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by Abigail Van Buren

Doctor Says Chronic Fatigue Is Not All in Sufferers' Heads

DEAR ABBY: Dr. Eugene Schoenfeld recently said in your column that most psychiatrists deny that chronic fatigue is a "real disease." I write to offer a different opinion, shared by a growing number of physicians who have studied the scientific literature on chronic fatigue syndrome -- which now numbers several thousand research articles.

There is no evidence of any psychiatric disorder in a sizable number of patients with this illness. However, in laboratory tests, there is evidence of abnormalities in the brain and immune system of many of these patients. The immune system abnormalities, fortunately, do not seem to make patients vulnerable to infections. I highlight those studies in an article published in the Journal of the American Medical Association in October 1997.

We still do not understand the cause of chronic fatigue syndrome, but studies around the world show that the illness involves real changes in the bodies of many patients. It is not, as Dr. Schoenfeld seems to believe, "all in their heads." -- ANTHONY L. KOMAROFF, M.D., PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL

DEAR DR. KOMAROFF: Thank you for sharing your professional opinion with me, and for offering other physicians a reliable source of information about chronic fatigue and immune dysfunction syndrome. I am pleased that advances in understanding this disease have been made. I know my readers will be also.