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    08-04-2010
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.M.E. (cvs) - Richtlijnen voor psychiaters - Deel I
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    M.E. (cvs) – Richtlijnen voor psychiaters


    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel I

    Zuiderzon – ME/CVS.Net, Interactieve website over de ziekte ME/CVS, 18-04-2009

    Eleanor Stein is psychiater met een private praktijk in Calgary (Alberta) Canada.
    Haar kennis aangaande M.E./CVS is mede het gevolg van het jarenlang zorgen voor en helpen van FM- & M.E./CVS-patiënten.
    Ze is welbekend voor het NIET onderschrijven van de mening die vele psychiaters er op na houden, nl. dat M.E./CVS een gedragsgerelateerde aandoening zou zijn.
    Ze getuigt ook als experte in gerechtszaken.

    Dr Stein beschreef ooit het ‘Stanford Model of Chronic Disease Self Management’ (cfr. : http://patienteducation.stanford.edu/programs/cdsmp.html -) – wereldwijd een veel gebruikt model – dat tegengesteld is aan met het van bovenaf opgelegde, op CGT gebaseerde gedragsmodel dat domineert in het V.K.
    Het gaat er van uit dat patiënten zich continu moeten engageren voor een heilzame gezondheidszorg, dat patiënten en professionals kennis en bevoegdheid moeten delen en dat patient-‘empowerment’ de sleutel tot succes is.
    Er worden klinische voordelen gerapporteerd voor diabetes en hypertensie (aandoeningen waarbij levensstijl een grote rol spelen) gebruikmakend van dit model maar er werd geen duidelijke voordeel gevonden voor arthritis.
    Dr Stein besloot dat gedragsinterventies kunnen leiden tot een schijnbare, subjectieve verbetering op korte termijn maar dat deze alleen niet leiden tot meetbare, objectieve wijzigingen of blijvende symptomatische veranderingen.
    Daarenboven is er geen bewijs dat dergelijke interventies de pathofysiologie van M.E./CVS aanpakken.

    Ze heeft ook het ‘E Team’ opgericht – het eerste multidisciplinair team in Canada – dat cognitieve, sensorische en geïntegreerde geneeskundige bepalingen uitvoert bij mensen met M.E./CVS, FM, MCS en blootselling aan toxische stoffen.
    Dit team bestaat uit twee artsen, twee psychologen, een optometrist en een audioloog.

    Het onderstaande komt uit haar document ‘Assessment and Treatment of Patients with M.E./CFS: Clinical Guidelines for Psychiatrists’ van 2005 (cfr. : http://sacfs.asn.au/download/guidelines_psychiatrists.pdf -) en is bedoeld om psychiaters die het biopsychosociaal model aanhangen andere inzichten bij te brengen…

    Assessment and treatment of depression and anxiety in patients with ME/CFS - A psychiatric perspective
    Eleanor Stein, MD, FRCP(C) - espc@shaw.ca - Psychiatric Treatment Guidelines—E. Stein, ©2005
    This paper outlines a conceptualization of and approach to the treatment of psychological symptoms in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) especially symptoms of depression and anxiety.
    This paper was written due to a perceived need to articulate an approach is under-represented in the medical literature.
    There are many psychological symptoms not represented in this paper.
    Only the most common are considered, however the approach discussed may serve as a template for other symptoms.
    The sources are : a thorough review of the medical literature, the author’s experience in a psychiatric practice restricted to patients with ME/CFS, Fibromyalgia and Multiple Chemical Sensitivity and the input of several experienced clinicians and persons suffering from ME/CFS.
    This topic remains controversial and there are other approaches.
    However this approach is recommended by being both evidence based and well accepted by patients.
    The author has given permission for this paper to be posted on the web sites of FM-CFS Canada (
    http://www.fm-cfs.ca/index.html -) and the ME-FM Action Network of Canada (http://www.mefmaction.net -) with the goal of increasing discussion and debate and improved outcome for patients.
    Abstract
    This paper will :
    - Define ME/CFS
    - Explain why ME/CFS is not a psychiatric disorder despite that a significant subgroup of patients h
    ave psychological symptoms
    - Outline how to differentiate the symptoms of ME/CFS from those of depression and anxiety
    - Suggest a treatment approach for common psychiatric symptoms in patients with ME/CFS
    - Summarize psychological treatment issues in patients with ME/CFS
    - Summarize issues relevant to children and adolescents with ME/CFS
    - Discuss the treatment issues of drug sensitivity and the utility of Cognitive Behavior Therapy and Graded Exercise in patients with ME/CFS
    .../...
    Conclusion
    ME/CFS is a multi-systemic potentially disabling medical disorder.
    Although a gold standard diagnostic test is not available, the medical literature is clear that ME/CFS is not the same as depression or any other psychiatric disorder.
    It is important to discern whether a patient has ME/CFS, a psychiatric disorder or both.
    Using the Canadian Criteria (a clinical diagnostic tool), the signs and symptoms of ME/CFS can clearly be distinguished from psychiatric disorders in most cases.
    Being knowledgeable in both physical and psychological medicine, psychiatry plays an important role in the overall management of ME/CFS.
    Psychiatrists can offer accurate diagnosis and treatment of psychiatric disorders, assessment of the patients’ phase of coping and adaptation and psychotherapeutic support.
    Comorbid psychological symptoms such as depression and anxiety occur in ME/CFS and are often secondary to loss of health, financial means and role in society.
    When present, psychiatric symptoms should be treated similarly to any other patient while paying attention to the increased incidence of drug side effects in this population and decreased energy available for therapy.
    Self management seems important in the long term outcome for patients with ME/CFS and empowerment facilitates self management.
    Research on psychosocial interventions is in its infancy.
    While awaiting further research it is important to first do no harm.
    Cfr. :
    -
    http://www.praxis-seegarten.ch/pages/medinfo/pages/cfs-guidelines_psychiatrists.pdf
    - http://www.mefmaction.net/Portals/0/docs//psychiatricguidelinesstein.pdf


    1. - Wat is M.E./CVS ?

    Myalgische Encefalomyelitis (M.E.) werd voor het eerst gedefinieerd door Acheson in 1959, gebaseerd op 14 gedocumenteerde uitbraken in verschillende landen en honderden sporadische ziekte-gevallen gekarakteriseerd door : hoofdpijn, spierpijn, parese, mentale symptomen, lage of geen koorts en geen mortaliteit (Acheson 1959).
    Dit was in contrast met polio en andere verlammende aandoeningen die toen prevalent waren.
    De aandoening werd later geoperationaliseerd door Ramsay met het opnemen van : spier-zwakte en vermoeibaarheid, betrokkenheid van het CZS en fluctuatie van symptomen.
    In vroege rapporten was emotionele labiliteit – gaande van lichte irritatie tot gewelddadige manifestaties – een bijna constante eigenschap.

    In 1988, na een uitbraak in Incline Village (Nevada), vormde het CDC een committee dat de aandoening ‘Chronische Vermoeidheid Syndroom” noemde en criteria suggereerde voor een research-definitie (Holmes et al. 1988 – cfr. 'Chronic Fatigue Syndrome - A working case definition' op : http://www.annals.org/cgi/content/abstract/108/3/387 -).

