Contested illness

Contested illnesses or contested disorders have been described as those in which "different 'experts' have different views as to the causes, and they are often considered medically unexplained" (Arroll, 2014).

"Real" illnesses
Some clinicians may not accept that certain illnesses, particularly invisible illnesses are "real", or may take the approach that the symptoms are real but are not caused by any particular illness or disease―or even that they are a form of health anxiety.

Some patients with contested illnesses have been labeled "hysterical" or being treated as if their illness was psychosomatic, even when physically seriously ill or when there are clear abnormal medical findings, for example Merryn Crofts and Sophie Mirza, who both died of myalgic encephalomyelitis.

Psychosocial theories
Historically, a number of different illnesses have been contested illnesses at some point, and as a result were treated as psychosomatic illnesses or resulted in the inappropriate blaming of particular people - often women - for causing them, for example Parkinson's disease was explained as psychosomatic, schizophrenia was supposed to be caused by emotionally distant mothers, and peptic stomach ulcers were said to be caused by stress before the discovery of H. pylori bacteria.

ME/CFS
The treatment of ME/CFS has been hotly contested for many years, with the controversial use of cognitive behavioral therapy, a form of psychotherapy, and graded exercise therapy, a behavioral treatment becoming the dominant approaches in the early 21st century.

From around 2016, a paradigm shift began, with cognitive and behavioral treatments largely abandoned, and symptomatic treatment and greater acceptance of medical abnormalities in patients with ME/CFS.

Fibromyalgia
Fibromyalgia remains a contested illness, although since the approval of some medication such as Lyrica, there has been greater acceptance of the illness as a physical illness with increased support for the use of medication.

Notable articles

 * 1991, The Psychologisation of Illness (Full text)
 * 2000, Functional somatic syndromes
 * 2008, Obstructions for quality care experienced by patients with chronic fatigue syndrome (CFS)—A case study (Abstract)
 * 2016, Listening to Lyrica: contested illnesses and pharmaceutical determinism (Full text)
 * 2017, Contesting the psychiatric framing of ME/CFS (Full text)
 * 2018, Facts and myths pertaining to fibromyalgia - (Full text)
 * 2021, How to Report with Accuracy and Sensitivity on Contested Illnesses - Open Notebook

Learn more

 * The Model of the Myth - Margaret Williams
 * Facts and myths pertaining to fibromyalgia - Wilfred Häuser