Overview
Epidemiology
Attributions
Chronic Fatigue Syndrome (CFS) emerged as a diagnostic
category during the last decade. Initial research suggested that CFS was
a relatively rare disorder with a high level of psychiatric
comorbidity. Many physicians minimized the seriousness of this disorder
and also interpreted the syndrome as being equivalent to a psychiatric
disorder. These attitudes had negative consequences for the treatment of
CFS. Both the CFS case definition criteria and biases in the scoring and
selection of psychiatric tests contributed to eliciting high rates of psychiatric
comorbidity as well as the possibility of misdiagnosing purely psychiatric
cases as CFS cases. In addition, early CFS epidemiological studies, which
were based on physician referrals for case ascertainment, underestimated
the prevalence of this illness. By the mid 1990's, findings from more representative
epidemiologic studies indicated considerably higher CFS prevalence rates.
However, the use of the revised CFS case definition might have produced heterogeneous
patient groups, possibly including some patients with pure psychiatric
disorders. This development complicated the interpretation of epidemiologic
data and treatment outcome studies, which currently recommend fundamentally
distinct and conflicting rehabilitation programs. Social scientists have
the expertise to more precisely define this syndrome and to develop appropriate
and sensitive research strategies for understanding this disease.