    Deze criteria werden klinisch problematisch bevonden en in 1994 herzag het CDC hun definitie en publiceerde wat nu genoegzaam bekend staat als de ‘Fukuda criteria’ (cfr. : http://www.cvscontactgroep.be/jml/medisch/41-criteria-voor-cvsme/62-1994-de-cdc-criteria-fukuda-et-al - (Fukuda et al. 1994 – cfr. 'The Chronic Fatigue Syndrome: A Comprehensive Approach to Its Definition and Study' op : http://www.annals.org/cgi/content/full/121/12/953 -).
    Deze definitie uit 1994 vereist minder fysieke tekenen dan de definitie uit 1988 en daarom selekteert ze minder ernstig zieke patiënten (De Becker et al. 2001 – cfr. : 'A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome' op :
    http://www.ingentaconnect.com/content/bsc/jint/2001/00000250/00000003/art00890 -).
    De criteria van Fukuda vereisen slechts één verplicht symptoom : invaliderende vermoeidheid die langer dan 6 maanden aanhoudt.
    Daarnaast moeten er ten minste 4 van de volgende symptomen zijn : gestoord geheugen/ concentratie, pijnlijke keel, gevoelige lymfeknopen, spier-pijn, pijn aan meerdere gewrichten, nieuwe hoofdpijn, niet-verfrissende slaap en post-exertionele vermoeidheid.
    Deze definitie mist specificiteit omdat gebruikelijke symptomen zoals autonome en endocriene symptomen niet werden opgenomen.
    De Fukuda criteria warden ook bekritiseerd omdat spier-vermoeibaarheid niet is vereist.
    Spier-moeheid is [wel] noodzakelijk voor de diagnose van M.E.

    Samenwerking tussen de ‘National ME-FM Action Network of Canada’ en ‘Health Canada’ resulteerde in 2003 tot de publikatie van waar naar wordt verwezen als de ‘Canadian Consensus Guidelines for M.E./CFS’ (Carruthers et al. 2003 – cfr. 'Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Clinical working case definition, diagnostic and treatment guidelines - A consensus cocument' op : http://www.amazon.com/Myalgic-Encephalomyelitis-Chronic-Fatigue-Syndrome/dp/0789022079 -) – cfr. ook : http://sacfs.asn.au/download/consensus_overview_me_cfs.pdf -&- 'The new Canadian Clinical Case Definition' op : http://www.cvscontactgroep.be/jml/medisch/criteria-voor-cvsme/65-2003-the-new-canadian-clinical-case-definition -).
    Deze Richtlijnen beschrijven een klinische definitie, klinische evaluatie, prognose, beroepsonbekwaamheid en behandel-protocol voor patiënten met M.E./CVS.
    De ‘Canadian Consensus’ definitie vereist de gezamenlijke aanwezigheid gedurende ten minste 6 maanden van vijf majeure criteria: invaliderende vermoeidheid, post-exertionele malaise en/of vermoeidheid, slaap-dysfunktie, pijn en twee of meer neurologische/cognitieve symptomen.
    Daarenboven moeten er twee van de volgende manifestaties zijn: autonome, neuro-endocriene en immune.
    Het opnemen van autonome, neuro-endocriene en immune symptomen als mineure criteria lijkt de specificiteit te verhogen gezien deze definitie minder patiënten met psychiatrische aandoeningen en meer patiënten met ernstige fysieke symptomen selekteert dan de Fukuda criteria (Jason et al. 2005 – cfr. 'Comparing the Fukuda et al. criteria and the Canadian case definition for chronic fatigue syndrome' op :
    http://www.theoneclickgroup.co.uk/documents/ME-CFS_res/Comparing%20the%20Fukuda%20et%20al%20Criteria%20and%20the%20Canadian%20Case%20Definition%20-%20CFS.pdf -).

    Er zijn nog twee andere definities in de literatuur te vinden : de ‘Oxford Criteria’ (Sharpe et al. 1991 – cfr. 'A report - Chronic fatigue syndrome - Guidelines for research' op : http://www.ncbi.nlm.nih.gov/pubmed/1999813 -&- http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1293107 -) en de ‘Australian Criteria’ (Lloyd et al. 1990 – cfr. : 'Prevalence of chronic fatigue syndrome in an Australian population' op : http://www.ncbi.nlm.nih.gov/pubmed/2233474 -).
    Deze beide zijn zo breed opgevat dat het onmogelijk is een homogene groep te verzekeren.
    Beide slagen er niet patiënten met primaire psychiatrische diagnosen uit te sluiten bij afwezigheid van fysieke symptomen.
    Geen van beide wordt dikwijls gebruikt bij research.
    (Cfr. ook 'ME/CVS Criteria' (een Nederlandstalig overzicht van de criteria voor ME/CVS) op :
    http://www.me-cvsvereniging.nl/me-cvs-nieuws/me-cvs-criteria.php -).

    Patiënten die lijden aan symptomen die consistent zijn met CVS hebben een afkeer van de naam omdat het de ernstige incapaciterende mentale en spier-moeheid die wordt ervaren, trivialiseert. Hoewel M.E. en and CVS verschillen qua definitie, refereren verscheidene groepen – inclusief de internationale groep researchers die de ‘Canadian Guidelines’ publiceerden – naar de aandoening als : Myalgische Encefalomyelitis/ Chronische Vermoeidheid Syndroom (M.E./CVS); wat patiënten met én epidemische én sporadische start en patiënten met milde tot extreem ernstige symptomen omvat.
    De term 'M.E./CVS' zal in dit artikel worden gebruikt.


    Klinische variabiliteit

    Het klinisch profiel van M.E./CVS is dat van een onophoudelijke en schommelende mentale en fysieke vermoeidheid, niet-verfrissende slaap, cognitieve dysfunktie en andere symptomen.
    De ernst kan variëren :

    • mild – waarbij men nog in staat is voltijds te werken/studeren maar niettemin met inspanning en rust tijdens de weekends:

    • matig – in staat is deeltijds te werken/studeren met inspanning;

    • ernstig – niet in staat te werken/studeren en assistentie om een onafhankelijk leven te leiden is vereist;

    • extreem - niet in staat een onafhankelijk leven te leiden, virtueel aan huis en soms aan bed gekluisterd.

    Het verloop van M.E./CVS is variabel.
    De karakteristieke eigenschap van de ziekte is invaliderende fysieke en cognitieve malaise en/of vermoeidheid en verergering van andere symptomen volgend op inspanning met langdurige reaktieve verslechteringen na aktivititeit.


    Co-morbiditeit

    In de grootste epidemiologische studie tot op heden, werd door Jason en collega’s in Chicago aangetoond dat slechts 40% van een CVS-gemeenshapscohort echt CVS had (Jason et al. 1999).
    15,6% van dit cohort had ook het fibromyalgie-syndroom (FM), een aandoening van chronische veralgemeende spier-pijn en gewricht-stijfheid met aanwezigheid van ten minste 11/18 aangewezen ‘tender points’ bij fysisch onderzoek.
    41 percent had ‘Multiple Chemical Sensitivity’ (MCS), een aandoening gedefinieerd als een chronische toestand met symptomen die reproduceerbaar terugkomen in respons op lage niveaus van blootstelling aan chemicaliën.
    De symptomen verbeteren of gaan weg wanneer de aanstokers worden verwijderd.
    De symptomen van of M.E./CVS komen voor bij meerdere orgaan-systemen en geen enkele andere aandoening kan verantwoordelijk worden geacht voor de symptomen.
    De invaliditeit die bij M.E./CVS-patiënten wordt gezien, wordt dikwijls verergerd door de co-morbiditeit van M.E./CVS met FM en MCS alsook met andere medische en psychiatrische aandoeningen, indien aanwezig.
    Een volledige anamnese moet worden afgenomen om alle symptomen die een impact hebben op funktie en gezondheid te identificeren.


