Chronic fatigue syndrome defies the mind-body-schism of medicine. New perspectives on a multiple realisable developmental systems disorder.
The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested.
Ulvestad
Elling
E
Department of Microbiology and Immunology, Haukeland University Hospital, and The Gade Institute, University of Bergen, Armauer Hansen Building, Bergen, 5021, Norway. elling.ulvestad@helse-bergen.no
D004992:Ethics, Medical; D015673:Fatigue Syndrome, Chronic / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D010686:Philosophy, Medical; D012803:Sick Role