Shahar, E, Lederer, J · The Journal of family practice · 1990
This study looked at fatigue and weakness complaints in a rural doctor's office over 10 years. Researchers found that about 1 in 3 patients reported these symptoms at some point, with more women affected than men. Most cases improved on their own, and doctors often couldn't identify a specific cause.
This study demonstrates that unexplained fatigue is common in primary care and proposes a classification system that may help clinicians and researchers identify distinct patterns of asthenic symptoms. For ME/CFS patients, understanding how fatigue presents and recurs in the general population provides context for recognizing more severe, persistent cases that warrant further investigation.
This study does not establish causation for fatigue symptoms or distinguish ME/CFS from other causes of asthenia. The classification proposed is descriptive rather than diagnostic, and the ~50% of cases without identified causes does not prove these are primary fatigue syndromes versus undiagnosed medical or psychiatric conditions. The study's rural, relatively small population may not generalize to other settings.
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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