Kingma, Eva M, Moddejonge, Raquel S, Rosmalen, Judith G M · Nederlands tijdschrift voor geneeskunde · 2012
This study asked 184 patients in Dutch waiting rooms how they felt about different medical terms used to describe unexplained tiredness. The researchers found that patients reacted most negatively to the term 'psychosomatic tiredness' (suggesting the tiredness is psychological), while they were more accepting of terms like 'chronic fatigue syndrome' and 'functional fatigue.' This suggests that patients prefer medical terms that don't imply their condition is 'all in their head.'
Terminology significantly influences how patients understand and accept their diagnosis, affecting treatment engagement and stigma perception. For ME/CFS patients, this research demonstrates that diagnostic labels emphasizing psychological etiology generate greater patient resistance and negative perception, suggesting that terminology choice has real clinical and psychological consequences. Understanding these language preferences can help clinicians communicate diagnoses more effectively and reduce unnecessary psychological burden.
This study does not establish whether patients' terminology preferences correlate with actual treatment outcomes or clinical effectiveness. The use of hypothetical vignettes rather than real diagnostic encounters means findings may not reflect how patients respond when actually diagnosed. Cross-sectional design prevents determination of causality or whether negative perceptions persist after diagnosis or change with symptom experience.
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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