E3 PreliminaryPreliminaryPEM unclearReview-NarrativePeer-reviewedMachine draft
What is called symptom?
Eriksen, Thor Eirik, Risør, Mette Bech · Medicine, health care, and philosophy · 2014 · DOI
Quick Summary
This paper explores what we actually mean by the word 'symptom' in medicine. The authors argue that when doctors can't find a clear medical cause for illness—like ME/CFS—our usual way of thinking about symptoms breaks down. They suggest we need to understand symptoms in broader ways, including how patients' social lives, personal experiences, and individual circumstances shape how they experience illness.
Why It Matters
This theoretical work addresses a fundamental problem in ME/CFS research and clinical care: the inadequacy of conventional medical language and concepts for understanding patient experience when no clear biological marker exists. By reconceptualizing symptoms beyond pure biomedicine, the paper provides philosophical grounding for more patient-centered, multidimensional approaches to diagnosis and management of ME/CFS.
Observed Findings
- The traditional biomedical symptom concept proves inadequate for understanding medically unexplained conditions including ME/CFS
- Diagnostic and management frameworks for unexplained conditions lack coherent conceptualization of what constitutes a symptom
- Current medical language and diagnostic criteria fail to capture socio-cultural and existential dimensions of patient experience in contested illnesses
Inferred Conclusions
- The concept of 'symptom' must be reconceptualized to include phenomenological, socio-cultural, and existential dimensions rather than relying solely on biomedical definitions
- Medically unexplained conditions like ME/CFS require expanded interpretative frameworks that acknowledge the complexity of patient-reported experiences
- Enriching medical language and conceptual categories may improve understanding and clinical management of conditions with unclear biological origins
Remaining Questions
- How should clinicians operationalize an enriched symptom concept in actual diagnostic and treatment practice?
- Which specific socio-cultural and phenomenological dimensions are most clinically relevant for understanding ME/CFS presentations?
- How can expanded symptom conceptualization be integrated into diagnostic criteria and medical education?
What This Study Does Not Prove
This is a conceptual/philosophical analysis, not an empirical study with data, so it does not prove any biological mechanisms, validate specific biomarkers, or establish causation between any variables. It does not provide evidence about the prevalence, etiology, or optimal treatment of ME/CFS specifically.
Tags
EXPLORATORYPEM UNCLEAR
Metadata
- DOI
- 10.1007/s11019-013-9501-5
- PMID
- 23877313
- Review status
- Machine draft
- Evidence level
- Early hypothesis, preprint, editorial, or weak support
- Last updated
- 10 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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