    Prevalentie

    De prevalentie van CVS in epidemiologische studies gebaseerd op de totale bevolking, gebruikmakend van de Fukuda criteria, is 0,24 – 0,42% (Reeves et al. 2003, Jason et al. 1999).
    Dit betekent dat in Canada er ongeveer 125.000 mensen zijn die voldoen aan de CDC criteria voor CVS.
    Gebaseerd op Amerikaanse schattingen is het jaarlijks verlies aan produktiviteit $ 20.000 per persoon.
    In Canada wordt de jaarlijks verloren produktiviteit geschat op $ 2,5 miljard (Reynolds et al. 2004).
    Dit is een reusachtige belasting voor de economie en suggereert dat meer onderzoeksfondsen zouden moeten worden aangewend voor het begrijpen van de preventie, diagnose en aanpak van M.E./CVS.


    Etiologie

    Ondanks 20 jaar research en meer dan 3.000 gepubliceerde ‘peer-reviewed’ artikels, blijft de etiologie van M.E./CVS onduidelijk.
    Het wordt nu algemeen aanvaard dat M.E./CVS een paraplu-term is voor een heterogene groep aandoeningen en dat één enkele etiologie of mechanisme wellicht niet zal worden gevonden.
    Dit heeft geleid tot een oproep voor zorgvuldig sub-typeren door het gebruik van gekende co-relaten bij toekomstig onderzoek (Jason et al. 2005).

    Niettemin worden sommige abnormaliteiten consistent gerapporteerd.
    Deze omvatten : dysfunktie van het autonoom zenuwstelsel, gebruikmakend van de objectieve meting van hartslag-variabiliteit (Cordero et al. 1996) of ‘tilt table’-test (Rowe & Calkins 1998).
    Meerder studies hebben deficiëntie in ‘natural killer’-cel funktie getoond (Whiteside & Friberg 1998;Ogawa et al. 1998) bij M.E./CVS.
    Studies van cytokine-profielen suggereren een Th1 naar Th2 verschuiving.
    Th1 is het aspekt van het immuunsysteem dat intracellulaire infektie controleert.
    […]
    Vele intracellulaire infekties bleken meer prevalent bij M.E./CVS vergeleken met controles.
    […]
    Dit suggereert dat de infekties secundair zijn aan immuun-dysfunktie.
    Cognitieve funktie (DeLuca et al. 1997, Michiels et al. 1999, Tiersky et al. 2003), hersen-doorbloeding bij SPECT (Ichise et al. 1992, Costa et al. 1995, Fischler et al. 1996) en kwantitatieve EEG zijn allemaal abnormaal (Flor-Henry et al. 2003).
    Hormonale studies tonen hypo-funktie ter hoogte van de hypothalamus.
    Recent werd gesuggereerd dat dit wellicht gevolg is van chronische ziekte eerder dan een oorzaak (Cleare 2004).


    2. - M.E./CVS is GEEN psychiatrische aandoening

    De eerste vraag bij veel psychiaters zal zijn of M.E./CVS een psychiatrische aandoening is.
    Als het zou zijn waarom zit het dan niet in de DSM ['Diagnostic and Statistical Manual of Mental Disorders', klassificatie voor psychische stoornissen – cfr. :
    http://nl.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders -&- http://www.bol.com/nl/p/boeken-engels/diagnostic-and-statistical-manual-of-mental-disorders-dsm-iv-tr/1001004001341827/index.html -] ?
    Als het zou zijn waarom worden er dan richtlijnen geschreven voor psychiaters ?

    De research toont steeds duidelijker dat M.E./CVS GEEN primaire psychiatrische aandoening is hoewel psychiatrische symptomen soms prominent kunnen zijn.
    De ‘World Health Organization’ heeft M.E./CVS als een neurologische aandoening geklassificeerd.
    Vroeger hypothesen van psychologische oorzaken zoals de quote van Abbey en Garfinkel uit 1991 (“De meerderheid van zij die lijden [aan of M.E./CVS] ervaren primaire psychiatrische aandoeningen of psychofysiologische reakties en de aandoening is dikwijls een cultureel gesanctioneerde vorm van ziekte-gedrag.”) werd weerlegd door steeds meer onderzoeksresultaten die biologische co-relaten voor M.E./CVS tonen die niet bij depressie of enig andere psychiatrische aandoening worden gevonden.


    Voorkomen van psychiatrische aandoening bij CVS is gelijk aan die bij andere chronische medische aandoeningen

    Als M.E./CVS een psychiatrische aandoening zou zijn, zouden psychiatrische symptomen universeel moeten zijn.
    Als de striktere Fukuda criteria echter worden gebruikt voor de selektie van patiënten, is de prevalentie van gekende psychiatrische aandoeningen onder patiënten met M.E./CVS gelijkaardig met die van patiënten met andere chronische, invaliderende medische aandoeningen zoals reumatoïde arthritis; ongeveer 30 – 40% (Thieme et al. 2004, Hickie et al. 1990, Fiedler et al. 1996).
    Jason’s vergelijkende studie van de Canadse en Fukuda criteria voor M.E./CVS toonden dat de Canadese criteria patiënten selekteerden die fysiek zieker waren, meer fysieke funktionele stoornissen, meer vermoeidheid/ zwakte en meer neuro-cognitieve, neurologische en cardiopulmoniare abnormaliteiten hadden en minder huidige of levenslange psychiatrische stoornissen (Jason et al. 2004) [cfr. ook : ‘Evaluatie van de CDC Empirische Definitie’ op :
    http://mecvswetenschap.wordpress.com/2009/02/23/431/ -].
    Dit draagt bij tot het bewijsmateriaal dat diagnostische criteria de selektie van patiënten beïnvloedt.
    Studies die een hogere prevalentie van psychiatrische aandoeningen rapporteerden, vertoonden vooroordelen qua recrutering, b.v. het selekteren van degenen die voor behandeling naar een specialistisch centrum gaan of het gebruiken van ongeschikte onderzoeksinstrumenten (Thieme et al. 2004).
    Jason heeft aangetoond dat het type vragenlijst die wordt gebruikt in een studie significant de prevalentie van psychiatrische aandoeningen, gerapporteerd bij M.E./CVS-populaties, kan beïnvloeden (50% gebruikmakend van de DIS [‘Dissociation Questionnaire’; dissociatieve stoornis = persoonlijkheidsstoornis – cfr. :
    http://www.tijdschriftvoorpsychiatrie.nl/meetinstrumenten/info.php?id=45 -] vs. 25% bij de SCID [‘Structured Clinical Interview for DSM-IV - Dissociative Disorders’; veelvuldig gebruikt diagnostisch instrument voor het vaststellen van persoonlijkheidsstoornissen – cfr. : http://www.tijdschriftvoorpsychiatrie.nl/meetinstrumenten/info.php?id=105 -]) (Jason et al. 2003).
    Voor research-doeleinden wordt de ‘Structured Clincial Interview for DSM-IV’ ontwikkeld door Spitzer et al. - cfr. :
    http://www.tijdschriftvoorpsychiatrie.nl/meetinstrumenten/ -, aanbevolen bij M.E./CVS-studies (Spitzer et al. 1992, Williams et al. 1992).


