Description
This article is from the Chronic Fatigue
Syndrome (CFS) FAQ, by cfs-news@cais.com (Roger Burns) with
numerous contributions by others.
2.021 CFS definition
In addition to the official researchers' definition discussed below,
patients and experienced clinicians have noticed symptom patterns that
seem prominent in CFS. These are described in question 1.01 above,
and also include the observations that cognitive dysfunction often
increases over time (over several years), and that brain scans often
show that blood flow to the brain is decreased.
CFS is defined somewhat differently by various medical groups in
different countries. The 1994 research definition published by the
U.S. Centers for Disease Control and Prevention recommends a step-wise
approach for identifying CFS cases. The first step is to clinically
evaluate the presence of chronic fatigue,
i.e. "self-reported persistent or
relapsing fatigue lasting 6 or more consecutive months".
Conditions that explain chronic fatigue should exclude a diagnosis of
CFS. These are:
- "any active medical condition that may explain the presence of
chronic
fatigue ..."
- any previous condition which might explain fatigue and which
has not documentably come to an end;
- "any past or current diagnosis of
a major depressive disorder with psychotic or melancholic features;
bipolar affective disorders; schizophrenia of any subtype; delusional
disorders of any subtype; dementias of any subtype; anorexia nervosa; or
bulimia";
- substance abuse within 2 years prior to onset;
- severe obesity.
The following should not exclude a diagnosis of chronic fatigue:
- conditions which cannot be confirmed by lab tests, "including
fibromyalgia, anxiety disorders, somatoform disorders, nonpsychotic or
nonmelancholic depression, neurasthenia, and multiple chemical sensitivity
disorder"; - any condition which might produce chronic fatigue but which
is being sufficiently treated; - any condition which might produce chronic
fatigue but whose treatment has already been completed; - any finding
which on its own is not sufficient to strongly suggest one of the
exclusionary conditions.
After the above criteria are met, the following core criteria for CFS
are applied: "A case of the chronic fatigue syndrome is defined by the
presence of the following:
1) clinically evaluated, unexplained persistent or relapsing chronic
fatigue that is
of new or definite onset (has not been lifelong); is not the result of
ongoing exertion; is not substantially alleviated by rest; and results
in substantial reduction in previous levels of occupational,
educational, social or personal activities; and
2) the concurrent occurrence of four or more of the following
symptoms, all of
which must have persisted or recurred during 6 or more consecutive
months of illness and must not have predated the fatigue:
- self-reported impairment in short term memory or concentration
severe enough to cause substantial reduction in previous levels of
occupational, educational, social or personal activities;
- sore throat;
- tender cervical or axillary lymph nodes;
- muscle pain;
- multi-joint pain without joint swelling or redness;
- headaches of a new type, pattern or severity;
- unrefreshing sleep;
- and post exertional malaise lasting more than 24 hours."
The journal citation for the CDC definition article is: Keiji Fukuda,
Stephen Straus, Ian Hickie, Michael Sharpe, James Dobbins, Anthony
Komaroff, and the International CFS Study Group. "The Chronic Fatigue
Syndrome: A Comprehensive Approach to Its Definition and Study". Ann
Intern Med. 1994;121:953-959.
Continue to:
Share and Enjoy
Bookmark this story so others can enjoy it:
Tags
health, chronic fatigue syndrome, CFS, medical care
