Thomas L. English, MD
English TL. Functional Somatic Syndromes. Ann Intern Med. 2000;132:329. doi: 10.7326/0003-4819-132-4-200002150-00021
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Published: Ann Intern Med. 2000;132(4):329.
TO THE EDITOR:
Barsky and Borus's review is logically flawed (1). The authors assert that several entities, including the chronic fatigue syndrome, are “functional.” They define functional somatic syndrome as “ … characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality.” Why include the chronic fatigue syndrome? The authors cite no postmortem examinations, no brain biopsies, no negative findings of any kind. Evidence suggests organic disease: abnormal findings on single-photon emission computed tomography, positron-emission tomography, and magnetic resonance imaging scans (2, 3); hypothalamic hypofunction (4); and cognitive deficits (5). The burden of proof is on the authors to show “no demonstrable tissue abnormality.” They do not. Subsequent discussion on the chronic fatigue syndrome lacks logical foundation.
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