title: Psychiatric misdiagnoses in patients with chronic fatigue syndrome.
abstract: OBJECTIVE
  The aim of this study was to examine the accuracy of doctors at diagnosing co-morbid psychiatric disorders in patients with chronic fatigue syndrome (CFS).
  
  
  METHODS
  Case series comparing clinical diagnoses with a standardized structured psychiatric interview.
  
  
  METHODS
  Secondary care specialist chronic fatigue syndrome clinic.
  
  
  METHODS
  One hundred and thirty-five participants of a randomized controlled trial of non-pharmacological treatments at one centre in the PACE trial.
  
  
  METHODS
  Current psychiatric diagnoses made by CFS specialist doctors, compared with current psychiatric diagnoses made independently using a structured psychiatric interview.
  
  
  RESULTS
  Clinicians identified 59 (44%, 95% CI 39-56%) of patients as suffering from a co-morbid psychiatric disorder compared to 76 (56%, CI 53-69%) by structured interview. Depressive and anxiety disorders were most common. Clinicians were twice as likely to miss diagnoses (30 patients, 22%) than misdiagnose them (13, 10%). Psychiatrists were less likely to miss diagnoses than other clinicians, but were as likely to misdiagnose them.
  
  
  CONCLUSIONS
  Doctors assessing patients in a chronic fatigue syndrome clinic miss psychiatric diagnoses more often than misdiagnosing them. Missed diagnoses are common. CFS clinic doctors should be trained to diagnose psychiatric disorders.
authors.affiliation: East London Foundation Trust , St Bartholomew's Hospital , London EC1A 7BE , UK.
authors.forename: Tara
authors.initials: T
authors.lastname: Lawn
authors.forename: Praveen
authors.initials: P
authors.lastname: Kumar
authors.forename: Bernice
authors.initials: B
authors.lastname: Knight
authors.forename: Michael
authors.initials: M
authors.lastname: Sharpe
authors.forename: Peter D
authors.initials: PD
authors.lastname: White