Abstract:
Chronic fatigue syndrome is associated with many misconceptions. In this review, we attempt to summarize various pathogenic hypotheses for this disease and discuss new lines of insight into causes and treatments of this baffling and most frustrating condition.
Source: Plioplys S, Plioplys AV. Chronic fatigue syndrome (myalgic encephalopathy). South Med J. 1995 Oct;88(10):993-1000. http://www.ncbi.nlm.nih.gov/pubmed/7481975
Abstract:
OBJECTIVE: To describe clinical and laboratory guidelines for assessment and management of patients presenting with chronic fatigue syndrome(CFS).
DATA SOURCES: Relevant international consensus diagnostic criteria and research literature on the epidemiology, pathophysiology, concurrent medical and psychological disturbance and clinical management of CFS.
CONCLUSIONS: Medical and psychiatric morbidity should be carefully assessed and actively treated, while unnecessary laboratory investigations and extravagant treatment regimens should be avoided. No single infective agent has been demonstrated as the cause of CFS, and immunopathological hypotheses remain speculative. The aetiological role of psychological factors is debated, but they do predict prolonged illness. The rate of spontaneous recovery appears to be high. Effective clinical management requires a multidisciplinary approach, with consideration of the medical, psychological and social factors influencing recovery.
Comment in: Chronic fatigue syndrome: is total body potassium important? [Med J Aust. 1996]
Source: Hickie IB, Lloyd AR, Wakefield D. Chronic fatigue syndrome: current perspectives on evaluation and management. Med J Aust. 1995 Sep 18;163(6):314-8. http://www.ncbi.nlm.nih.gov/pubmed/7565238
When patients walk through your door and declare they have “chronic fatigue syndrome” (CFS), they could well be chronically fatigued and need your help, but it is unlikely they fit the National Institute of Health’s (NIH) criteria for CFS, according to Dr Derrick Thompson, a Clinical Associate Professor in the University of Calgary’s Department of Medicine.
“Most patients with complaints of chronic fatigue don’t have CFS, but rather one or often a combination of overlapping sleep disorders, soft tissue pains, allergies, or autonomic nervous system disruptions, such as labile blood pressure, panic attacks, and irritable bowel,” he says.
You can read the rest of this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2146574/pdf/canfamphys00088-0180.pdf
Source: Kermode-Scott B. Don’t worry about the label. Diagnose underlying perpetuating factors in chronic fatigue syndrome. Can Fam Physician. 1995 Jun;41:1126-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2146574/pdf/canfamphys00088-0180.pdf (Full article)
Abstract:
Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is estimated to affect 2 to 5 million people in the United States. Despite its high incidence, persons with CFIDS have been neglected by the medical community mainly because there is no singular confirming diagnostic test or proven effective treatment.
The CFIDS population is incorrectly stereotyped as upper-middle-class, white, female hypochondriacs; consequently, symptoms often are belittled or ignored. In reality, CFIDS is a severe medical condition that affects women, men, and children of any race and often causes long-term or total disability.
The results of a modified functional capacity evaluation developed by the author and completed on 86 persons with CFIDS between 1988 and 1990 confirm that this population has severe physical and cognitive disabilities that affect their professional, familial, and social lives. The results of these evaluations are used to present a profile of persons with CFIDS that can serve as a basis for understanding this population and for guiding intervention.
Source: Barrows DM. Functional capacity evaluations of persons with chronic fatigue immune dysfunction syndrome. Am J Occup Ther. 1995 Apr;49(4):327-37. http://www.ncbi.nlm.nih.gov/pubmed/7785715
Abstract:
Despite its new name, chronic fatigue syndrome is not a new disease. This chapter reviews current definitions, emphasizing that chronic fatigue syndrome is a diagnosis of exclusion. The author also discusses viral infections that are associated with CFS, including Epstein-Barr virus, cytomegalovirus, herpesvirus type 6, enteroviruses, and retroviruses.
Source: Glover DM. Chronic Fatigue Syndrome. Adolesc Med. 1995 Feb;6(1):101-114. http://www.ncbi.nlm.nih.gov/pubmed/10358305
Abstract:
Chronic fatigue syndrome (CFS) is a disorder of unknown etiology characterized by debilitating fatigue and other somatic and neuropsychiatric symptoms. A range of heterogeneous clinical and laboratory findings have been reported in patients with CFS. Various theories have been proposed to explain the underlying pathophysiologic processes but none has been proved.
