Journal of Clinical Epidemiology
Volume 54, Issue 5 , Pages 433-439, May 2001

The Blame-X syndrome:

Problems and lessons in nosology, spectrum, and etiology

  • Alvan R Feinstein

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel: 203-785-4145; fax: 203 785-5177.(A.R. Feinstein)

Sterling Professor of Medicine and Epidemiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA

Received 5 September 2000; received in revised form 20 November 2000; accepted 24 November 2000.

Abstract 

Symptoms of a functional somatic syndrome have been noted in individual persons and groups for more than a century. Often associated with war, the syndrome has received diverse names and many proposed but unproved etiologies, including exposure to trauma, stress, chronic infection, psychosomatic, chemical, or environmental causes. In recent years, when attributed to agent X, the syndrome could be called the Blame-X syndrome. The clinical, legal, and other problems associated with the syndrome are a reflection of nosologic difficulties in identifying and choosing titles for apparently “new” ailments. The difficulties arise from the complex overlap of symptoms, diseases, and laboratory abnormalities found with modern technology, and from the frequent abandonment of pathophysiologic demands for appropriate correlation of symptoms and objective abnormalities. An important principle in naming apparently new ailments is to avoid etiologic titles until the etiologic agent has been suitably demonstrated. A premature causal name can impair a patient's recovery from the syndrome, and impede research that might find the true cause.

Keywords:  Syndrome, Nosology, Spectrum, Functional Somatic Syndrome, Blame-X

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0895-4356(00)00374-7

Journal of Clinical Epidemiology
Volume 54, Issue 5 , Pages 433-439, May 2001