Chronic Fatigue Syndrome versus Chronic Neuroendocrineimmune Dysfunction Syndrome

Jason, Leonard A.; Holbert, Cordelia; Torres-Harding, Susan; Taylor, Renée R.; LeVasseur, Jeanne J.; Breitinger, Petar; LaBarbera, Dawn; Siegel, Lori

doi:10.1300/j045v18n01_03

Cited by 5 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study into the attributions by medical personnel, for example, physician assistants were presented with a case study of a patient with the symptoms of CFS. When this case was presented under the (somatic sounding) term neuroendocrine-immune dysfunction syndrome it was rated as a more severe and disabling illness than when it was presented as CFS (Jason et al, 2003). This ambiguity of the status of CFS as a medical condition, and the experienced stigmatization by others (Looper & Kirmayer, 2004), might also have an influence on the way in which the positioning repertoires of the adolescents with CFS are organized.…”

Section: Discussionmentioning

confidence: 99%

Health and identity: Self-positioning in adolescent chronic fatigue syndrome and juvenile idiopathic arthritis

Fuchs

Geelen

Geel

et al. 2012

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

The aim of this study is to gain more insight into basic aspects of identity, in relation to adolescent chronic fatigue syndrome (CFS) and juvenile idiopathic arthritis (JIA). In dialogical self theory, identity is regarded as incorporating multiple self-positions, such as 'I as tired', 'I as pessimistic', or 'I as decisive'. Physical and psychosocial impairment might alter the organization of these self-positions. The Personal Position Repertoire procedure, a quantitative method to analyse the prominence of self-positions, the Child Health Questionnaire, assessing health-related functioning, and the Checklist Individual Strength, measuring fatigue, were completed by 42 adolescents with CFS, 37 adolescents with JIA and 23 healthy teenagers. Adolescents with JIA report impaired physical functioning and general health. However, they position themselves very similar to healthy teenagers - i.e. as strong and healthy. While this self-positioning approach might be adequate and sustainable in adolescence, it could prove too strenuous to maintain throughout adult life. Adolescents with CFS, besides indicating severe physical difficulties, also report more psychosocial problems. They position themselves as significantly less strong and more unwell. With this emphasis on positions relating to their illness, there seems to be little room left for stronger positions. It is regarded of clinical importance to address these issues in this crucial developmental period.

show abstract

Section: Discussionmentioning

confidence: 99%

Health and identity: Self-positioning in adolescent chronic fatigue syndrome and juvenile idiopathic arthritis

Fuchs

Geelen

Geel

et al. 2012

Clin Child Psychol Psychiatry

View full text Add to dashboard Cite

show abstract

“…In particular, fatigue and nervous system impairment could depend on altered acetylcholine activity; myalgia could rely on nitric oxide and endogenous opioid dysfunction, while disturbance in immunomodulation could lead to an abnormal immune response [81]. All these scientific speculations have led to identify CFS with the term " Chronic Neuroendocrine Immune Dysfunction Syndrome" [82].…”