Research findings of immunologic dysfunction and neuroendocrine changes suggest the possible dysregulation of interactions between the nervous system and the immune system. Without a clear understanding of its etiopathogenesis, CFS has no definitive treatment.
Management approaches have been necessarily speculative, and they have evolved separately in a number of medical and nonmedical disciplines. The results of several controlled treatment studies have been inconclusive. An accurate case definition identifying homogeneous subtypes of CFS is needed. The integration of medical and psychologic treatment modalities and the use of both biologic and psychologic markers to evaluate treatment response will enhance future treatment strategies.
Source: Farrar DJ, Locke SE, Kantrowitz FG. Chronic fatigue syndrome. 1: Etiology and pathogenesis. Behav Med. 1995 Spring;21(1):5-16. http://www.ncbi.nlm.nih.gov/pubmed/7579775
Abstract:
The complexities of the chronic fatigue syndrome and the methodologic problems associated with its study indicate the need for a comprehensive, systematic, and integrated approach to the evaluation, classification, and study of persons with this condition and other fatiguing illnesses. We propose a conceptual framework and a set of guidelines that provide such an approach. Our guidelines include recommendations for the clinical evaluation of fatigued persons, a revised case definition of the chronic fatigue syndrome, and a strategy for subgrouping fatigued persons in formal investigations.
Comment in:
The chronic fatigue syndrome. [Ann Intern Med. 1995]
The chronic fatigue syndrome. [Ann Intern Med. 1995]
The chronic fatigue syndrome. [Ann Intern Med. 1995]
The chronic fatigue syndrome. [Ann Intern Med. 1995]
Source: Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953-9. http://www.ncbi.nlm.nih.gov/pubmed/7978722
Abstract:
Diagnosis and management of chronic fatigue syndrome (CFS) is a difficult challenge for nurse practitioners. The syndrome is widespread, poorly-defined, and problematic. Despite extensive etiologic research, no cause has been identified. Each case should be carefully evaluated for possible organic, psychiatric, and other factors reported as potential causes. Clinical manifestations, possible causes, and options for management are reviewed.
Source: Fox DS. Chronic fatigue syndrome: a review and practical guide. J Am Acad Nurse Pract. 1994 Dec;6(12):565-70. http://www.ncbi.nlm.nih.gov/pubmed/7848743
Abstract:
Chronic fatigue syndrome (CFS) is characterized by a sudden onset of an influenza-like illness followed by marked chronic fatigue and abnormal exercise-induced exhaustion. The precise pathogenesis of this disorder is unknown, but viral infection triggering immune imbalance has been suggested. The literature on CFS is reviewed. We find no consistent support for chronic viral infection or immunological dysfunction. The data in the published studies are rather conflicting, and further research in order to identify parameters that differentiate CFS from other disorders is necessary.
Comment in:
[Chronic fatigue syndrome and angiotensin-converting enzyme]. [Ugeskr Laeger. 1995]
[Chronic fatigue syndrome–a psychosocial syndrome?]. [Ugeskr Laeger. 1995]
Source: Rasmussen AK, Andersen V, Nielsen H, Wiik A. Chronic fatigue syndrome–a defined unity?Ugeskr Laeger. 1994 Nov 14;156(46):6832-6. [Article in Danish] http://www.ncbi.nlm.nih.gov/pubmed/7839497
Abstract:
Fatigue chronic syndrome (SFC) is the heir-at-law of neurasthenia. Both are seen like physical diseases and share certain therapeutic measures, such as sleep; they have the same symbolic function and enable patients as well as doctors reluctant to psychological dimensions of pathology, to get and express sympathy and attention. A strong controversy developed these last years concerning the SFC physiopathology particularly concerning the responsibility of viral infectious agents or psychiatric troubles.
The SFC fatigue is unlikely hysterical or neuromuscular but it probably depends on several associated factors; cerebral neurobiochemistry anomalies (possibly induced by an infection or immune reactions), effort perception trouble, affective trouble, lack of physical activity. The handicap seems to be worse on account of unsuitable care and inefficacious treatment. Especially sleep, which is often beneficial in a short term, is source of ulterior chronicisation. Antidepressants are the only justified pharmacological treatment for SFC at the moment. Referring to the existence and the nature of cognitive distortions, the author suggests a cognitive-behavioural therapy, whose aim is a progressive activity resumption.
Source: Wessely S. Chronic fatigue syndrome. Clinical, social psychological problems and management. Encephale. 1994 Nov;20 Spec No 3:581-95. [Article in French] http://www.ncbi.nlm.nih.gov/pubmed/7843055