehrlich argues that illnesses such as CFS are lacking in scientific
validity. However, the process of scientific validation has been greatly hampered
by the diagnostic criteria developed by the Centers for Disease Control and
Prevention in 1994.2 This case definition
relies on self-reported subjective symptoms that cannot be confirmed or measured
and, for the most part, are the same symptoms commonly used to diagnose various
primary psychiatric disorders. The 1994 case definition does not adequately
discriminate between cases and noncases, and instead increases the probability
that patients who have primary psychiatric disorders will be diagnosed as
Gilbert RB, Kaan R, Lipkin DM, Lepp M. Chronic Fatigue: Syndrome or Disease?. JAMA. 2000;283(6):744-745. doi:10.1001/jama.283.6.741