Huibers Marcus J H, Wessely Simon
Department of Medical, Clinical & Experimental Psychology, Maastricht University, The Netherlands.
Psychol Med. 2006 Jul;36(7):895-900. doi: 10.1017/S0033291705006926. Epub 2006 Jan 10.
One of the many controversies surrounding chronic fatigue syndrome (CFS) is the possible impact of the diagnostic label: is it disabling or enabling? In this paper, we discuss the pros and cons of labelling CFS.
A narrative synthesis of the literature.
Diagnosed CFS patients have a worse prognosis than fatigue syndrome patients without such a label. The ways in which CFS patients perceive themselves, label their symptoms and appraise stressors may perpetuate or exacerbate their symptoms, a process that involves psychological, psychosocial and cultural factors. Labels can also lead to conflicts with doctors who fear diagnosis might lead to worse outcomes. However, on the other hand, finding a label that fits one's condition can provide meaning, emotional relief and recognition, whilst the denial of the diagnosis of CFS in those who have already reached their own conclusion can be very counter productive. The act of diagnosis therefore seems to be a trade-off between empowerment, illness validation and group support, contrasted with the risk of diagnosis as self-fulfilling prophecy of non-recovery.
The answer to the question of 'to label or not to label' may turn out to depend not on the label, but on what that label implies. It is acceptable and often beneficial to make diagnoses such as CFS, provided that this is the beginning, and not the end, of the therapeutic encounter.
围绕慢性疲劳综合征（CFS）的众多争议之一是诊断标签可能产生的影响：它是使人致残还是使人获得帮助？在本文中，我们讨论了给CFS贴上标签的利弊。
对文献进行叙述性综合分析。
被诊断为CFS的患者比没有该诊断标签的疲劳综合征患者预后更差。CFS患者感知自我、标记症状和评估压力源的方式可能会使他们的症状持续或加重，这一过程涉及心理、心理社会和文化因素。标签也可能导致与医生产生冲突，因为医生担心诊断可能会导致更糟的结果。然而，另一方面，找到一个符合自身状况的标签可以带来意义、缓解情绪并获得认可，而对于那些已经有自己结论的人否认CFS诊断可能会产生适得其反的效果。因此，诊断行为似乎是在赋予权力、疾病确认和群体支持之间进行权衡，与诊断成为无法康复的自我实现预言的风险形成对比。
“是否贴标签”这个问题的答案可能并不取决于标签本身，而是取决于该标签所暗示的内容。做出诸如CFS这样的诊断是可以接受的，而且通常是有益的，前提是这是治疗过程的开始，而不是结束。
