Coping by limiting activity

Most CFS patients believe that rest and reduced activity is helpful in controlling symptoms, while maintaining activity is unhelpful (Ray, Jefferies and Weir 1995). This limiting coping style, distinguishes CFS patients from depressed patients, suggests that this form of coping may be one of the defining features of the illness (Moss-Morris 1997). An interesting pattern emerges from patients' accounts of how they limit their activity. Rather than consistently limiting activity, they adjust...

Contemporary case definitions The American definition

A primary task of the formative American working party was to decide on an appropriate name for the condition. CFS was unanimously agreed upon as it describes the central symptom of the disorder while avoiding assumptions about aetiology (Holmes et al. 1988). The name was less well received by the sufferers of the illness, epitomised by one patient's lament The new name 'Chronic Fatigue Syndrome' is far too benign. It trivialises. How seriously would you take something called 'Chronic Thirst...

Neurasthenia

Chronic fatigue-like illnesses were described as long ago as the eighteenth century, but the origins of CFS have generally been traced back to the end of the nineteenth century in a condition known as neurasthenia (Shorter 1993 Wessely 1990 White 1989). Neurasthenia was a term coined by an American neurologist, George Beard, to describe a condition of profound nervous exhaustion (Beard 1869). The illness was characterised by mental and physical fatigue which could be exacerbated on the...

Postinfectious fatigue syndromes

Glandular fever was linked to persistent fatigue as long ago as 1948 (Isaacs 1948), although it took another twenty years before EBV was identified as a major cause of the illness (Henle, Henle and Diehl 1968). This discovery was followed by a series of reports in the seventies and eighties that serologic markers of EBV were associated with idiopathic ongoing fatigue (Demitrack and Abbey 1996 Shafran 1991 Shorter 1992). Much of the recent interest in CFS has been attributed to two of these...

Theoretical background

Illness perceptions are a relatively new area of health psychology. The field can be traced back to early work by an American health psychologist, Howard Leventhal. In the early 1980s Leventhal and his colleagues were conducting a study of lymphoma patients undergoing chemotherapy (Nerenz, Leventhal and Love 1982). Leventhal noticed that patients seemed to respond to their illness in terms of implicit theories they held about the disease and its treatment. Many patients seemed to determine the...

Warrelated fatigue syndromes

Fatigue syndromes occurring during or after active combat also attracted attention at the turn of the century (Greenberg 1990 Hyams, Wignall and Roswell 1996). At the same time that ideas about neurasthenia were being formulated, another American physician described a very similar disease episode afflicting soldiers of the American Civil War, which he labelled 'irritable heart' (Da Costa 1871). The illness usually began with gastrointestinal upset followed by functional impairment aggravated by...

Laboratory studies of symptoms in CFS

The concepts discussed so far in this chapter can be used to explain the findings from laboratory studies which have attempted to provide objective evidence of neuropsychological and fatigue symptoms in CFS. The neuropsychological studies have used standard measures to quantify the extent of the memory and attention deficit in CFS patients. Taken together the results of these studies suggest that CFS patients are slower to process information than healthy controls and that this is reflected in...

The epidemiology and impact of chronic fatigue syndrome

Although CFS may be part of a broad spectrum of disorders, the fact that we have definite diagnostic criteria for the illness means that it is possible to estimate how many people are afflicted with this disorder. In this final section we demonstrate that CFS, as currently defined, is not an uncommon illness. Perhaps the most important feature of the illness is not whether or not it is unique, but rather that it has a profound impact both on the individual and on society. Fatigue itself is one...

Muscle cardiovascular and respiratory abnormalities

Another characteristic symptom of CFS is the experience of extreme post-exertional malaise. Patients frequently relate that while they can tolerate physical exertion reasonably well, six to twenty-four hours later they experience marked worsening of their symptoms, particularly pain and weakness in the muscles Komaroff and Buchwald 1991 . We asked 282 CFS patients what would happen to them if they exerted themselves Petrie et al. 1995 . Almost all patients felt that this would have a negative...

Then and now

Most of us have felt unduly tired at some time or another. While this sensation is often unpleasant, the impact on our lives is seldom profound. We may cut down on certain commitments, but in most instances we can continue to perform our day-to-day tasks. However, for some people, like Judy, the experience of fatigue is devastating and ongoing. In describing her nine-year battle with fatigue, Judy explains I had no energy or drive whatsoever. I used to feel that I had fifty-pound weights on...