Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment [Hardcover]

Susan E. Abbey (Author), Mark A. Demitrack (Author)

Book Description

Publication Date: May 3, 1996 | ISBN-10: 1572300388 | ISBN-13: 978-1572300385 | Edition: 1

Chronic fatigue syndrome - a debilitating disorder associated with fatigue and a range of other constitutional complaints - has been the subject of much controversy in recent years. Originally conceptualized as a persistent viral infection, the disorder is now understood to be a much more complex phenomeon. This acclaimed volume assembles leading experts on CFS form the fields of psychiatry, infectious diseases, general internal medicine, and neuropsychology. Chapters explore the factors that contribute to the development of the disorder and present a multidisciplinary approach to evaluation and clinical management.

Editorial Reviews

Review

"As a research reference, the text has appreciable value in graduate education and clinical practice. Clinicians who are regularly involved in the diagnosis and care of patients whose chief complaints suggest CFS will find the text essential to their informational database. Clinicians concerned about the specificity of differential diagnosis will require both the foundation that the text provides and its structure and direction of care." --David B. Adams, PhD, FAPM Atlanta Medical Psychology, Psychotherapy
"The editors have done an outstanding job in collecting and organizing the background material to provide the reader with a complete history of this syndrome. The book also gives excellent criteria for diagnosing the syndrome and delineates its psychological aspects in an accurate and nonjudgmental manner." --Elaine Young in Science Books and Films

"...All [chapters] are excellently written, authoritative, and well referenced. The overview they provide is a real contribution to the current understanding of this most perplexing syndrome." --R.S. Kowalczyk, North Central Michigan College in Choice

"This is a scholarly and yet practical overview on the subject written by more than a dozen clinical scientists working at the cutting-edge of expanding knowledge of this all-too-common and harrowing syndrome. CFS has evolved in recent years from an illness in search of an infectious etiology to one in which not only may a variety of common and ordinarily self-limited infections play a role, to one in which such diverse topics as psychoneuroendocrinology, immune dysregulation, sleep disorders, physical deconditioning, and many others bring important perspectives to our understanding of the syndrome. These and other new concepts are reviewed scientifically and dispassionately by experts. One of the underlying themes that is well-developed is that mental health professionals play an important role in management of patients with CFS; a concept that has been admitted only with reluctance by many patients. The medical and neuropsychiatric manifestations, assessments, and diagnostic criteria for the syndrome are carefully delineated. Psychotherapeutic approaches to treatment are covered in depth in three related chapters. Two excellent additional chapters concerning medical and psychopharmacologic therapy conclude the book and cover all that we know that is scientific about what you can do for patients who suffer from the malady, including excellent discussions about antidepressants and 'alternative therapies.' This book will be of value to everyone who does research on CFS or who treats patients with the syndrome." --Robert Fekety, M.D., Professor Emeritus of Internal Medicine, University of Michigan Medical School

"Drs. Demitrack and Abbey are to be congratulated for providing a timely and thoughtful overview of a rapidly changing field. This is a thorough review of a confusing literature. Especially valuable are the sections on the history of the concept chronic fatigue syndrome and the evolution of the definition and diagnostic criteria. The chapters on the central nervous system and its role in this final common pathway as well as multiple system involvement leads to a sophisticated and broad approach to people with these disorders. Treatment has to be multi-faceted and is thoroughly explored. The chapters on cognitive behavior therapy are noteworthy for their careful attention to practical details." --Paul E. Garfinkel, M.D., F.R.C.P.(C), Professor and Chair, Department of Psychiatry, University of Toronto, Clarke Institute of Psychiatry

About the Author

Mark A. Demitrack, M.D., has been involved in the research and clinical care of patients with chronic fatigue syndrome for over a decade. A recognized authority on the topic, he has lectured widely at national and international conferences, and has published extensively in the peer-reviewed scientific literature. His work on the neuroendocrine correlates of the disorder was one of the pioneering efforts to suggest a role for central nervous system dysfunction in the pathophysiology of this disorder. He is currently working as a Research Physician at Lilly Research Laboratories, and is an Adjunct Associate professor of Psychiatry at the University of Michigan Medical Center.

Susan Abbey, M.D., F.R.C.P.(C), is the Director of the Program in Medical Psychiatry at the Toronto Hospital and Assistant Professor in the Department of Psychiatry at the University of Toronto. She completed psychiatric residency training at the University of Toronto, a clinical fellowship in medical psychiatry at Massachusetts General Hospital and Harvard University, and a doctoral research fellowship related to the psychiatric aspects of chronic fatigue syndrome at the Institute of Medical Science, University of Toronto.

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Product Details

• Hardcover: 317 pages
• Publisher: Guilford Press; 1 edition (May 3, 1996)
• Language: English
• ISBN-10: 1572300388
• ISBN-13: 978-1572300385
• Product Dimensions: 9 x 6.1 x 1.3 inches
• Shipping Weight: 1.3 pounds (View shipping rates and policies)
• Average Customer Review: 1.0 out of 5 stars  See all reviews (3 customer reviews)
• Amazon Best Sellers Rank: #7,012,451 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

16 of 18 people found the following review helpful:

1.0 out of 5 stars Huge conflict of interest: edited and written by researchers, executives, and psychiatrist consultants funded by Eli Lilly, July 12, 2005

By 

profile deleted - See all my reviews

This review is from: Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment (Paperback)

There is nothing here for patients, scientists or doctors requiring factually accurate biomedical information regarding the organically classified brain disorder ICD-10 G93.3 Chronic Fatigue Syndrome (CFS).