    Aantallen van persoonlijkheidsstoornissen bij M.E./CVS zijn NIET verhoogd

    Als M.E./CVS een psychiatrische aandoening zou zijn, zou men verwachten dat het aantal persoonlijkheidsstoornissen verhoogd zou zijn zoals dat bij psychiatrische groepen het geval is.
    Nochtans hebben mensen met M.E./CVS gelijkaardige percentages persoonlijkheidsstoornissen (ca. 10%) als de algemene bevolking en lagere percentages dan deze die worden gevonden bij depressie (Thieme et al. 2004, Pepper et al. 1993, Saltzstein et al. 1998, Chubb et al.1999).
    Er zijn studies die hogere percentages psychologisch leed rapporteren gebruikmakend van de MMPI [Minnesota Multiphasic Personality Inventory; één van de meest frequent gebruikte persoonlijkheidstesten – cfr. :
    http://www.bol.com/nl/p/boeken-engels/mmpi-2/1001004002582122/index.html -] (Blakely et al. 1991) bij M.E./CVS vergeleken met gezonde controles maar er werd echter geargumenteerd dat de MMPI geen accurate bepaling is bij mensen met chronische medische aandoeningen omdat de items werden afgeleid en genormeerd gebaseerd op fysiek gezonde individuen.
    Wanneer ze wordt gebruikt bij groepen met chronische ziekte, dragen de fysieke symptomen bij tot de ‘hypohondriase’ [bezorgheid over lichamelijk symptomen] en ‘hysterie’ [bewustzijn van problemen en kwetsbaarheden] schalen, wat resulteert in vals-positieven (Pincus et al. 1986, Goldenberg 1989).

    Ondanks het overwicht van research voor het tegengestelde, blijft een groep van hoofdzakelijk Britse psychiaters publiceren dat M.E./CVS wordt veroorzaakt en verergerd door verkeerde zelf-perceptie en vermijdend gedrag.
    De foute overtuigingen worden omschreven als : “het geloof dat men een ernstige ziekte heeft; de verwachting dat haar/zijn toestand wellicht zal verslechten; de ‘ziekte-rol’ – met inbegrip van de effekten van processen en compensatie; en de alarmerende portretering van de aandoening als katastrofisch en invaliderend” (Barsky & Borus 1999).
    Het moet worden opgemerkt dat noch dit artikel van Barsky noch enig ander met gelijkaardige opinies ‘evidence-based’ is; het zijn de persoonlijke meningen van de auteurs.


    Genetica van depressie en M.E./CVS zijn onafhankelijk

    De genetica van M.E./CVS is onafhankelijk van deze van depressie; wat suggereert dat de twee aandoeningen GEEN gelijkaardig genetisch risico dragen (Thieme et al. 2004, Hickie et al. 1999).


    Fysiologische metingen verschillen tussen M.E./CVS en depressie

    Bij depressie is de hypothalamus-hypofyse-bijnier [HPA] as gestimuleerd en moeilijk te onderdrukken met dexamethasone [synthetisch glucocorticoid, geeft negatieve feedback aan de hypofyse om de secretie van ACTH te onderdrukken; kan niet doorheen de bloed-hersen-barrière zodat het toelaat een specifiek deel van de HPA-as te testen], terwijl het tegenovergestelde waar is bij M.E./CVS.
    Cortisol-waarden in de urine zijn laag, serum-cortisol stijgt scherp en voor langere perioden na oraal dexamethasone (Scott & Dinan 1998).
    Het is onduidelijk of deze veranderingen in HPA-as funktie primair of secundair zijn (Cleare 2004).
    Elektrodermale huid-respons en huid-temperatuur aan de vinger zijn verschillend bij M.E./CVS en bij depressie (Pazderka-Robinson et al. 2004 : ‘Quantitative EEG profiles discriminate between ME/CFS, depression and healthy controls’ [cfr. ‘Onderscheid CVS & depressie via Huid-geleiding’ op :
    http://mecvswetenschap.wordpress.com/2009/02/28/onderscheid-cvs-depressie-via-huid-geleiding/ -], Flor-Henry et al. 2003).


    Ernst van de ziekte en NIET psychologische factoren voorspellen uitkomst

    Als M.E./CVS een psychiatrische aandoening zou zijn, zou men verwachten dat psychologische symptomen de uitkomst zouden voorspellen.
    Dit is echter niet het geval.
    Studies tonen consistent dat de ernst van de symptomen bij aanvang en of iemand voldoet aan de volledige criteria voor M.E./CVS de prognose bij M.E./CVS voorspelt (Darbishire et al. 2005) maar psychologische symptomen en cognitieve overtuigingen NIET (Deale et al. 1998, Jones et al. 2004, Darbishire et al. 2005, White et al. 1998).

    Gezien de steeds groeiende hoeveelheid research-data dat M.E./CVS in feite een ernstige, dikwijls invaliderende aandoening is, is het achterlaten van het psychologisch model begrijpelijk.
    Psychiatrische stoornissen bij M.E./CVS zijn meestal secundair aan het verlies van gezondheid, levensstijl, sociale rol en financiële middelen zowel als het sociaal stigma van het hebben van een ernstige invaliderende maar zeer slecht begrepen ziekte.
    […]


    3. - Behandelingskwesties

    […]

    Medicijn-dosage en -gevoeligheid

    Het wordt algemeen aanvaard dat sommige patiënten met M.E./CVS gevoeliger zijn voor de ongunstige gevolgen van medicatie dan de meeste gezonde mensen.
    Ze delen deze eigenschap met patiënten met chronische pijn en fibromyalgie.
    Tricyclische antidepressiva mogen dan misschien bv. nuttig zijn bij het onderhouden van de slaap en het verminderen van centrale pijn-gevoeligheid maar veel patiënten met M.E./CVS hebben slechts voordeel van en tolereren slechts heel lage dosissen.
    […]
    SSRIs, die over het algemeen goed worden getolereerd bij de behandeling van depressie en angst, worden niet getolereerd door een sub-groep van M.E./CVS- patiënten.
    Het mechanisme van deze reakties is onbekend.
    Het opdrijven van de dosering wetende dat ongunstige gevolgen kunnen optreden bij deze patiënten is echter flirten met rampspoed en verzwakt de therapeutische relatie.
    […]
    In sommige gevallen kan medicijn-gevoeligheid de behandeling van de subset van deze patiënten ernstig hinderen.


