INVITED REVIEW
The act of diagnosis: pros and cons of labelling chronic fatigue syndrome
Marcus J H Huibers and Simon Wessely
Psychological Medicine, Page 1 of 8. f 2006 Cambridge University Press
doi:10.1017/S0033291705006926
http://www.simonwessely.com/Downloads/Publications/CFS/179.pdf
"Like it or not, CFS is not simply an illness, but a cultural phenomenon and metaphor of our times."
"Labelling physical symptoms as an illness carries the risk of the symptoms becoming self-validating and self-reinforcing, often promoted by the Internet, support groups, self-help literature and mass media."
"The ways in which CFS patients perceive themselves, label their symptoms and appraise stressors may perpetuate or exacerbate their physical and psychosocial dysfunction (Afari & Buchwald, 2003)."
"Many CFS patients, particularly in hospital settings, share a strong conviction that their symptoms are physical in nature. A plausible explanation is that biological illness attributions provide legitimacy, alleviate personal responsibility and protect against stigma (HortonSalway, 2001), as opposed to psychosocial illness attributions. As a result, CFS patients will seek doctors who offer explanations in keeping with their own illness beliefs."
"Diagnosis elicits the belief the patient has a serious disease, leading to symptom focusing that becomes self-validating and self reinforcing and that renders worse outcomes, a self-fulfilling prophecy, especially if the label is a biomedical one like ME."