Disease Management Clinical Decisions
Chronic Fatigue Syndrome
- Diagnostic criteria established by the CDC define CFS to be present when there is fatigue lasting at least 6 months associated with decreased functional activity and somatic symptoms, and the symptoms must be not attributable to another disease.
- There are no physical findings or laboratory abnormalities unique to CFS, the diagnostic process requires a careful history and physical exam, mental status screening, and a core set of laboratory tests.
- Before a diagnosis of CFS is made, other treatable causes of fatigue must be excluded.
- Both graded exercise therapy and cognitive behavioral therapy have been proved effective in managing CFS when combined with specialist medical care.
- CFS is not associated with increased mortality but does reduce quality of life.
- The following are predictors of poor prognosis in CFS: longer duration of illness, depression and anxiety, higher level of fatigue, and attributing the syndrome to a physical cause.