It is of course impossible to disagree with Dr Van Houdenhove's statement that it is important to listen to the patient's life history. We have been doing this for many years. Therefore, the reason that he finds PTSD in so many of his patients with CFS and we do not is not our lack of listening. From previous presentations by this group from Belgium we know that they recruit patients with CFS with higher psychopathology scores than we do in our centre and than is usually found in other CFS cohorts. Hence it is understandable that they find higher rates of psychiatric comorbidity. To date there are no controlled studies indicating that a history of abuse is a characteristic of many patients with CFS.