When is something called a "disease"?

Us skeptics that need a precise clinical definition for CFS should note that it seems even traditionally objectively defined clinical diagnoses are leaning toward more open, arguably less clinically significant, and/or more subjective diagnostic criteria. Diagnostic criteria for obesity and hyptertension have recently been modified in relation to carrying out clinical pathways for treatment. The same goes for hyperglycemia, obstructive sleep apnea, certian mental illnesses, and probably hundreds of others over the past few years. Testament both to the scientific process and the powers driving health care.

As CFS struggles to be legitimate, seems other once formalized conditions are trending toward de-legitimacy by accepting a wider population. We then become skeptical of diagnoses of polycystic ovary, lupus, Raynaud's, lyme disease, etc. Others may not so quickly come to mind.

There is a recent BMJ article that addresses "The making of a disease" that uses an example of how common symptoms are formulated into a syndrome that then qualifies for a specific proprietary treatment. http://bmj.com/cgi/content/full/326/7379/45 Is it not sound marketing practice that if I have a drug with limited FDA approval to treat depression, that I pursue any means to expand my qualifying population base that has "depression?" If I'm not recruiting potential patients by reaching them with direct-to-consumer info about depression, I'm recruiting investors by protraying an epic need for the product.

Another reminder to us clinicians who have the patient's needs truly at heart that money often drives medicine, and to beware the health care fads, perhaps even in the guise of grass-roots efforts to "raise public awareness."