DefinitionChronic fatigue and chronic fatigue syndrome: shifting boundaries and attributions
Section snippets
Prevalence of chronic fatigue and chronic fatigue syndrome
When utilizing self-report surveys, the measurement of fatigue in the community hinges closely on the interpretation of particular words and their connotations in the questionnaires completed by respondents.3 For example, after excluding subjects with symptoms attributable to medication or recognized medical disorder, the Epidemiologic Catchment Area (ECA) study demonstrated a 14% community prevalence of “feeling tired out,” compared with 2.2% for “feeling weak.”1 In this context, the specific
Chronic fatigue syndrome and other fatigue-related syndromes
A natural consequence of these difficult diagnostic boundaries is overlap with other similar syndromal disorders, notably those that share fatigue as a major symptom. The list of such conditions is long, but notably includes fibromyalgia, irritable bowel syndrome, neurasthenia, multiple chemical sensitivity syndrome, sick building syndrome, as well as depressive and anxiety disorders.
The overlap between chronic fatigue syndrome and fibromyalgia, for example, has been specifically examined.
Chronic fatigue syndrome and psychological comorbidity
The relation of the chronic fatigue syndrome to the syndrome of major depression is also paramount. Neuropsychologic complaints such as concentration difficulties, memory impairment, sleep disruption, and mood disturbance are almost universal in patients with chronic fatigue syndrome, and concurrent psychiatric diagnoses (predominantly depression or anxiety) can be made in a substantial proportion of cases.26, 27, 28 This high degree of comorbidity with depression is, in part, an artefact of
The validity of a postinfective fatigue syndrome
The potential role of infectious agents in producing chronic fatigue has been a strongly favored hypothesis. This notion arose naturally from the historical observations linking specific infections such as brucellosis to a subsequent fatigue state. Further support for this possibility comes from the anecdotal histories that patients with chronic fatigue syndrome give and the attributions made to the prior events by physicians. These recollections typically describe a “flu-like” illness
Conclusions
Interpretation and comparison of the results of epidemiologic studies evaluating chronic fatigue and chronic fatigue syndrome should be undertaken only after careful consideration of: (1) the survey instrument (i.e., the questionnaire) and methodology (e.g., self-report alone versus physician assessment); (2) the setting from which cases are identified (community surveys versus primary care, or tertiary referral practice); and (3) the case definition utilized. Even after these key factors have
References (35)
- et al.
Postinfectious fatigueprospective cohort study in primary care
Lancet
(1995) - et al.
What is myalgic encephalomyelitis?
Lancet
(1988) - et al.
Viruses, neurosis, and fatigue
J Psychosom Res
(1994) - et al.
The epidemiology of fatiguemore questions than answers
J Epidemiol Community Health
(1992) - et al.
Reviving the diagnosis of neurasthenia
Psychol Med
(1997) - et al.
Muscle strength, endurance and recovery in the post-infection fatigue syndrome
J Neurol Neurosurg Psychiatry
(1988) - et al.
Muscle endurance, twitch properties, voluntary activation and perceived exertion in normal subjects and patients with chronic fatigue syndrome
Brain
(1991) Is a fatigue test possible?
Br J Psychol
(1921)- et al.
The health and lifestyles survey
(1987) - et al.
Psychiatric Illness in General Practice
(1981)
Chronic fatigue in primary careprevalence, patient characteristics and outcome
JAMA
Tired, weak or in need of restfatigue in general practice attenders
BMJ
Fatigue in selected primary care settingssociodemographic and psychiatric correlates
Med J Aust
Prevalence of fatigue and chronic fatigue syndrome in a primary care practice
Arch Intern Med
Population based study of fatigue and psychological distress
BMJ
Chronic fatigue and chronic fatigue syndromeprevalence in a Pacific Northwest health care system
Ann Intern Med
Chronic fatigue syndromea comprehensive approach to its definition and study
Ann Intern Med
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2022, Pharmacological Research - Modern Chinese MedicineCitation Excerpt :First, because the symptoms are subjective symptoms of patients, it is difficult to record their real symptoms. Second, a significant proportion of CFS patients also meet diagnostic criteria for other syndromes (including fibromyalgia [29], depression, anxiety [30], irritable bowel syndrome [31], and postural tachycardia syndrome [32]). In addition, psychological effects play a role in the development of CFS, affecting the degree of disease development and prognosis [33].
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