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August NaN, 2001

Chronic Fatigue Syndrome and Posttraumatic Stress Disorder—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorJody W.ZylkeMD, Contributing Editor


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JAMA. 2001;286(8):916-917. doi:10.1001/jama.286.8.916-JLT0822-2-2

In Reply: Dr Lipschitz asks whether CFS is one of the protean manifestations of PTSD. In the course of doing our medical entry evaluation on our patients, we perform a computerized psychiatric diagnostic interview (Q-DIS).1 One of the Q-DIS modules queries patients about the specific symptoms, listed by Lipschitz, which would allow for the diagnosis of PTSD. As might be expected, PTSD is common in veterans of the Persian Gulf War having CFS; we have found it in 50% of the health care–seeking Gulf War veterans whose symptoms fulfill the 1994 case definition for CFS.2 In contrast however, PTSD is very unusual in nonveterans with CFS. Of 240 nonveteran CFS Cooperative Research Center patients who also fulfill the 1994 case definition for CFS3 and who were negative for any axis I psychopathology in the 5 years prior to the onset of their illness, only 3 were positive for PTSD.2 Thus while CFS and PTSD frequently occur together in Gulf War veterans having CFS, this is not the case for nonveterans with CFS.

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