A review of the definitional criteria for chronic fatigue syndrome

Abstract

This paper presents a critical review of the most frequently used case definitions in CFS. There are currently five case definitions of CFS; however, the most prominent and widely used of these definitions is the 1994 Centre for Disease Control and Prevention Case Definitions. However, the pre-eminence of this definition over the others has never been substantiated and it has been widely criticized for its lack of specificity. Furthermore, none of the above case definitions have produced evidence to demonstrate their accuracy or precision at defining cases of CFS. A summary description of the symptom profile included in each of the case definitions is provided. The inconsistencies that have emerged in CFS research as a consequence of differing approaches to case definition are also highlighted and discussed.

Neurobiological studies of fatigue

“…The focus in this paper is on acute fatigue of the sort that might be triggered by a viral infection or radiation therapy, and that may last well after the triggering event. Chronic fatigue syndrome is more than simply the experience of fatigue in that it is defined by debilitating fatigue lasting 6 months or longer, along with other symptoms such as cognitive dysfunction, sleep disturbance, myalgia, arthralgia, headache, gastrointestinal upset, sore throat and painful lymph nodes (Christley et al, 2012). …”

Characterising eye movement dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome

“…The illness also has widespread physiological impact and has been shown to affect the immune system [2] , the central nervous system [3] , and the cardiovascular system [4]. 1 There are a variety of case definitions for ME/CFS [7] and the most widely used for research is the 1994 Center for Disease Control and Prevention (CDC) definition [8]. Other case definitions for ME/CFS have been developed [5,6], though to date none of these definitions have been formally operationalised.…”

“…Diagnosing ME/CFS is based on categorising the range of symptoms reported by patients and differentiating them from the symptoms occurring with other fatigue related illnesses. It is a diagnosis of exclusion because there is currently no specific diagnostic test for ME/CFS [7]. This diagnosis can be problematic due to the number of symptoms overlapping with other illnesses and the reliance on patients to report their symptoms accurately.…”

Defining ARDS: do we need a mandatory waiting period?

“…In this context, ARDS is not unique. For example, the definition of AIDS changed rapidly as more of the underlying pathogenesis became understood [2]; the definitions of chronic fatigue syndrome [3] and of chronic migraine [4] are controversial. Nevertheless, it is unquestionable that effective and shared definitions are needed by clinicians to guide selection of the most appropriate treatment for the patients that are expected to benefit the most and to optimize use of resources and communication to the relatives by predicting outcome and by clinical scientist to generate consistent and reproducible clinical studies by including patients with a consistent phenotype [5].…”