    Bruikbaarheid van CGT/graduele training bij M.E./CVS

    Hoewel Cognitieve Gedrag Therapie (CGT) algemeen aanbevolen wordt voor patiënten met M.E./CVS, is het helemaal niet duidelijk of het nuttig is voor de meeste patiënten.
    De rationale voor het gebruik van CGT bij M.E./CVS is dat onterechte overtuigingen (dat de etiologie fysisch is) en ineffektieve ‘coping’ (vermijden van aktiviteit) M.E./CVS morbiditeit in stand houden en bestendigen (Deale et al. 1997, Sharpe et al. 1996).
    Het werd echter nooit bewezen dat deze overtuigingen bijdragen tot de morbiditeit bij M.E./CVS.
    […]
    Van de 6 gerapporteerde studies die CGT gebruiken bij [wat zij noemen] “M.E./CVS”, zijn er twee die patiënten selekteerden met de Oxford criteria (Deale et al. 1997, Sharpe et al. 1996), één waar de Australische criteria werden gebruikt (Lloyd et al. 1993) en één die de Fukuda criteria gebruikte “met uitzondering van het criterium dat vier van de acht bijkomende symptomen vereist” (Prins et al. 2001).
    Deze methoden van patient-selektie laten aanzienlijke heterogeniteit en inclusie van psychiatrisch zieke patiënten met vermoeidheid toe.
    Daarom zijn de resultaten niet toepasbaar op de gemiddelde, door Fukuda of Canadese criteria gedefinieerde patiënten.
    Van de overblijvende twee studies die valabele selektie-criteria gebruikten, was er één die geen nut voor CGT vond (Friedberg & Krupp 1994).
    De enige studie die voordelen meldde (verbeterde funktionele capaciteit en verminderde vermoeidheid) werd uitgevoerd bij adolescenten (Stulemeijer et al. 2005).

    Het is belangrijk te noteren dat geen enkele CGT-studie heeft gerapporteerd dat patiënten genoeg verbeterd waren om terug aan het werk te gaan; noch veranderingen qua fysieke M.E./CVS-symptomen zoals bv. spier-pijn, koorts, lymfadenopathie, hoofdpijn of orthostatische intolerantie.
    Verder suggereert klinische ervaring dat het proberen overtuigen van een M.E./CVS-patient dat zij/hij geen fysieke aandoening heeft en niet zou mogen rusten wanneer men vermoeid is, leidt tot conflicten in de arts-patient relatie en slechte uitkomsten voor de patiënten.
    […]

    Ondanks het feit dat verergering van symptomen na inspanning een verplicht criterium voor diagnose van of M.E./CVS is, wordt graduele training dikwijls voorgeschreven voor dergelijke patiënten.
    Vermoedelijk worden deze aanbevelingen gemaakt in de veronderstelling dat inspanning vergezeld zal gaan van een verbeterde aërobe capaciteit, een verhoogde anaërobe drempel en verbeterde inspanningstolerantie.
    Bij patiënten met M.E./CVS verbeterde echter noch de inspanningstolerantie noch de fitness bij trainingsprogrammas.
    Dit kan gelinkt zijn met abnormale responsen op inspanning bij mensen met M.E./CVS.
    De hartslag bij rust van patiënten is verhoogd en de maximum zuurstof-opname is gereduceerd vergeleken met gezonde sedentaire controles (Riley et al. 1990, Farquhar et al. 2002, Fulcher & White 1997, De Becker et al. 2000).
    Hersen-analyses via SPECT-scan wijzen op verergering van hypo-perfusie (Goldstein 1993) en verminderde cerebrale doorbloeding (Peterson et al. 1994) na inspanning.
    Gedaalde cognitie (Blackwood et al. 1998a, LaManca et al. 1998), gedaalde pijn-drempels (Whiteside et al. 2004) en verminderde maximale spier-contractie (Paul et al. 1999) werden ook gemeld.

    Volgens een ‘Cochrane Collaboration’ meta-analyse (Edmonds et al. 2004) zijn er vijf studies over training en M.E./CVS die methodologisch deugdelijk zijn.
    Drie van deze studies gebruikten echter de Oxford criteria (vereisen slechts vermoeidheid gedurende 6 maand voor een diagnose) voor patient-selektie.
    Eén ervan sloot patiënten met een verstoorde slaap uit (Fulcher & White 1997); wat betekent dat virtueel alle patiënten die gezien worden in de klinische praktijk zouden zijn uitgesloten.
    Er zijn twee studies die valabele diagnostische criteria gebruiken en beide melden minder zelf-gerapporteerde vermoeidheid (via de ‘Chalder Fatigue Scale’ [cfr. ‘Vermoeidheid bij Myalgische Encefalomyelitis’ op :
    http://mecvswetenschap.wordpress.com/2008/10/18/vermoeidheid-bij-myalgische-encefalomyelitis/ - voor kritiek]) (Wallman et al. 2004, Moss-Morris et al. 2005).
    Geen van deze melden follow-up langer dan 12 weken, noch over de fysieke kern-symptomen van M.E./CVS zoals pijn, niet-verfrissende slaap, infektueuze, autonome, neurologische of endocriene symptomen.
    Het is onduidelijk of deze bevindingen toepasbaar zijn op ernstig zieke patiënten aangezien geen enkele van deze patiënten in staat is deel te nemen aan studies.
    Het zal veel meer studie vergen bij een bredere groep patiënten, met rapportering over alle symptomen om ooit te uit te maken of graduele training de kern-symptomen van M.E./CVS beïnvloedt.

    Cfr. : http://mecvswetenschap.wordpress.com/2009/04/18/mecvs-richtlijnen-voor-psychiaters/


    Cfr. ook :

    1. A 37 kDa 2-5A binding protein as a potential biochemical marker for chronic fatigue syndrome
      DeMeirleir K, Bisbal C, Campine I et al. - Am J Med 2000; 108: 99-105

    2. A 56-Year-Old Woman With Chronic Fatigue Syndrome
      A. L. Komaroff - JAMA, October 8, 1997; 278(14): 1179 – 1185
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      A 56-year-old woman with chronic fatigue syndrome, 1 year later
      Delbanco TL, Daley J, Hartman EE - JAMA. 1998 Jul 22-29;280(4):372 - PMID: 9686556
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    Lees verder : Deel II


    08-04-2010 om 23:22 geschreven door Jules

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    Tags:chronic fatigue syndrome, fbromyalgia, fibromyalgie, FM, M.E./CFS, ME/CFS, Myalgische Encefalomyelitis (M.E.), psychiater, psychiatrist, psychological, psycholoog
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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel II


    1. A behavioural approach based on reconstructing the sleep-wake cycle
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    14. A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome
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      Galland BC, Jackson PM, Sayers RM, Taylor BJ, Department of Women's & Children's Health, University of Otago, Dunedin 9015, New Zealand : barbara.galland@otago.ac.nz - Pediatr Res. 2008 Feb;63(2):196-202 - PMID: 18091356

      This study aimed to define cardiovascular and heart rate variability (HRV) changes following head-up tilt (HUT) in children/adolescents with chronic fatigue syndrome (CFS) in comparison to age- and gender-matched controls.
      Twenty-six children/adolescents with CFS (11-19 y) and controls underwent 70-degree HUT for a maximum of 30 min, but returned to horizontal earlier at the participant's request with symptoms of orthostatic intolerance (OI) that included lightheadedness.
      Using electrocardiography and beat-beat finger blood pressure, a positive tilt was defined as OI with 1) neurally mediated hypotension (NMH); bradycardia (HR <75% of baseline) and hypotension [systolic pressure (SysP) drops >25 mm Hg)] or 2) postural orthostatic tachycardia syndrome (POTS); HR increase >30 bpm or HR >120 bpm (with/without hypotension).
      Thirteen CFS and five controls exhibited OI generating a sensitivity and specificity for HUT of 50.0% and 80.8%, respectively. POTS without hypotension occurred in seven CFS subjects but no controls.
      POTS with hypotension and NMH occurred in both.
      Predominant sympathetic components to HRV on HUT were measured in CFS tilt-positive subjects.
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    23. A preliminary assessment of the association of SCL-90-R psychological inventory responses with changes in urinary metabolites in patients with chronic fatigue syndrome
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      Benefits of exercise therapy
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    40. Acute infectious mononucleosis - Characteristics of patients who report failure to recover
      Buchwald DS, Rea TD, Katon WJ et al. - Am J Med 2000; 109: 531-537

