Date

2003

Author

Usubütün, Seda

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Pseudo diseases" that will be explored in that study are Undifferentiated Somatoform Disorder (USD), Fibromyalgia Syndrome (FMS) and Chronic Fatigue Syndrome (CFS). CFS is a diagnostic label that is not currently used in Turkish medical practice. In order to document the latency or absence of CFS diagnosis in our context, 108 medical specialists from Neurology, Infectious Diseases, Physical Treatment and Rehabilitation, and Psychiatry were asked to read a case scenario of a possible CFS patient and to give diagnosis for that patient It is demonstrated that clinicians recognized CFS diagnosis among five possible diagnoses provided, however, the rate of recognition is low (45.4%). Clinicians were also asked to report the symptoms of a recent patient, similar to case scenario, from their own clinical practice. Analysis of reported symptoms with confirmatory factor analysis revealed that clinicians in our context base their reasoning for undifferentiated patients not on "holistic" explanatory model that takes the patient as a whole, but on "fragmentalist" model that takes the patient as differentiated functional systems. iiiQualitative part of the study was carried out with three cases with diagnosis of FMS or USD, once in the hospital and once at their home. Interpretative repertoires of patients voiced through subject positions that are made available by professional discourses in our context were explored with principles of Discourse Analysis (Potter and Wetherellj 19&1), Patients displayed two broad illness narratives. While patients who accepted psychological explanations voiced sensitivity-vulnerability narratives from "sensitive" subject positioning, patients who rejected psychological explanations voiced self-exploratory quest narratives from "self responsible" subject positioning. It is concluded that social construction of "pseudo disease" diagnosis is yet limited to doctor-patient encounter; and "pseudo disease" patients are not yet parties that have claims on the classification of "pseudo disease" in our context "Pseudo disease" patient discourse, on tile other hand, is interpreted as more in line with developing "sensitive" subject positions in acceptance of psychological explanations instead of developing "pseudo disease" identities from "self responsible" subject positions as in western examples.

Subject Keywords

Sick, Chronic fatigue syndrome, Pseudo disease, Classification, Discourse analysis, Subject positions, Illness narratives

URI

https://hdl.handle.net/11511/13463

Collections

Graduate School of Social Sciences, Thesis