Tag: fibromyalgia

Definition of the chronic fatigue syndrome and its issues

Abstract:

This article reviewed Definition of CFS proposed by CDC 1988. There are several issues in Definition for CFS of CDC. It is presented that other chronic clinical conditions have been satisfactorily excluded, including preexisting psychiatric diseases in (2) of major criteria.

However, fibromyalgia can not be excluded from the fifth symptom of minor criteria, myalgia, and also depression from the ninth symptom.

It is practically difficult to define impairment of average daily activity below 50% of the patient’s premorbid activity level for a period of at least 6 months, as shown in (1) of major criteria, and it is not adapted for a first visit patient.

Definition for CFS of CDC has been discussed on EBV infection, but not written on postviral fatigue syndrome and myalgic encephalomyelitis. Especially whether epidemic type of CFS is present or not was not discussed. Diagnostic criteria of CFS is necessary for clinical practice.

 

Source: Hashimoto N. Definition of the chronic fatigue syndrome and its issues. Nihon Rinsho. 1992 Nov;50(11):2591-9. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1287235

 

Pain syndromes, disability, and chronic disease in childhood

Abstract:

Childhood disability and chronic disease are common, and their prevalence is increasing as children survive with conditions that were previously fatal. It is important that physicians in training learn about disability and handicap, and the functioning of multidisciplinary teams to manage these problems. Chronic ill-health is often very expensive to manage, and some serious and creative thinking about the best way to fund such health care is urgently needed.

Pediatric rheumatologists are involved with the care of many children with chronic and recurrent musculoskeletal pain; however, they have not perhaps focused enough research effort on the investigation of pain and its management. Whether reflex neurovascular dystrophy, fibromyalgia, and chronic fatigue syndrome are part of a disease continuum is unclear, but it seems probable that psychosocial problems are often important contributing factors in all three conditions.

Immunoglobulin subclass deficiencies are being increasingly delineated, occurring in chronic fatigue syndrome as well as many other disease states. Their clinical relevance still remains, for the most part, uncertain. Short stature occurs in many chronic illnesses, and the role of growth hormone treatment in these conditions is beginning to be investigated.

 

Source: Malleson PN. Pain syndromes, disability, and chronic disease in childhood. Curr Opin Rheumatol. 1991 Oct;3(5):860-6. http://www.ncbi.nlm.nih.gov/pubmed/1836344

 

Myth of the chronic fatigue syndrome

THE CHRONIC FATIGUE SYNDROME is a symptom complex characterized by fatigue, myalgias, arthralgias, neurologic symptoms-headaches, paresthesias, dizziness-lymph node swelling or tenderness, cognitive dysfunction, sleep disorders, and depression. The symptoms are similar to those seen in inflammatory illnesses and can be induced by the systemic administration of interferon beta. Severe fatigue is a perplexing and constant complaint in many patients with multiple sclerosis. This indicates that the perception of energy level has a sensitive physiologic basis that is dependent on the homeostasis of other body systems.

The chronic fatigue syndrome has gained popularity among the lay public and has stimulated considerable scientific debate about its existence. Many investigators and practitioners have attributed the disorder to chronic depression. Difficulty arises from the diverse symptoms associated with fatigue states; fatigue is a prominent feature of many systemic, neurologic, and psychiatric disorders. Also, fatigue is a subjective complaint without a quantifiable measure. This interweaving of many symptoms and diagnoses with disabling fatigue makes it difficult to compare patient groups. Terms applied to disorders that probably represent chronic fatigue syndrome are chronic infectious mononucleosis, myalgic encephalomyelitis, idiopathic chronic fatigue and myalgia syndrome, epidemic neuromyasthenia, postviral fatigue syndrome, and fibrositis-fibromyalgia.

You can read the rest of this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1002920/pdf/westjmed00095-0070a.pdf

 

Source: Murray RS. Myth of the chronic fatigue syndrome. West J Med. 1991 Jul;155(1):68. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1002920/

 

A supplemental interview for forms of “affective spectrum disorder”

Abstract:

OBJECTIVE: Recent evidence suggests that a number of psychiatric and medical conditions may be members or candidate members of a larger family of conditions, which we have termed “affective spectrum disorder (ASD).” In order to facilitate further research into this concept, we drafted seven interview modules, using the format of the Structured Clinical Interview for DSM-III-R (SCID), designed to diagnose the following psychiatric and medical disorders: irritable bowel syndrome, narcolepsy, Tourette’s disorder, migraine, fibromyalgia, chronic fatigue syndrome, and kleptomania.

METHOD: Published operational diagnostic criteria for these seven disorders were sought in the literature. Questions in SCID format were then drafted in accordance with these operational criteria. Draft modules were then sent to experts familiar with each of the disorders and suggestions and revisions from these experts incorporated into the final modules.

RESULTS: The complete supplemental interview is presented with this report. Preliminary experience with this interview in more than 100 patients tentatively suggests that it is reliable for diagnosing the disorders in question; however, a formal test-retest reliability assessment is still required.

CONCLUSIONS: It is hoped that this supplemental interview, used in conjunction with the SCID, will be helpful in further studies of the epidemiology, pathogenesis, and treatment of these possible forms of affective spectrum disorder.

 

Source: Pope HG Jr, Hudson JI. A supplemental interview for forms of “affective spectrum disorder”. Int J Psychiatry Med. 1991;21(3):205-32. http://www.ncbi.nlm.nih.gov/pubmed/1955274