Chronic fatigue

Jill McLaughlin, Executive director
National CFIDS Foundation Inc

Needham, Mass. -- This is regarding "Rethinking cognitive behavior therapy; Treatment for mental woes gets new attention amid antidepressant fears" (Q, May 9). Chronic fatigue syndrome is not a mental illness. Although there is no known etiology and no known diagnostic marker, there is substantial objective, well-documented evidence of central nervous system, immune, endocrine, cardiovascular and autonomic nervous system abnormalities, which
indicates that CFS is biologically, not psychologically, determined.

Published studies have shown that in patients with CFS, co-morbid psychiatric disorders, including anxiety, depression, etc., did not compromise physical functioning. CFS was found to be more disabling than diabetes, arthritis, cancer or congestive heart failure. Therefore, if psychological factors do not contribute to the profound physical disability, then psychological interventions, whether pharmacological or non-pharmacological (while they may reduce anxiety or improve mood), would not contribute to improvement in physical functioning.

There is a renewed interest in changing the name "Chronic Fatigue Syndrome."  The prominent association of "fatigue" with psychiatric illness, especially depression, has caused many erroneous assumptions and attributions and caused this type of misinformation to flourish.

"Myalgic encephalomyelitis" has been the preferred term, as it is a more specific and accurate diagnosis than "chronic fatigue syndrome," and describes a distinctive condition with muscle and neurological symptoms, not only the ubiquitous symptom of fatigue.