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June 3, 1998

Seeking Answers to Chronic Fatigue Syndrome

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(21):1697-1698. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-21-jbk0603

To the Editor.—Dr Loudon1 reviews a book by Floyd Skloot in which Skloot describes his experience as a patient with CFS. Loudon refers to Skloot's dismay over the suggestion by one of his physicians that his illness might be of psychological origin. Skloot is so wary of having a psychosomatic illness that he is alarmed by his inclusion in a study with a placebo arm because, if he were to improve on placebo, he would be humiliated. Leaving aside the question of the cause of CFS, I wish to condemn the attitude toward psychological illness exemplified by this treatise, namely, that this illness is somehow unacceptable. Why does a psychological diagnosis represent "betrayal"? It is an important question, relevant to trying to offer cost-effective medicine and in helping people to feel better and to function better. This regrettably common antipsychology attitude is based on the unfortunate mind-body dualism that has gained preeminence in the West during this century. The reluctance of both physicians and patients to accept depression, anxiety, and related illnesses as legitimate and, more important, as treatable is a shame.

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