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March 19, 2003

Organic vs Cultural Explanations of Chronic Fatigue Syndrome and Fibromyalgia—ReplyOrganic vs Cultural Explanations of Chronic Fatigue Syndrome and Fibromyalgia—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(11):1385. doi:10.1001/jama.289.11.1385-a

In Reply: Fibromyalgia and CFS describe sociopathies, chronic pain, and tiredness in an urban social context much given to imitative behavior and symptom amplification. The patients truly have pain, but I believe that its severity and persistence are iatrogenic, promoted by patient support groups, lawyers, and their allies in the medical profession. These diagnoses have become a profitable industry, but not profitable for the patients who are offered a prognosis that they can not get well and will worsen and be disabled, along with a variety of medicines that do not work. The supposed laboratory abnormalities are shared with people who do not carry the diagnoses, and it would be to the patients' benefit to abandon these illegitimate names and dissolve the advocacy groups; they might then be able to get better. Authors from within different disciplines have effectively denied the existence of fibromyalgia and CFS and provide ample documentation for the iatrogenic exacerbation of chronic pain that the diagnoses and those who espouse them produce.14 The book by Malleson5 helps undermine the concepts that erroneously gave rise to these diagnoses.

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