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Home > QR-E-Letter Archive > 4-28-2005
Issue No. 5 April 28, 2005
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QUICK REFERENCE #10: What are the diagnostic criteria for chronic fatigue syndrome (CFS)?
To qualify for a diagnosis of CFS, there must be (based on a thorough clinical evaluation) a medically unexplained persistent or relapsing fatigue of at least 6 months' duration that:
• is of new onset (ie, not lifelong)
• is not a result of ongoing exertion
• is not substantially alleviated by rest
• results in a substantial reduction in previous levels of activity
In addition, the occurrence of at least 4 of the following primary symptoms is required:
• substantial impairment in short-term memory or concentration
• sore throat
• tender lymph nodes
• muscle pain
• multi-joint pain without swelling or redness
• headaches of a new type, pattern or severity
• unrefreshing sleep
• postexertional malaise lasting more than 24 hours
Before making a diagnosis of CFS, it is important to rule out the following potential causes of fatigue: hypothyroidism, sleep apnea, narcolepsy, major depressive disorders, chronic mononucleosis, bipolar affective disorders, schizophrenia, eating disorders, cancer, autoimmune disease, certain hormonal disorders, subacute infections, obesity, alcohol or substance abuse, and reactions to prescribed medications. In addition to the 8 primary symptoms of CFS, patients have reported a number of other symptoms. These include abdominal pain, alcohol intolerance, bloating, chest pain, chronic cough, diarrhea, dizziness, dry eyes or mouth, earaches, irregular heartbeat, jaw pain, morning stiffness, nausea, night sweats, psychological problems (depression, irritability, anxiety, panic attacks), shortness of breath, skin sensations, tingling sensations, and weight loss.
Source: The Complete Practitioner: Mental Health Applications (March 2000), based on information from the Centers for Disease Control and Prevention. Paid subscribers to The Complete Practitioner: Mental Health Applications can access related content by conducting a search for "chronic fatigue syndrome" in the Subscribers' Area of our Web site (http://www.completepractitioner.com).
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THE COMPLETE PRACTITIONER: MENTAL HEALTH APPLICATIONS
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