    41. Advances in fibromyalgia - Possible role for central neurochemicals
      Russell IJ - Am J Med Sci. 1998;315 :377 –384
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    42. Aerobic work capacity in patients with chronic fatigue syndrome
      Riley MS, O'Brien CJ, McCluskey DR, Bell NP, Nicholls DP, Department of Medicine, Royal Victoria Hospital, Belfast - BMJ. 1990 Oct 27;301(6758):953-6 - PMID: 2249024
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2249024
      Lees ook de commentaren op dit artikel :
      Aerobic work capacity in chronic fatigue syndrome
      Rosen SD, King JC, Wilkinson JB, Nixon PG - BMJ. 1990 Nov 24;301(6762):1217 - PMID: 2082990
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      veryPanel.Pubmed_RVAbstractPlus

      -
      Aerobic work capacity in chronic fatigue syndrome
      Mäntysaari M - BMJ. 1991 Jan 5;302(6767):50 - PMID: 1991195
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      veryPanel.Pubmed_RVAbstractPlus

    43. Alcohol- and drug-use disorders in Australia - Implications of the National Survey of Mental Health and Wellbeing
      Teesson M, Hall W, Lynskey M, Degenhardt L - Aust N Z J Psychiatry 2000; 34: 206-213

    44. Alteration of spatial-temporal parameters of gait in chronic fatigue syndrome patients
      Saggini R, Pizzigallo E, Vecchiet J et al. - J Neurol Sci 1998; 154: 18-25

    45. Amma Therapy(R) - A Holistic Approach to Chronic Fatigue Syndrome
      A. Young - J Holist Nurs, June 1, 1993; 11(2):172 – 182
      Cfr. : http://jhn.sagepub.com/cgi/content/abstract/11/2/172

    46. Amplified amplitudes of circadian rhythms and nighttime hypotension in patients with chronic fatigue syndrome - Improvement by inopamil but not by melatonin
      Leonie van de Luit, MD, Jan van der Meulen, MD, PhD, Ton J. M. Cleophas, MD, PhD, FACA & Aeilko H. Zwinderman, MathD, PhD - Angiology, Vol. 49, No. 11, 903-908 (1998) Cfr. : http://ang.sagepub.com/cgi/content/abstract/49/11/903

    47. An assessment of cognitive function and mood in chronic fatigue syndrome
      Marshall PS, Watson D, Steinberg P et al. - Biol Psychiatry 1996; 39: 199-206

    48. An evaluation of multidisciplinary intervention for chronic fatigue syndrome with long-term follow-up and a comparison with untreated controls
      Marlin RG, Anchel H, Gibson JC et al. - Am J Med 1998; 105: 110S-114S

    49. An examination of the working case definition of chronic fatigue syndrome
      Komaroff AL, Fagioli LR, Geiger AM et al. - Am J Med 1996; 100: 56-64

    50. An inventory for measuring depression
      Beck AT, Ward CH, Menselson M, Mock J, Erbaugh J - Arch Gen Psychiatry. 1961 Jun;4:561–571
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/13688369

    51. An investigation of sympathetic hypersensitivity in chronic fatigue syndrome
      Sendrowski DP, Buker EA, Gee SS - Optom Vis Sci 1997; 74: 660-663

    52. An open study of the efficacy and adverse effects of moclobemide in patients with the chronic fatigue syndrome
      White, P.D. & Cleary, K.J. (1997), Department of Psychological Medicine, St Bartholomew's and the Royal London Medical School, London - International Clinical Psychopharmacology, 12, 47-52
      Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=2661461

    53. Anaesthesia and chronic fatigue syndrome
      British Journal of Anaesthesia 2008 101(4):NP
      Cfr. : http://bja.oxfordjournals.org/cgi/content/extract/101/4/NP

    54. Anaesthesia for patients with idiopathic environmental intolerance and chronic fatigue syndrome
      Fisher MM, Rose M, Royal North Shore Hospital of Sydney, St Leonards, NSW 2065, Australia : mfisher@med.usyd.edu.au - Br J Anaesth. 2008 Oct;101(4):486-91
      Cfr. :
      -
      http://www.ncbi.nlm.nih.gov/pubmed/18782886
      - http://bja.oxfordjournals.org/cgi/content/abstract/101/4/486

    55. Analysis of neuropsychological functioning in patients with chronic fatigue syndrome
      Grafman J, Schwartz V, Dale JK, Scheffers M, Houser C, Straus SE - J Neurol Neurosurg Psychiatry. 1993 Jun;56(6):684–689
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    56. Antidepressant-like activity of a Kampo (Japanese herbal) medicine, Koso-san (Xiang-Su-San) and its mode of action via the hypothalamic-pituitary-adrenal axis
      Ito N, Nagai T, Yabe T, Nunome S, Hanawa T, Yamada H - Phytomedicine ( 2006;) 13:: 658–67

    57. Antimuscle and anti-CNS circulating antibodies in chronic fatigue syndrome
      Plioplys AV - Neurology 1997; 48: 1717-1719

    58. Antioxidant status and lipoprotein peroxidation in chronic fatigue syndrome
      Manuel y Keenoy B, Moorkens G, Vertommen J, De Leeuw I - Life Sci ( 2001;) 68:: 2037–49

    59. Anxiety and depression among the epileptics in general population in Benin (Western Africa)
      Nubukpo P, Houinato D, Preux PM, Avodé G, Clément JP, Doctorat de Santé Publique, Institut d'Epidémiologie Neurologique et de Neurologie Tropicale, Equipe EA 3174, Faculté de Médecine, 2, rue du Dr Marcland, 87025 Limoges - Encephale. 2004 May-Jun;30(3):214-19
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15235518

    60. Applying cluster analysis to define a typology of chronic fatigue syndrome in a medically evaluated, random community sample
      Jason LA, Taylor RR. - Psych Health 2002; 17: 323-337
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    61. Are chronic fatigue and neurally mediated hypotension related ?
      Journal Watch Psychiatry November 1, 1995
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    62. Assessing somatization disorder in the chronic fatigue syndrome
      Johnson SK, DeLuca J, Natelson BH - Psychosom Med 1996; 58: 50-57

    63. Assessment of anxiety and depression in primary care
      Ellen SR, Norman TR, Burrows GD - Med J Aust 1997; 167: 328-333

    64. Assessment of regional cerebral perfusion by 99Tcm-HMPAO SPECT in chronic fatigue syndrome
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      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1491843

    65. Association between chronic fatigue syndrome and the corticosteroid-binding globulin gene ALA SER224 polymorphism
      Torpy DF, Bachmann AW, Gartside M et al. - Endocr Res. 2004;30 :417 –429
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15554358

