Tuesday, May 25, 2010

Submission to APA Re: "Complex Somatic Symptom Disorder", DSM-5

From: Dr John H Greensmith, ME Free For All.org

The fundamental stumbling block in finding a single diagnostic category most suitable for CFS/ME, whether in the Diagnostic and Statistical Manual for Mental Disorders (DSM) of the American Psychiatric Association, or the World Health Organisation (WHO) Handbook, or elsewhere, is that it contains, by definition, more than one term, each of which is unlikely to be
satisfactorily accommodated within only one category.

Even if each component, M.E. and CFS, (whether one takes M.E. to be Myalgic Encephalomyelitis or Myalgic Encephalopathy), fitted neatly and exclusively into one category (for example, neurological), or another category (for example psychiatric), or if it appeared always in more than one category (for example neurological and psychiatric) but never in some other category at all, the terms must first be separated.

The problem is further complicated for Chronic Fatigue Syndrome because, even when separated from M.E., CFS comprises several heterogeneous conditions, each with a variety of organic and/or psychiatric causes, which could not be placed in a single category. Even if M.E. is taken to be a discrete illness with no subsets (and this is not universally agreed), it is possible that some patients may co-incidentally have an additional but unrelated psychiatric history, or concurrent psychiatric illness, that did not cause, or was not caused by also having, M.E.

We should be mindful of a couple of concerns beyond the establishment of ...

1 comment:

Victoria said...


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vicky silvers


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