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Chronic fatigue syndrome defies the mind-body-schism of medicine

New perspectives on a multiple realisable developmental systems disorder

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Abstract

The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested.

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References

  • Appel, S., J. Chapman, and Y. Shoenfeld. 2007. Infection and vaccination in chronic fatigue syndrome: Myth or reality? Autoimmunity 40: 48–53.

    Article  PubMed  Google Scholar 

  • Arthur, W. 2004. The effect of development on the direction of evolution: Toward a twenty-first century consensus. Evolution & Development 6: 282–288.

    Article  Google Scholar 

  • Barker, D.J.P. 2007. The origins of developmental origins theory. Journal of Internal Medicine 261: 412–417.

    Article  CAS  PubMed  Google Scholar 

  • Barrett, B., D. Muller, D. Rakel, D. Rabago, L. Marchand, and J. Scheder. 2006. Placebo, meaning and health. Perspectives in Biology and Medicine 49: 178–198.

    Article  PubMed  Google Scholar 

  • Buchwald, D., R. Herrell, S. Ashton, M. Belcourt, K. Schmaling, P. Sullivan, M. Neale, and J. Goldberg. 2001. A twin study of chronic fatigue. Psychosomatic Medicine 63: 936–943.

    CAS  PubMed  Google Scholar 

  • Buskila, D., and J. Press. 2001. Neuroendocrine mechanisms in fibromyalgia-chronic fatigue. Best Practice & Research Clinical Rheumatology 15: 747–758.

    Article  CAS  Google Scholar 

  • Claypoole, K.H., C. Noonan, R.K. Mahurin, J. Goldberg, T. Erickson, and D. Buchwald. 2007. A twin study of cognitive function in chronic fatigue syndrome: The effects of sudden illness onset. Neuropsychology 21: 507–513.

    Article  PubMed  Google Scholar 

  • Craig, A.D. 2003. Interoception: The sense of the physiological condition of the body. Current Opinion in Neurobiology 13: 500–505.

    Article  CAS  PubMed  Google Scholar 

  • Craig, A.D. 2004. Human feelings: Why are some more aware than others? TRENDS in Cognitive Sciences 8: 239–241.

    Article  PubMed  Google Scholar 

  • Dantzer, R., and K.W. Kelley. 2007. Twenty years of research on cytokine-induced sickness behavior. Brain, Behaviour, and Immunity 21: 153–160.

    Article  CAS  Google Scholar 

  • Dantzer, R., J.C. O’Connor, G.C. Freund, R.W. Johnson, and K.W. Kelley. 2008. From inflammation to sickness and depression: When the immune system subjugates the brain. Nature Reviews Neuroscience 9: 46–57.

    Article  CAS  PubMed  Google Scholar 

  • Descartes, R. 1989. The passions of the soul. Indianapolis: Hackett Publishing Company.

    Google Scholar 

  • Devanur, L.D., and J.R. Kerr. 2006. Chronic fatigue syndrome. Journal of Clinical Virology 37: 139–150.

    Article  CAS  PubMed  Google Scholar 

  • Feinberg, A.P. 2007. Phenotypic plasticity and the epigenetics of human disease. Nature 447: 433–440.

    Article  CAS  PubMed  Google Scholar 

  • Frank, S.A. 1997. Developmental selection and self-organization. Biosystems 40: 237–243.

    Article  CAS  PubMed  Google Scholar 

  • Gaillard, R.C., and E. Spinedi. 1998. Sex- and stress–steroids interactions and the immune system: Evidence for a neuroendocrine-immunological sexual dimorphism. Domestic Animal Endocrinology 15: 345–352.

    Article  CAS  PubMed  Google Scholar 

  • Gluckman, P., and M. Hanson. 2005. The fetal matrix: Evolution, development and disease. Cambridge: Cambridge University Press.

    Google Scholar 

  • Goldberger, A.L. 2006. Complex systems. Proceedings of the American Thoracic Society 3: 467–471.

