CHRONIC-FATIGUE-SYNDROME - A QUALITATIVE INVESTIGATION OF PATIENTS BELIEFS ABOUT THE ILLNESS

The chronic fatigue syndrome is a disabling chronic condition of uncer tain cause. Previous studies have found that patients seen in hospital clinics with the syndrome often strongly believe that their illness i s physical in nature and minimize the role of psychological and social factors. There is also evidence that patients cope by avoiding activi ty. However, almost all of these studies have assessed illness beliefs only by questionnaire. The aim of this study was to explore the natur e and origin of illness beliefs in more detail using in-depth intervie ws and a qualitative analysis of patient responses, Sixty-six consecut ive referrals meeting Oxford criteria for chronic fatigue syndrome wer e recruited. Analysis of responses indicated that, whereas the most co mmonly described explanation for the illness was a physical one, more than half the patients also believed ''stress'' had played a role. Pat ients believed that they could partially control the symptoms by reduc ing activity but felt helpless to influence the physical disease proce ss and hence the course of the illness. Patients reported that they ha d arrived at these beliefs about the illness after prolonged reflectio n on their own experience combined with the reading of media reports, self-help books, and patient group literature. The views of health pro fessionals played a relatively small role. There is potentially a cons iderable opportunity to help patients arrive at a wider and more enabl ing explanation of their illness when they first present to primary ca re. (C) 1997 Elsevier Science Inc.