Doctors and Patients Roiled By CDC's All in the Head Rationale

By MIKAELA CONLEY, ABC News Medical Unit, Nov. 29, 2010

"They're focusing on the wrong problem by saying it's all in your head," said Adams, a part-time teacher who lives in Lake City, Fla. "Believe me, if it was all in my head, I'd be so happy. Send me to a shrink and give me some medicine."

In the study, published in the August issue of journal of Psychotherapy and Psychosomatics, study authors examined more than 500 patients from Georgia. More than 100 participants had been diagnosed with CFS, 264 participants had unexplained fatigue without CFS and another 124 healthy participants made up the control group.

Study authors said that 29 percent of participants with CFS had at least one personality disorder, compared with 28 percent of the non-CFS patients and 7 percent of the control group.

"A lot of people cried foul when this study came out, and since then, there has been rigorous debate," said Dr. Nancy Klimas, a professor of medicine, psychology, microbiology and immunology at the University of Miami Miller School of Medicine. "My reaction from my own clinical experience is: no, I don't believe that. My patients tend not to have those [personality] issues."

Klimas explained that extensive scientific research shows that CFS is similar to an autoimmune disorder.

Dr. Anthony Komaroff, the Simcox-Clifford-Higby professor of medicine at Harvard Medical School and editor-in-chief of Harvard Health Publications, said CFS first gain substantial attention in the mid-1980s. Komaroff said many doctors thought CFS to be a psychiatric condition.

"It was a reasonable possibility, but over the course of 25 years, there are literally thousands of peer-reviewed papers showing things you can measure in patients that are different from healthy people," said Komaroff. "There is abundant evidence showing that there are objective things to measure that people aren't just imagining being there. There is an underlying biological process."

"I feel bad about this study because these poor patients get nothing but attitude, they're patronized and have a poor standard of care," said Klimas. "It's just not right. They're terribly ill and they deserve better than that. "

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