Comment in: Chronic fatigue syndrome. [Br J Gen Pract. 1992]
Comment on: Antidepressant therapy in the chronic fatigue syndrome. [Br J Gen Pract. 1991]
Sir, The adoption of the term chronic fatigue syndrome for conditions like myalgic encephalomyelitis and effort syndrome in the paper by Lynch and colleagues (August Journal, p.339) is difficult to understand. The differences between these disorders are so marked, that an umbrella term is destined to be both confusing and misleading.
The emphasis on the term fatigue is unfortunate for many reasons. First; research has shown that only a tiny proportion of people with unexplained fatigue fulfil the standard diagnostic criteria for myalgic encephalomyelitis. (1) Secondly, Lynch and colleagues’ definition of chronic fatigue syndrome is too broad to distinguish people with myalgic encephalomyelitis from those who are feeling run down or depressed or suffering from the more common and less severe post-viral syndrome. Thirdly, the term trivializes the illness. Everyone gets tired now and then and most people find it hard to understand how some may be disabled by it. In our view, the name suggests something which is tolerable and volitional, requiring little more than adequate rest and a positive attitude. What the term fails to communicate is that the fatigue reported by people with myalgic encephalomyelitis is severe and debilitating; that it is unlike anything most of them have experienced before and that it is often associated with an intense influenza-like malaise. (2’3) We therefore agree with English that as far as myalgic encephalomyelitis is concerned, ‘fatigue is the most pathetically inadequate term’. (2)
You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371802/pdf/brjgenprac00062-0041.pdf
Source: Goudsmit EM, Macintyre A, Sullivan M. Chronic fatigue syndrome. Br J Gen Pract. 1991 Nov;41(352):479-80. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371802/