Introduction

        In the near future, it is hoped that treatments directed at the cause(s) and pathophysiology of CFIDS will become available.  At this time, however, treatment is primarily aimed at symptomatic relief.  There is much that can be done.

        The physician's most important initial intervention is to make the diagnosis.  Diagnostic validation is critically important to the patient, as it reduces fear, confusion, and isolation.  Recognition of the nature of the illness allows the patient to shift her/his focus from uncertainty and self-directed doubts to the work of coping with a specific chronic illness.

        The second most important intervention is to assure the patient that, although there is no definitive treatment at this time, there are ways to live with this illness, to ameliorate symptoms, and to facilitate chances for gradual improvement [50,51,52].  there have been reports of complete recovery.  It is important to foster hope, as a sense of optimism can only improve the possibility of enhanced immune competence [53]. 

        The primary care physician must directly or indirectly address all of the patient's needs.  With such a complex illness, however, a team approach is often necessary and most patients require some referral(s).  Team members might include medical subspecialists (rheumatologist, neurologist, psychiatrist, eyecare specialist, etc.), physical therapist, psychotherapist, nutritionist, etc.  A cooperative partnership with the patient should be established.  It is very useful for patients to keep a daily journal, which can be analyzed for symptom patterns, to structure daily routines, and to judge the results of specific interventions. 

       Referral to local support groups as well as state and national organizations can be extremely helpful to patients and their families.   Ssuch groups can reduce a patient's sense of isolation, offer a forum to share coping strategies, and provide educationsal programs covering emerging research news as well as a variety of other topics.