Diagnosis in chronic illness: disabling or enabling--the case of chronic fatigue syndrome.
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
R V
RV
National Centre for Epidemiology and Population Health, Australian National University, Canberra.
Broom
D H
DH
Legge
D G
DG
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001315:Australia; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012934:Social Isolation