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To the Editor: In his Contempo Updates article about chronic fatigue syndrome (CFS), Dr Natelson¹ did not discuss the relationship between CFS and posttraumatic stress disorder (PTSD). The 2 diagnoses share many features, including fatigue, hypocortisolism,^2-3 abnormalities of immune function,⁴ unrefreshing restless sleep, fluctuations in concentration or memory, headaches, muscle pain, joint pain, and withdrawal from occupational, educational, and social activities.^5-6

Psychiatrists tend to use different terminology to describe some of these signs and symptoms. One example would be the term "leaden paralysis" for the profound fatigue and inertia of CFS. Additionally, patients with PTSD sometimes describe pain and/or dysesthesias that are eventually found to be manifestations of "flashbacks."

Many of the treatments for PTSD and CFS are similar, as well. Examples include psychodynamic psychotherapy, cognitive behavioral therapy,¹ selective serotonin reuptake inhibitors, -blockers, and -agonists.⁷ Patients who have these concurrent diagnoses often report a decrease in symptoms when treated specifically . . . [Full Text of this Article]

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RELATED ARTICLE

Chronic Fatigue Syndrome
Benjamin H. Natelson
JAMA. 2001;285(20):2557-2559.
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