Diagnosis in chronic illness: disabling or enabling–the case of Chronic Fatigue Syndrome (CFS)

This paper examines doctors' and patients' views on the consequences
of an increasingly common symptomatic diagnosis, chronic
fatigue syndrome (CFS). Two studies were conducted: the first
comprised interviews with 20 general practitioners; the second
was a longitudinal study, comprising three interviews over a
period of 2 years with 50 people diagnosed with CFS. Contrasts
were apparent between doctors' practical and ethical concerns
about articulating a diagnosis of CFS and patients'
experiences with and without such a diagnosis. Seventy per
cent of the doctors were reluctant to articulate a diagnosis
of CFS. They felt constrained by the scientific uncertainty
regarding its aetiology and by a concern that diagnosis might
become a disabling self-fulfilling prophecy. Patients, by
contrast, highlighted the enabling aspects of a singular
coherent diagnosis and emphasized the negative effects of
having no explanation for their problems.

Woodward RV, Broom DH, Legge DG

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