    66. Association of chronic fatigue syndrome with human leucocyte antigen class II alleles
      J Smith, E L Fritz, J R Kerr, A J Cleare, S Wessely and D L Mattey - J. Clin. Pathol., August 1, 2005; 58(8): 860 – 863
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/16049290

    67. Associations between perfectionism, mood and fatigue in chronic fatigue syndrome - A pilot study
      Blenkiron PMA, Edwards R, Lynch S - J Nerv Ment Dis 1999; 187: 566-570

    68. Attention and information processing efficiency in patients with Chronic Fatigue Syndrome
      Michiels, V., de, G., V, Cluydts, R. & Fischler, B. (1999) - Journal of Clinical & Experimental Neuropsychology, 21, 709-729
      Cfr. : http://www.informaworld.com/smpp/content~db=all~content=a714014569

    69. Attention and verbal learning in patients with chronic fatigue syndrome
      Michiels V, Cluydts R, Fischler B - J Int Neuropsychol Soc 1998; 4: 456-466

    70. Attributions and self-esteem in depression and chronic fatigue syndromes
      Powell R, Dolan R, Wessely S - J Psychosom Res. 1990;34(6):665–673
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2290139

    71. Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care
      Neerinckx E, Van Houdenhove B, Lysens R et al. - J Rheumatol 2000; 27: 1051-1055

    72. Australia's mental health - An overview of the general population survey
      Henderson S, Andrews G, Hall W - Aust N Z J Psychiatry 2000; 34: 197-205

    73. Autoantibodies to a 68/48 kDa protein in chronic fatigue syndrome and primary fibromyalgia - A possible marker for hypersomnia and cognitive disorders
      Nishikai M, Tomomatsu S, Hankins RW et al. - Rheumatology (Oxford) 2001; 40: 806-810

    74. Autoantibodies to nuclear envelope antigens in chronic fatigue syndrome
      Konstantinov K, von Mikecz A, Buchwald D et al. - J Clin Invest 1996; 98: 1888-1896

    75. Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion
      Stewart JM - Pediatr Res 2000; 48: 218-226

    76. Autonomic nervous system dysfunction in adolescents with postural orthostatic tachycardia syndrome and chronic fatigue syndrome is characterized by attenuated vagal baroreflex and potentiated sympathetic vasomotion
      Stewart JM - Pediatr Res 2000; 48: 218-226.

    77. Autonomic testing in patients with chronic fatigue syndrome
      De Becker P, Dendale P, De Meirleir K et al. - Am J Med 1998; 105: 22S-26S

    78. Barriers to healthcare utilization in fatiguing illness - A population-based study in Georgia
      Lin JM, Brimmer DJ, Boneva RS, Jones JF, Reeves WC, Chronic Viral Diseases Branch, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA : dwe3@cdc.gov - BMC Health Serv Res. 2009 Jan 20;9:13 - PMID: 19154587
      Background - The purpose of this study was to determine the prevalence of barriers to healthcare utilization in persons with fatiguing illness and describe its association with socio-demographics, the number of health conditions, and frequency of healthcare utilization.
      Furthermore, we sought to identify what types of barriers interfered with healthcare utilization and why they occurred.
      Methods
      - In a cross-sectional population-based survey, 780 subjects, 112 of them with chronic fatigue syndrome (CFS), completed a healthcare utilization questionnaire.
      Text analysis was used to create the emerging themes from verbatim responses regarding barriers to healthcare utilization.
      Multiple logistic regression was performed to examine the association between barriers to healthcare utilization and other factors.
      Results
      - Forty percent of subjects reported at least one barrier to healthcare utilization. Of 112 subjects with CFS, 55% reported at least one barrier to healthcare utilization.
      Fatiguing status, reported duration of fatigue, insurance and BMI were significant risk factors for barriers to healthcare utilization.
      After adjusting for socio-demographics, medication use, the number of health problems and frequency of healthcare utilization, fatiguing status remained significantly associated with barriers to healthcare utilization.
      Subjects with CFS were nearly 4 times more likely to forego needed healthcare during the preceding year than non-fatigued subjects while those with insufficient fatigue (ISF) were nearly 3 times more likely.
      Three domains emerged from text analysis on barriers to healthcare utilization : 1) accessibility; 2) knowledge-attitudes-beliefs (KABs); and, 3) healthcare system.
      CFS and reported duration of fatigue were significantly associated with each of these domains.
      Persons with CFS reported high levels of healthcare utilization barriers for each domain : accessibility (34%), healthcare system (25%) and KABs (19%).
      In further examination of barrier domains to healthcare utilization, compared to non-fatigued persons adjusted ORs for CFS having "
      accessibility", "KAB" and "Healthcare System
      " barrier domains decreased by 40%, 30% and 19%, respectively.
      Conclusion
      - Barriers to healthcare utilization pose a significant problem in persons with fatiguing illnesses.
      Study results suggested two-fold implications: a symptom-targeted model focusing on symptoms associated with fatigue; and an interactive model requiring efforts from patients and providers to improve interactions between them by reducing barriers in accessibility, KABs and healthcare system.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/19154587?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

    79. Basal activity of the hypothalamic-pituitary-adrenal axis in patients with the chronic fatigue syndrome (neurasthenia)
      Young AH, Sharpe M, Clements A et al. - Biol Psychiatry 1998; 43: 236-237

    80. Bed rest - A potentially harmful treatment needing more careful evaluation
      Allen C, Glasziou P, Del Mar C - Lancet 1999; 354: 1229-1233

    81. Behavioural problems associated with the chronic fatigue syndrome
      Smith AP, Behan PO, Bell W, Millar K, Bakheit M - Br J Psychol. 1993 Aug;84 (:411–423
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8401992

    82. Bioaccumulated chlorinated hydrocarbons and red/white blood cell parameters
      Dunstan RH, Roberts TK, Donohoe M et al. - Biochem Mol Med 1996; 58: 77-84

    83. Biochemical evidence for a novel low molecular weight 2-5A-dependent RNase L in chronic fatigue syndrome
      Suhadolnik RJ, Peterson DL, O'Brien K et al. - J Interferon Cytokine Res 1997; 17: 377-385

    84. Blood volume and its relation to peak O(2) consumption and physical activity in patients with chronic fatigue
      Farquhar WB, Hunt BE, Taylor JA, Darling SE, Freeman R, Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA - Am J Physiol Heart Circ Physiol. 2002 Jan;282(1):H66-71 - PMID: 11748048
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11748048

    Lees verder : Deel III


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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel III

    1. Blunted adrenocorticotropin and cortisol responses to corticotropin-releasing hormone stimulation in chronic fatigue syndrome
      Scott LV, Medbak S, Dinan TG - Acta Psychiatr Scand 1998; 97: 450-457

    2. Blunted pressor and intramuscular metabolic responses to voluntary isometric exercise in multiple sclerosis
      Ng et al. - J. Appl. Physiol. 2000;88:871-880
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    3. Blunted serotonin-mediated activation of the hypothalamic-pituitary-adrenal axis in chronic fatigue syndrome
      Dinan TG, Majeed T, Lavelle E et al. - Psychoneuroendocrinology 1997; 22: 261-267

    4. Borna disease virus infection in two family clusters of patients with chronic fatigue syndrome
      Nakaya T, Takahashi H, Nakamura Y et al. - Microbiol Immunol 1999; 43: 679-689

