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Assessing somatization disorder in the Chronic Fatigue Syndrome (CFS)

  [ 24 votes ]   [ Discuss This Article ] • January 15, 1996

This study was conducted to examine the rates of somatization
disorder (SD) in the chronic fatigue syndrome (CFS) relative
to other fatiguing illness groups. It further addressed the
arbitrary nature of the judgments made in assigning
psychiatric vs. physical etiology to symptoms in controversial
illnesses such as CFS. Patients with CFS (N = 42), multiple
sclerosis (MS) (N = 18), and depression (N = 21) were compared
with healthy individuals (N = 32) on a structured psychiatric
interview. The SD section of the Diagnostic Interview Schedule
(DIS) III-R was reanalyzed using different criteria sets to
diagnose SD. All subjects received a thorough medical history,
physical examination, and DIS interview. CFS patients received
diagnostic laboratory testing to rule out other causes of
fatigue. This study revealed that changing the attribution of
SD symptoms from psychiatric to physical dramatically affected
the rates of diagnosing SD in the CFS group. Both the CFS and
depressed subjects endorsed a higher percentage of SD symptoms
than either the MS or healthy groups, but very few met the
strict DSM-III-R criteria for SD. The present study
illustrates that the terminology used to interpret the
symptoms (ie, psychiatric or physical) will determine which
category CFS falls into. The diagnosis of SD is of limited use
in populations in which the etiology of the illness has not
been established.

Johnson SK, DeLuca J, Natelson BH

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