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Book Review   |    
Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment
Gary Rodin, M.D.
Psychiatric Services 1998; doi:
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edited by Mark A. Demitrack, M.D., and Susan E. Abbey, M.D.; New York City, Guilford Press, 1996, 317 pages, $35

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This text is a welcome addition to the controversial and perplexing field of chronic fatigue. In an area marked by disagreement and polarization, editors Demitrack and Abbey present a comprehensive and balanced view of the syndrome. They have compiled reviews of the literature and critical evaluations of the scientific evidence from a variety of perspectives by experts in the field. Dr. Demitrack is a specialist who has been interested in the neuroendocrine aspects of psychiatric disorders, and Dr. Abbey is an expert in the clinical and sociocultural aspects of somatizing conditions.

The editors take the position that chronic fatigue is a multidetermined condition for which a single linear cause is unlikely to be found. Their approach is evidence based and leaves room for considerable speculation about the causes and consequences of this condition. The text begins with an interesting historical overview of chronic fatigue. In the assessment section are very strong chapters by Drs. Abbey and Demitrack on psychiatric assessment and by Anthony Komaroff and Laura Fagioli on medical assessment. The treatment section includes an excellent chapter on psychotherapy by Dr. Abbey and two separate chapters on cognitive-behavior therapy by Drs. Simon Wessely and Michael Sharpe.

Chronic Fatigue Syndrome is extremely well written and will be of value to clinicians and investigators experienced in the field as well as to those new to the area. This text brings a balanced voice of reason, science, and compassion to a condition that has generated considerable suffering and controversy. It should encourage further research and discussion among practitioners and patients with diverse points of view.

Dr. Rodin is affiliated with the department of psychiatry of the Toronto Hospital in Toronto, Ontario.




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