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The Chronic Fatigue Syndrome
- John H. Dodge, MD; and
- Michael W. Kita, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
The recent article on the chronic fatigue syndrome by Fukuda and colleagues [1] improves the clinical framework for viewing what seems to be an etiologically diverse group of disorders that vary in their course (severity, duration, and completeness of recovery). When the authors, citing two studies, inform readers that “some persons afflicted by the chronic fatigue syndrome improve with time” but “most remain functionally impaired for several years,” readers may equate “functionally impaired for. years” with chronically disabled.
We do feel that many physicians are doing their patients a disservice by emphasizing the extent of disability possibly attributable to the syndrome. We believe that the physician who, on making a diagnosis of the syndrome, automatically tells his or her patient to cease working is doing a disservice to that patient. Such an action can lead to an unfulfilling life of dependency that denies the patient the value of employment and family and community activities. Those who are encouraged to do little more than rest are cut off from those actions that our society has traditionally viewed as providing satisfaction and meaning in one's life.
Among those whose level of impairment because of the syndrome has made them eligible for disability benefits under private insurance coverage, our experience has been that the best functional outcomes have occurred for those whose motivation and expectations have been guided by case-management strategies of optimism, activity prescription, and early return to at least part-time work.
We believe that patients with the chronic fatigue syndrome should be encouraged to adapt to their illness and to pursue as fulfilling a life as they are able. Physicians can do a great service to their patients through supportive, caring therapy and vocational rehabilitation when needed, an approach that concentrates on returning patients to a productive role in their community. We hope that such an outcome is an important goal of all physicians caring for persons with the chronic fatigue syndrome.
John H. Dodge, MD
Michael W. Kita, MD
UNUM Life Insurance Company of America; Portland, ME 04122
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
