Excerpts from two NY Times articles about CFS...
http://www.nytimes.com/2007/07/17/science/17fatigue.html?th&emc=th
Chronic Fatigue No Longer Seen as ‘Yuppie Flu’
By DAVID TULLER Published July 17, 2007
For decades, people suffering from chronic fatigue syndrome have struggled to convince doctors, employers, friends and even family members that they were not imagining their debilitating symptoms. Skeptics called the illness "yuppie flu" and "shirker syndrome." But the syndrome is now finally gaining some official respect.
Studies have shown that people with the syndrome experience abnormalities in the central and autonomic nervous systems, the immune system, cognitive functions, the stress response pathways and other major biological functions.
"There are many, many conditions that are psychological in nature that share symptoms with this illness but do not share much of the underlying biology," said John Herd, 55, a former medical illustrator and a C.F.S. patient for two decades.
"You can change people’s attributions of the seriousness of the illness if you have a more medical-sounding name," said Dr. Leonard Jason, a professor of community psychology at DePaul University in Chicago.
http://www.nytimes.com/2005/03/29/health/29tire.html?ex=1184817600&en=31d19bf62cf25955&ei=5070
For Chronic Fatigue, Placebos Fail the Test
By NICHOLAS BAKALAR Published: March 29, 2005
Many doctors believe that sugar pills are likely to be effective for patients with chronic fatigue syndrome, trusting that a placebo will help relieve the mental and physical exhaustion that characterize the illness.
But a new study has found that people who have the syndrome respond at a lower rate to placebos than patients with other diseases. The paper was published in the March-April issue of Psychosomatic Medicine.
Studies suggest that placebos relieve the symptoms for about 30 percent of patients suffering from a wide variety of illnesses. Migraine headaches, for example,respond at a rate of about 29 percent to placebo treatment, major depression at about 30 percent and reflux esophagitis at about 26 percent. ... among people with chronic fatigue syndrome, only 19.6 percent responded to placebos.
But Dr. Brian Fallon, an associate professor of psychiatry at Columbia University, offers a different interpretation. The fact that chronic fatigue syndrome responds so poorly to placebo treatment, he said, provides evidence that the syndrome has a physiological basis, though one that is still poorly understood.
"The finding by Dr. Cho and colleagues will come as no surprise to patients with C.F.S. who experience debilitating fatigue despite numerous treatment interventions," Dr. Fallon said. "That the placebo response in C.F.S. was far lower that in primary psychiatric disorders such as depression highlights the distinct nature of C.F.S. and how little we know."
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This has always been the problem – doctors who believe that CFS and fibromyalgia are "all in your head" and therefore can be fixed with some counseling, a placebo, an anti-depressant or a kick in the pants. And when that doesn’t cure you, you’re scolded for not cooperating or "not wanting to go back to work", rather than the doctor considering that you need serious treatment to get well from a serious disease.
The only two treatments that have shown promise in improving CFS are both anti-virals ... hardly evidence that patients are imagining their symptoms!
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