    Article  PubMed  Google Scholar 

  • Hamburger, V. 1980. Embryology and the modern synthesis in evolutionary theory. In The evolutionary synthesis, ed. E. Mayr and W.B. Provine, 96–112. Harvard University Press: Cambridge.

    Google Scholar 

  • Heidegger, M. 1962. Being and time. Oxford: Blackwell Publishers Ltd.

    Google Scholar 

  • Hickie, I.B., A.S. Bansal, K.M. Kirk, A.R. Lloyd, and N.G. Martin. 2001. A twin study of the etiology of prolonged fatigue and immune activation. Twin Research 4: 94–102.

    Article  Google Scholar 

  • Hooper, M. 2007. Myalgic encephalomyelitis: A review with emphasis on key findings in biomedical research. Journal of Clinical Pathology 60: 466–471.

    Article  CAS  PubMed  Google Scholar 

  • Kaminsky, Z., S.C. Wang, and A. Petronis. 2006, ‘Complex disease, gender and epigenetics. Annals of Medicine 38: 530–544.

    Article  CAS  PubMed  Google Scholar 

  • Kerr, J.R., P. Christian, A. Hodgetts, P.R. Langford, L.D. Devanur, R. Petty, B. Burke, L.I. Sinclair, S.C. Richards, J. Montgomery, C.R. McDermott, T.J. Harrison, P. Kellam, D.J. Nutt, and S.T. Holgate. 2007. Current research priorities in chronic fatigue syndrome/myalgic encephalomyelitis: Disease mechanisms, a diagnostic test and specific treatments. Journal of Clinical Pathology 60: 113–116.

    Article  CAS  PubMed  Google Scholar 

  • Kirkengen, A.L. 2008. Inscriptions of violence: Societal and medical neglect of child abuse—impact on life and health. Medicine, Health Care and Philosophy. doi:10.1007/s11019-007-9076-0.

    Google Scholar 

  • Koelle, D.M., S. Barcy, M.L. Huang, R.L. Ashley, L. Corey, J. Zeh, S. Ashton, and D. Buchwald. 2002. Markers of viral infection in monozygotic twins discordant for chronic fatigue syndrome. Clinical Infectious Diseases 35: 518–525.

    Article  PubMed  Google Scholar 

  • Martinez-Lavin, M., O. Infante, and C. Lerma. 2008. Hypothesis: The chaos and complexity theory may help our understanding of fibromyalgia and similar maladies. Seminiars in Arthritis and Rheumatism 37: 260–264.

    Article  Google Scholar 

  • Mayer, E.A., B.D. Naliboff, and A.D. Bud Craig. 2006. Neuroimaging of the brain-gut axis: From basic understanding to treatment of functional GI disorders. Gastroenterology 131: 1925–1942.

    Article  PubMed  Google Scholar 

  • Moran, D. 2000. Introduction to phenomenology. London: Routledge.

    Google Scholar 

  • Morris, J.A., C.L. Jordan, and S.M. Breedlove. 2004. Sexual differentiation of the vertebrate nervous system. Nature Neuroscience 7: 1034–1039.

    Article  CAS  PubMed  Google Scholar 

  • Osmond, C., and D.J. Barker. 2000. Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environmental Health Perspectives 108 (Suppl. 3): 545–553.

    Article  PubMed  Google Scholar 

  • Owens, I.P. 2002. Ecology and evolution. Sex differences in mortality rate. Science 297: 2008–2009.

    Article  PubMed  Google Scholar 

  • Padgett, D.A., and R. Glaser. 2003. How stress influences the immune response. Trends in Immunology 24: 444–448.

    Article  CAS  PubMed  Google Scholar 

  • Perlman, R.L. 2005. Why disease persists: An evolutionary nosology. Medicine, Health Care and Philosophy 8: 343–350.

    Article  Google Scholar 

  • Reid, S., T. Chalder, A. Cleare, M. Hotopf, and S. Wessely. 2005. Chronic fatigue syndrome. Clinical Evidence, 1366–1378.

