Elling Ulvestad is a specialist in immunology and transfusion medicine, head of the Department of Microbiology at Haukeland University Hospital and professor at the Department of Clinical Science at University of Bergen. He has written a text for The Norwegian Medical Association titled: Subjectivity and illness I understood very little of it, but as he mentions chronic fatigue syndrome, I thought it might be of interest to others on the forum. Maybe someone could even decipher it? The text is available both in Norwegian and English. Here is the bit where CFS is mentioned: Insufficient recognition of the pathophysiological influence of subjectivity may perhaps be the reason why certain complex diseases – including chronic fatigue syndrome – remain unexplained (12). In this syndrome, there are no biomarkers that can distinguish the ill from the healthy, and the diagnosis is therefore made on the basis of the patient’s subjective experience of his or her bodily functioning. This is the same subjectivity by which patients and controls are included in research studies. Subsequently, however, the researcher largely neglects the importance of subjectivity in favour of objective measurements of cellular, molecular and functional parameters, despite the fact that there is widespread agreement among researchers that the syndrome is associated with the function of adaptive systems and that ‘basic research linked to infections, inflammation, immunology, neurology and genetics’ ought to receive support (13). The author has received one reply from a GP and a psychologist. The reply is in Norwegian, but here is a google translation They are following up on CFS with amongst other horrendously inaccurate: DSM's disease understanding focuses on symptoms and not on context and cause.This causes the diagnostics to provide high reliability, but low validity. The diagnoses are nevertheless used as a fixed point in the absence of any better. ADHD and ME diagnoses can act as models for objective categorization of disorders without biomedical findings. A debate in the journal shows that hospital specialists and authorities adapt, for resource and political reasons, to the ME Association's preferred biomedical disease model (4, 5). And for the record - yes, this is written in 2018.