To understand why the information in this book does not apply to patients with the organic brain disorder Chronic Fatigue Syndrome (CFS), readers need to understand a basic principle of scientific medical research.

Organically classified diseases already HAVE medical explanations for symptoms whether or not the exact cause is known.

Patients with organic diseases, by definition alone, do not meet the criteria for psychiatric somatization (psychosomatic) disorders.

And according to the principles of scientific research information based on factually incorrect assumptions and study group selection criteria cannot be extrapolated to organically ill patients.

Nor, for that matter, do beliefs, personalities or behavior cause or perpetuate organic damage caused by active or cyclically reactivated neurotropic (brain/heart) viruses such as HHV-6 and EBV (check PubMed for biomedical studies).

Verification is beyond simple: Myalgic encephalomyelitis (ME)/post viral fatigue syndrome (PVFS)/chronic fatigue syndrome (CFS) are exclusively listed under G93.3 on page 494 - photocopies are available to the public.

Many doctors and patients are unaware of the ongoing ideological battle currently raging between psychiatrists over who is actually mentally ill and where mental illness ends and organic disease begins.

Or that adherents of psychiatrist George Engel's "Biopsychosocial" theory are reclassifying many organic diseases, not just G93.3 ME/PVFS/CFS or M79 fibromyalgia, as psychosomatic disorders in an effort to validate their theory.

Looking for a list of these organic disorders? Check the list of patient medical disorders covered under the lawsuits filed and won by states attorneys nationwide against UnumProvident Disability Insurance conglomerate or read biopsychosocial psychosomatic research by AJ Barsky.

Readers interested in accurate, applicable psychological information on CFS and fibromyalgia need to read books by longtime CDC and NIH researchers Dr. Leonard Jason and Renee Taylor also on Amazon.

3 of 3 people found the following review helpful:

1.0 out of 5 stars Good for a Laugh, November 15, 2009

By 

Justin Reilly, esq. (Boulder, CO) - See all my reviews

This review is from: Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment (Paperback)

Stephen Strauss, Peter Manu, Susan Abbey, Simon Wesseley; it's a veritable who's who of sadistic charlatans long ago disgraced and throughly repudiated by the top authorities on ME. Recommended for fans of fiction and nonsense.

Internist Paul Cheney, MD, PhD, the world's foremost clinican and top researcher on ME said of Straus' findings in his most (self-)publicized study, "it's an absolute lie." Internist Dan Peterson, also one of the world's foremost clinicians and researchers on ME said "Stephen Straus is a snake." Straus was still doing grand rounds in the mid- late 90's saying possible retroviral association with ME made no sense because retroviruses cause neurological, cognitive, immunological and endocrine pathology, which aren't prominent features of ME. These are in fact the central, disabling features of the disease. And of course quite a few bench scientists have found retroviral involvement since 1986, most recently Dan Peterson finding 95-98% of studied ME patients with antibodies to XMRV.

2 of 2 people found the following review helpful:

1.0 out of 5 stars The Empire Strikes Back..., March 22, 2010

By 

e. verrillo (williamsburg, ma) - See all my reviews

This review is from: Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment (Paperback)

I picked up this book in the hope that it would present relevant theories regarding the evaluation of CFS as well as some useful treatments. But when I came to the section in which typhoid was redefined as an "anxiety disorder" ("Historical Overview" by Mark Demitrack and Susan Abbey) my mind came to a screeching halt. How was it possible that two MDs could ignore the reality of rampant infectious diseases during the Civil War in favor of a wildly inappropriate psychological "diagnosis"? The answer is that they, along with the majority of the doctors who contributed to this volume, are psychiatrists, a profession which has traditionally attributed psychogenic causes to physical ailments.

Psychiatrists have long maintained the position that physical symptoms can be generated by the mind. (The mind does not, in fact, control physiological responses. The brain does. Try to lower your body temperature with your mind.) Freud,himself, mistakenly diagnosed patients with MS, sarcoma and hemophilia as "hysterics," a "diagnosis" which nearly resulted in the death of at least one of them (Emma Eckstein). Despite the existence of germ theory this trend continued unabated for a century. However, due to the increasing sophistication of medical tests, most psychological "explanations" for neurological disorders have fallen by the wayside. I can only imagine the glee with which the psychiatric community laid hold of Chronic Fatigue Syndrome, an illness for which no etiology had been discovered. CFS was their baby!

This book represents nothing more than a compilation of unsupported conjectures regarding CFS. These can be summarized as follows: CFS is largely caused by depression, "stress," and "psychological predisposition." The symptoms are psychosomatic, brought on by "illness beliefs," and lack of exercise. The treatments predictably revolve around "educating the patient with restructuring of beliefs and perspectives of the illness" and "graded exercise." Antidepressants, that staple of psychiatry, are also recommended. Not recommended are any treatments which might address the causes or physical symptoms of the illness (itemized by Anthony Komaroff on p. 169 in the book's single praiseworthy moment), since these have been rejected by the psychiatric community (which apparently believes that swollen glands, fevers, and night sweats can be produced by "beliefs").

I wish I could say that since the publication of this book, the larger medical community has changed its deplorable attitude towards people with the neuroimmunological disorder known as CFS/ME. Sadly, it has not. There is too much money at stake to release the stranglehold maintained by psychiatrists and financed by insurance companies. (Peter Manu, one of the most vocal of the "all in your head" theorists, is employed by Metlife.) Unfortunately, as long as psychiatry is considered to be a legitimate branch of medicine, the antiquated, and, in this case, profoundly damaging notions of psychiatrists will continue to be taken seriously.