Chronic fatigue syndrome Role of psychological factors overemphasised

摘要: EDITOR, - In concluding that psychological factors are more important than immunological ones in determining the long term outcome of myalgic encephalomyelitis or chronic fatigue syndrome Andrew Wilson and colleagues seem overconfident validity their findings.1 Although use self rated measures is necessary, investigators' treatment such data questionable. For example, five point global illness was dichotomised an original response “not improved at all” recorded to “worsened” a decision investigators fail justify. It also dubious whether patients' recall own premorbid state accurate, given average onset 9.2 years before finding memory event affected by subsequent events.2 Further association “disease conviction” lack follow up may reflect fact patients with severe physical symptoms (for inability walk) attribute disease basis do who experience mild headaches tiredness). this way conviction could be measuring severity. The possibility variables thus invalidated suggest caution needed interpretation, which authors note. In line above reasoning, objective representative true affairs, case results delayed hypersensitivity skin tests Karnofsky performance index (rated one investigators) should receive relatively focus. only significant predictors up, however, were cutaneous energy initial assessment, not surprising (and suggests people immunologically compromised entry study …