  • Reik, W. 2007. Stability and flexibility of epigenetic gene regulation in mammalian development. Nature 447: 425–432.

    Article  CAS  PubMed  Google Scholar 

  • Sabath, D.E., S. Barcy, D.M. Koelle, J. Zeh, S. Ashton, and D. Buchwald. 2002. Cellular immunity in monozygotic twins discordant for chronic fatigue syndrome. Journal of Infectious Disease 185: 828–832.

    Article  Google Scholar 

  • Shakhar, K., H.B. Valdimarsdottir, J.S. Guevarra, and D.H. Bovbjerg. 2007. Sleep, fatigue, and NK cell activity in healthy volunteers: Significant relationships revealed by within subject analyses’. Brain, Behavior, and Immunity 21: 180–184.

    Article  CAS  PubMed  Google Scholar 

  • Svenaeus, F. 2007. Do antidepressants affect the self? A phenomenological approach. Medicine, Health Care and Philosophy 10: 153–166.

    Article  Google Scholar 

  • Tanriverdi, F., Z. Karaca, K. Unluhizarci, and F. Kelestimur. 2007. The hypothalamo-pituitary-adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome. Stress 10: 13–25.

    Article  CAS  PubMed  Google Scholar 

  • Ullrich, P.M., N. Afari, C. Jacobsen, J. Goldberg, and D. Buchwald. 2007. Cold pressor pain sensitivity in monozygotic twins discordant for chronic fatigue syndrome. Pain Medicine 8: 216–222.

    Article  PubMed  Google Scholar 

  • Ulvestad, E. 2007. Defending life. The nature of host–parasite relations. Dordrecht: Springer.

    Google Scholar 

  • Vollmer-Conna, U., C. Fazou, B. Cameron, H. Li, C. Brennan, L. Luck, T. Davenport, D. Wakefield, I. Hickie, and A. Lloyd. 2004. Production of pro-inflammatory cytokines correlates with the symptoms of acute sickness behaviour in humans. Psychological Medicine 34: 1289–1297.

    Article  CAS  PubMed  Google Scholar 

  • Vollmer-Conna, U., B. Cameron, D. Hadzi-Pavlovic, K. Singletary, T. Davenport, S. Vernon, W.C. Reeves, I. Hickie, D. Wakefield, and A.R. Lloyd, for the Dubbo Infective Outcomes Study Group. 2007. Postinfective fatigue syndrome is not associated with altered cytokine production. Clinical Infectious Diseases 45: 732–735.

    Article  CAS  PubMed  Google Scholar 

  • von Bertalanffy, L. 1962. General system theory—a critical review. General Systems 7: 1–20.

    Google Scholar 

  • Wessely, S., C. Nimnuan, and M. Sharpe. 1999. Functional somatic syndromes: One or many? Lancet 354: 936–939.

    Article  CAS  PubMed  Google Scholar 

  • Wittgenstein, L. 1960. The blue and brown books. New York: Harper & Row.

    Google Scholar 

  • Wulff, H.R., S.A. Pedersen, and R. Rosenberg. 1990. Philosophy of medicine. An introduction. London: Blackwell Scientific Publications.

    Google Scholar 

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Acknowledgement

The help and inspiration provided by Anna Luise Kirkengen is highly appreciated.

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Authors and Affiliations

  1. Department of Microbiology and Immunology, Haukeland University Hospital, and The Gade Institute, University of Bergen, Armauer Hansen Building, Bergen, 5021, Norway

    Elling Ulvestad

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  1. Elling Ulvestad
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Correspondence to Elling Ulvestad.

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Ulvestad, E. Chronic fatigue syndrome defies the mind-body-schism of medicine. Med Health Care and Philos 11, 285–292 (2008). https://doi.org/10.1007/s11019-008-9126-2

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  • DOI: https://doi.org/10.1007/s11019-008-9126-2

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