Section: Altered Immune Responsiveness In Psychiatric Disorders and Mmentioning

confidence: 99%

Drug Targets in Stress-Related Disorders

Covelli¹,

Passeri²,

Leogrande³

et al. 2005

CMC

View full text Add to dashboard Cite

Nervous and immune systems mutually cooperate via release of mediators of both neurological and immunological derivation. Adrenocorticotropin hormone (ACTH) is a product of the hypothalamus-pituitary adrenal axis (HPAA) which stimulates secretion of corticosteroids from adrenals. In turn, corticosteroids modulate the immune response in virtue of their anti-inflammatory activity. On the other hand, catecholamines, products of the sympathetic nervous system (SNS), regulate immune function by acting on specific beta-adrenergic receptors. Conversely, cytokines released by monocytes/macrophages and lymphocytes, upon antigenic stimulation, are able to cross the blood-brain-barrier, thus modulating nervous functions (e.g., thermoregulation, sleep, and appetite). However, cytokines are locally produced in the brain, especially in the hypothalamus, thus contributing to the development of anorexic, pyrogenic, somnogenic and behavioural effects. Besides pathogens and/or their products, the so-called stressors are able to activate both HPAA and SNS, thus influencing immune responses. In this respect, many studies conducted in medical students taking exams have evidenced an array of stress-induced immune alterations. Phobic disorders and migraine without aura (MWA) represent examples of stress-related disorders in which phagocytic immune deficits, endotoxemia and exaggerated levels of proinflammatory cytokines [Tumor Necrosis Factor-alpha (TNF- alpha), and interleukin- 1 beta] have been detected. Quite interestingly, administration of a thymic hormone could ameliorate clinical symptoms in phobic patients. In MWA patients, a beta-blocker, propranolol, could mitigate migraine, whose cessation coincided with a drop of TNF-alpha serum concentration. In phobic disorders and in MWA, benzodiazepines are very often administered and, in this respect, some of them, such as diazepam, inhibit immune functions, while others, e.g., alprazolam, enhance immune responses. Alprazolam could improve clinical symptoms in MWA patients. Chronic Fatigue Syndrome (CFS) is a disorder whose etiology and pathogenesis are still unknown. In this syndrome both abnormalities of nervous and immune systems have been reported. Despite many immune parameters evaluated in CFS no specific biomarkers of disease have been found. Our own data are in agreement with current literature in that we found decreased levels of serum (IFN)-gamma in these patients, thus indicating a predominance of T helper (h)1 response in CFS. Also leptin, a hormone which regulates food intake, fluctuates within normal ranges in CFS individuals. Quite interestingly, in depressed patients, used as controls, leptinaemia was more elevated than in CFS. Finally, in a series of recent therapeutic trials several immunomodulating agents have been used, such as staphypan Berna, lactic acid bacteria, kuibitang and intravenous immunoglobulin. In conclusion, it seems that major drug targets in stress-related disorders are immune cells in terms of inhibition of proinflammatory cytokines and modulation o...

show abstract

“…Since the majority of research studies in the last decades have been investigated patients with CFS (or even CF), research into ME [2,[5][6][7] has been scarce since the 1980's. However, to unravel the etiology and pathophysiology of ME and diseases currently meeting the 'umbrella diagnosis' CFS [52,53] making a distinction is unavoidable.…”

Section: A Clear Distinction Between Me and Cfsmentioning

confidence: 99%

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

Twisk¹

2017

J Med Diagn Meth

View full text Add to dashboard Cite

Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS) are subject to controversy. Although ME and CFS are often considered to be to be synonymous, the case criteria for ME and CFS define two distinct diseases with partial overlap. ME, recognized as a new clinical entity in the 1950's, is characterized by distinctive muscular, neurological and autonomic symptoms. In contrast the core feature of CFS, introduced in 1988 and redefined in 1994, is chronic fatigue. Some researchers consider CFS to be equivalent to (incapacitating) chronic fatigue (CF). After the introduction of CFS, other criteria for ME, ME/CFS, CFS and CF were introduced and used in research studies, creating obfuscation and controversy. The use of various diagnostic criteria has hampered effective research into ME and CFS.Next to the various diagnostic criteria, the assessment of symptoms is almost always based on questionnaires and subjective measures, e.g. physical functioning. Due to their nature subjective measures are incomparable over time and between patients. Moreover subjective measures introduce a significant risk of bias, for example due to researcher allegiance, the Hawthorne effect, and buy-in effects. Despite the fact that ME and CFS (subtypes) lack a clear etiological explanation (yet), the symptoms can and should be assessed by objective test measures, since subjective measures are ambiguous, incomparable and introduce the risk of bias. Objective test measures can also confirm the seriousness of both ME and CFS.To resolve the diagnostic issues in research studies and clinical practice, a clear distinction between ME and CFS (not ME), based on the original criteria, is crucial.Although the use of objective test methods is more expensive and time-consuming and severe cases cannot be subjected to these tests, considering the (scientific) confusion originating from the use of subjective measures it is essential to assess the symptoms of patients objectively both in clinical practice and research settings.

show abstract

Chronic Fatigue Syndrome versus Chronic Neuroendocrineimmune Dysfunction Syndrome

Cited by 5 publications

References 17 publications

Health and identity: Self-positioning in adolescent chronic fatigue syndrome and juvenile idiopathic arthritis

Health and identity: Self-positioning in adolescent chronic fatigue syndrome and juvenile idiopathic arthritis

Drug Targets in Stress-Related Disorders

An Accurate Diagnosis of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome requires strict Clinical Case definitions and Objective Test Methods

Contact Info

Product

Resources

About