This week, the nonprofit Institutes of Medicine (IOM) released a report calling for more detailed diagnostic criteria and a new name for the condition currently known as chronic fatigue syndrome (also sometimes called myalgic encephalomyelitis).
Under the direction of the US Department of Health and Human Services (HHS), the Agency for Healthcare Research and Quality (AHRQ), and other government agencies, the IOM convened an expert panel to examine the research and clinical practices related to this condition.
Chronic fatigue syndrome (CFS) has long been a confusing and controversial diagnosis. Many healthcare providers are dismissive of symptoms, and many others consider it a mental disorder, not a physical condition, according to the report.
In fact, much of the research on treatment for CFS has focused on psychotherapy. (For example, see Recovery from Chronic Fatigue Syndrome Possible on Psych Central.)
Up to 2.5 million American suffer from CFS, characterized by intense fatigue brought on by often-minimal physical, mental, or emotional exertion. It is more common in women than men, and most people diagnosed are Caucasian, although research shows that it might actually be more prevalent among minority groups.
To help patients get a more accurate and timely diagnosis for this debilitating disease, the IOM makes a number of recommendations. One of the biggest is changing the name of CFS to the more descriptive “systemic exertion intolerance disease” or SEID.
The second major change the IOM recommends is new ICD diagnostic criteria that includes these key symptoms:
- New (not life-long) substantial reductions in the ability to participate in pre-illness levels of work, school, social, and personal activities that lasts for more than six months and is accompanied by fatigue and not alleviated by rest
- Post-exertion malaise
- Unrefreshing sleep
- In addition, patients should experience orthostatic intolerance (fatigue upon being upright, which subsides with laying back down) or cognitive impairment
Cognitive impairment, mental and emotional exhaustion, and unrefreshing sleep are often symptoms of mental disorders like depression, so it’s important for everyone who sees patient with these symptoms to consider SEID as a possible cause, the report’s authors say.
The IOM report recommends that HHS creates a screening and diagnosis kit for use by physicians, but also for emergency departments, mental/behavioral health clinics, and other specialists’ offices.
Photo courtesy of Sodanie Chea on flickr