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To the Editor.

Don Houts, MD
Arch Intern Med. 1986;146(7):1448. doi:10.1001/archinte.1986.00360190240040.
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—As a psychiatrist interested in the treatment of patients with psychosomatic complaints, I found the article by Smith et al, in the January 1986 issue of the Archives to be most interesting.1 It is critically important to find a way to sort out those patients with psychosomatic illness from those with illnesses that are not primarily serving a psychopathologic function. However, with the recent articles on chronic Epstein-Barr virus (CEBV),2-4 I do not think the task is quite as straight forward as simply reviewing symptoms, noting the patient's age, and then consulting the DSM III to see if the minimum criteria have been reached for the diagnosis of somatization disorder.

It is unclear to me if CEBV was considered in any of the patients in the Smith study. Many of the same multisystemic complaints of patients with somatization disorder are present in patients with CEBV, such as


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