Stigma and chronic fatigue syndrome.

We predicted that the largely female population seeking relief from the incapacitating symptoms of chronic fatigue syndrome (CFS), an enigmatic illness, would feel stigmatized, and that attribution of CFS symptoms to psychological causes by physicians would contribute significantly to the CFS-related stigma. Most subjects scored high on measures of stigma: 95% had feelings of estrangement, 70% believed that others attributed their CFS symptoms to psychological causes, 77% coped by using an educational strategy (disclosure) and 39% saw a need to be secretive about their symptoms in some circumstances. Most subjects (77%) were labeled as `psychological cases' by one or more of the physicians (mean = 8) consulted, but of the 4 stigma measures, only disclosure was related to physician labeling. Such factors as duration of illness and unemployment, dissatisfaction with spouse, and symptom severity correlated significantly with measures of stigma. That many physicians were reportedly ignorant or skeptical of CFS (male more so than female MD's) may influence attempts of CFS patients to legitimize their symptoms by disclosure and lead to high rates of health care system use. [ABSTRACT FROM AUTHOR]