Financial Times FT.com

If it’s in the mind, it’s still the real thing

By Margaret McCartney

Published: March 22 2008 02:55 | Last updated: March 24 2008 05:58

Medically unexplained conditions are common and frequently contentious. Conditions such as myalgic encephalitis (also ME or chronic fatigue syndrome), fibromyalgia (a disorder where pain is felt at various points in the body), repetitive strain injury and irritable bowel syndrome are comparable in that they do not have a diagnostic test, and are usually diagnosed by a process of exclusion. Additionally, none has a clear pathological or biochemical abnormality.

Could they in fact be all part of the same syndrome? This hypothesis was raised a few years ago by Professor Simon Wessley and colleagues in a paper in the Lancet medical journal. Every medical speciality has its own “unexplained” syndromes, from “non-cardiac chest pain” in cardiology to chronic pelvic pain in gynaecology. As the authors of the paper postulated: “The existence of specific somatic syndromes is largely an artefact of medical specialisation.”

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