Matthews, D A, Manu, P, Lane, T J · The American journal of the medical sciences · 1991 · DOI
This review article examines how doctors diagnose and treat patients who experience chronic fatigue in everyday medical practice. The authors note that chronic fatigue has many possible causes, including medical illnesses, psychiatric conditions like depression and anxiety, lifestyle factors, and medications. They emphasize that building trust with patients and using a combination of psychiatric evaluation, functional assessment, and both medication and behavioral therapy approaches are important for effective care.
This review is historically important for understanding how chronic fatigue was conceptualized and managed in primary care prior to more recent ME/CFS research. It highlights the persistent challenge that patients with serious fatigue conditions often have their symptoms attributed to psychiatric causes, which remains a relevant issue in ME/CFS clinical encounters today.
This review does not provide original research data or evidence that psychiatric disorders cause chronic fatigue in all patients. It does not evaluate ME/CFS as a distinct biological entity or provide evidence about the prevalence of any specific diagnosis. The article's approach may not apply to ME/CFS specifically, which involves post-exertional malaise and other features not addressed in this general chronic fatigue review.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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