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Somatization, illness attribution & the sociocultural psychiatry of Chronic Fatigue Syndrome (CFS)

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www.ProHealth.com • January 3, 1993


In addition to epidemiological and neurobiological perspectives on
the relationship between chronic fatigue syndrome (CFS) and
psychiatric disorders there has been increasing interest in
the role of cognitive-behavioural, psychological,
psychodynamic and social factors in the psychiatric aspects of
this syndrome. These factors may be important in the
initiation and/or maintenance of CFS and play important roles
in the misdiagnosis of primary psychopathology as CFS. They
may be important targets for intervention and treatment. This
paper examines the relevance of the following issues for
better understanding the relationship between CFS and the
results of psychiatric studies: (1) the concepts of
somatization and abnormal illness behaviour; (2) the role of
patients' illness attributions; (3) psychological and
psychodynamic constructs such as depressive vulnerability
occurring in individuals dependent upon achievement for the
maintenance of self-esteem and euthymic mood, perfectionism,
and helplessness; (4) the role of personality characteristics
and styles; (5) the potential iatrogenic role of the health
care system in producing disability in individuals with a
diagnosis of CFS; (6) the role of the media and other
sociocultural forces in the patient's choice of the CFS label;
and (7) the impact of the CFS label on the patient. The
importance of differentiating between initiating and
maintaining or perpetuating factors is emphasized.

Abbey SE



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