One Test Too Many: Toward an Integrated Approach to Psychosomatic Disorders

Conditions such as chronic fatigue syndrome (CFS), fibromyalgia, and several others belong to the group of disorders in which both physiologic and psychologic factors are substantially involved, and in some cases there may be no real distinction between the two. However, primary patient assessment usually employs an array of clinical tools, and only after known physiologic factors are excluded is the patient referred for psychologic or psychiatric evaluation. This chapter suggests that clinical evaluation should initially include both physiologic and psychosocial assessment, which would minimize the division and greatly improve the efficacy of the treatment.