Chronic Fatigue Syndrome: Hopes Raised with Discovery of Virus

Chronic fatigue is an interesting clinical syndrome that quite often gets an individual either referred to psychiatry or diagnosed with psychiatric problems. It has stumped clinicians in terms of effective treatments.

The current study discussed in the article below, has identified a retrovirus that was present in 67% of those with Chronic fatigue vs. 3% in the general population. This is promising, but not quite as sensitive or specific as one would wish.

This syndrome is a good example of how health care providers often marginalize conditions that they are not able to identify and manage well. Some of this results from the desire or expectation (unrealistic usually) that our health providers will identify, manage and alleviate our health problems. A result of this projection is the provider often feels a failure for not being able to cure problems that still have not had adequate study. Then I think the marginalization happens, and often the problem gets labeled a ‘psychiatric or mental health’ issue. When this happens it is as if the world is then saying it is all in your head. As if you are making it up! What a crime!

I have known many people with Chronic Fatigue who were quite well balanced and without psychiatric symptoms of any kind until this syndrome literally ‘took over’ their lives. I have also worked with patients referred to psych as a last ditch effort to ‘fix this person’. Unfortunately we cannot ‘fix’ those with this syndrome. I am certain that psychotherapy (and some pharmacologic agents) can be helpful to those coping with this problem. But I do not see it as that different than coping with many chronic diseases.

Perhaps health care providers need to be more comfortable with what we have not yet learned. If we owned up to what we were not certain of, the expectations of those we serve would also be lowered. Perhaps then those with real health problems would not be 'banished' to psychiatry.

Hopefully this study is a true step forward in our learning more about Chronic Fatigue Syndrome.

http://www.nytimes.com/2009/10/13/health/13fatigue.html?pagewanted=1&_r=1&th&emc=th