Research indicates that the prevalence of CFS is significantly higher among women aged 40 to 70. Additionally, studies have shown a notably higher prevalence in low-income populations, highlighting the potential impact of social risk factors, such as stress.
Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis, is a medical condition with an unclear and debated pathogenesis. There is an existing controversy about whether CFS is due to a single cause or has multiple contributing factors. Various theories have suggested the roles of infections, the immune system, and genetics in this complex interplay. Research indicates that the prevalence of CFS is significantly higher among women aged 40 to 70. Additionally, studies have shown a notably higher prevalence in low-income populations, highlighting the potential impact of social risk factors, such as stress.
Diagnostic Criteria for CFS
Chronic fatigue syndrome (CFS) is a diagnosis made on clinical examination after excluding other possible causes. A person is diagnosed with CFS if they have experienced fatigue, post-exertional malaise, and unrefreshing sleep for more than six months at a moderate or severe intensity for at least 50% of the time.
In addition to the above symptoms, diagnostic criterion fulfilment also requires any one of the additional below-mentioned symptoms.
Depressed mood and the psychiatric diagnosis of major depressive disorder (MDD) are common findings in patients with chronic fatigue syndrome (CFS). The relationship between depression and CFS is unclear and may be explained by one of three models:
Despite noting that two-thirds of patients with CFS have signs of major depressive illness, patients with CFS also show symptoms that are not typical of clinical depression, such as sore throat, lymphadenopathy, and post-exertional malaise. While this may be true, it is important to note that these symptoms, including lymphadenopathy, are often self-reported in patients with CFS, just as back pain, headache, and other somatic symptoms. The percentage of patients self-reporting somatic symptoms is higher in those battling depression.
Impact on Quality of Life
Another notable factor in CFS is the compromised quality of life (QOL), which is associated with the ability of individuals to remain active and perform roles in society. In individuals with CFS, quality of life is often inversely related to distress, disability, and loss of function, and hence, preserving functional ability and well-being to achieve effectiveness in life becomes a major goal. However, people with myalgic encephalomyelitis or chronic fatigue syndrome often fail to achieve these goals, and their carers' emotional well-being is also affected.
Management of CFS
Management of CFS involves a multidisciplinary approach with a team of psychiatrists, psychologists, pain physicians, physiotherapists, and dieticians for better outcomes. Antidepressants, steroids, NSAIDs, cognitive behavioral therapy (CBT), mindfulness therapy, graded exercise therapy, and a balanced diet are often effective management strategies.
This article is authored by Dr. Harsha G T, Consultant – Psychiatry, Manipal Hospital Yeshwanthpur