    5. Brain MRI abnormalities exist in a subset of patients with chronic fatigue syndrome
      Lange G, DeLuca J, Maldjian JA et al. - J Neurol Sci 1999; 171: 1-2

    6. Brain positron emission tomography (PET) in chronic fatigue syndrome - Preliminary data
      Tirelli U, Chierichetti F, Tavio M et al. - Am J Med 1998; 105: 54S-58S

    7. Brain stem hypoperfusion in patients with myalgic encephalomyelitis-chronic fatigue syndrome
      Costa DC, Brostoff J, Douli V, Ell PJ - Eur J Nucl Med 1992; 19: 733

    8. Brainstem perfusion is impaired in chronic fatigue syndrome
      Costa DC, Tannock C, Brostoff J, Department of Psychiatry, UCL Medical School, London, UK - QJM. 1995 Nov;88(11):767-73 - PMID: 8542261
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8542261
      Lees ook de commentaar op dit artikel :
      Brainstem hypoperfusion in CFS
      Nixon PG - QJM. 1996 Feb;89(2):163-4 - PMID: 8729560
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8729560?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    9. Building a 'national coalition for people with depression'
      Hickie IB - Australas Psychiatry 2000; 8: 125-131

    10. Can CBT substantially change grey matter volume in chronic fatigue syndrome ?
      Inge Bramsen, Centre of Expertise Participation, Occupation and Health, Rotterdam University, Rotterdam, The Netherlands - Correspondence to : Inge Bramsen, PhD, Centre of Expertise Participation, Occupation and Health, Rotterdam University, Rotterdam, Museumpark 40, 3015 CX Rotterdam, The Netherlands : i.bramsen@hro.nl - Brain 2009 132(6):e110; doi:10.1093/brain/awn207
      Cfr. :
      -
      http://brain.oxfordjournals.org/cgi/content/extract/132/6/e110
      - http://brain.oxfordjournals.org/cgi/content/full/132/6/e110
      Also read the reply to this article :
      Can CBT substantially change grey matter volume in chronic fatigue syndrome ? - Reply
      F. P. de Lange, A. Koers, J. S. Kalkman, G. Bleijenberg, P. Hagoort, J. W. M. van der Meer, and I. Toni - Brain, June 1, 2009; 132(6): e111 – e111
      Cfr. :
      -
      http://brain.oxfordjournals.org/cgi/content/full/132/6/e111
      - http://brain.oxfordjournals.org/cgi/content/extract/132/6/e111?ck=nck

    11. Can sustained arousal explain the Chronic Fatigue Syndrome ?
      Wyller VB, Eriksen HR, Malterud K, Division of Paediatrics, Rikshospitalet University Hospital, Oslo, Norway : brwylle@online.no - Behav Brain Funct. 2009 Feb 23;5:10 - PMID: 19236717
      We present an integrative model of disease mechanisms in the Chronic Fatigue Syndrome (CFS), unifying empirical findings from different research traditions.
      Based upon the Cognitive activation theory of stress (CATS), we argue that new data on cardiovascular and thermoregulatory regulation indicate a state of permanent arousal responses - sustained arousal - in this condition.
      We suggest that sustained arousal can originate from different precipitating factors (infections, psychosocial challenges) interacting with predisposing factors (genetic traits, personality) and learned expectancies (classical and operant conditioning).
      Furthermore, sustained arousal may explain documented alterations by establishing vicious circles within immunology (Th2 (humoral) vs Th1 (cellular) predominance), endocrinology (attenuated HPA axis), skeletal muscle function (attenuated cortical activation, increased oxidative stress) and cognition (impaired memory and information processing).
      Finally, we propose a causal link between sustained arousal and the experience of fatigue.
      The model of sustained arousal embraces all main findings concerning CFS disease mechanisms within one theoretical framework.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/19236717?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_PMC&linkpos=2&log$=citedinpmcarticles&logdbfrom=pub
      med

    12. Can the chronic fatigue syndrome be defined by distinct clinical features ?
      Hickie I, Lloyd A, Hadzi-Pavlovic D et al. - Psychol Med 1995; 25: 925-935

    13. Cardiac involvement in patients with chronic fatigue syndrome as documented with holter and biopsy data in Birmingham, Michigan, 1991-1993
      Lerner AM, Goldstein J, Chang C et al. - Infect Dis Clin Pract 1997; 6: 327-333

    14. Cardiac rehabilitation and secondary prevention
      Hare DL, Bunker SJ - Med J Aust 1999; 171: 433-439

    15. Cardiac sympathetic dysautonomia in chronic orthostatic intolerance syndromes
      Goldstein et al. - Circulation 2002;106:2358-2365
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    16. Cardiovascular responses of women with chronic fatigue syndrome to stressful cognitive testing before and after strenuous exercise
      LaManca JJ, Peckerman A, Sisto SA et al. - Psychosom Med 2001; 63: 756-764
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/63/5/756

    17. Cardiovascular stress responses and their relation to symptoms in Gulf War veterans with fatiguing illness
      Peckerman et al. - Psychosom. Med. 2000;62:509-516
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/62/4/509

    18. Case control study of chronic fatigue in pediatric patients
      Carter BD, Edwards JF, Kronenberger WG et al. - Pediatrics 1995; 95: 179-186

    19. Case-control study of GP attendance rates by suicide cases with or without a psychiatric history
      Power K, Davies C, Swanson V et al. - Br J Gen Pract 1997; 47: 211-215

    20. CD4 T lymphocytes from patients with chronic fatigue syndrome have decreased interferon-gamma production and increased sensitivity to dexamethasone
      Visser J, Blauw B, Hinloopen B et al. - J Infect Dis 1998; 177: 451-454

    21. Cerebrospinal fluid biogenic amine metabolites, plasma-rich platelet serotonin and [3H]imipramine reuptake in the primary fibromyalgia syndrome
      Legangneux E, Mora JJ, Spreux-Varoquaux O et al. - Rheumatology (Oxford). 2001;40 :290 –296
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    22. Change in grey matter volume cannot be assumed to be due to cognitive behavioural therapy
      Tom Kindlon, Irish ME/CFS Association, PO Box 3075 Dublin 2, Ireland : tomkindlon@oceanfree.net -&- tkindlon@maths.tcd.ie - Brain Advance Access published online on January 29, 2009
      Cfr. : http://brain.oxfordjournals.org/cgi/content/extract/awn358v1

    23. Change in grey matter volume cannot be assumed to be due to cognitive behavioural therapy – Reply
      F. P. de Lange, G. Bleijenberg, J. W. M. van der Meer, P. Hagoort and I. Toni - Brain, July 1, 2009; 132(7): e120 – e120
      Cfr. : http://brain.oxfordjournals.org/cgi/content/full/132/7/e120

    24. Changes in Australia's Mental Health Services under the First National Mental Health Plan of the National Mental Health Strategy 1993–98 - Sixth Annual Report of the Commonwealth Department of Health and Aged Care
      Commonwealth Department of Health and Aged Care - National Mental Health Report 2000 – Canberra : Mental Health and Special Programs Branch, Department of Health and Ageing, 2000

    25. Changes in growth hormone, insulin, insulinlike growth factors (IGFs) and IGF-binding protein-1 in chronic fatigue syndrome
      Allain TJ, Bearn JA, Coskeran P et al. - Biol Psychiatry 1997; 41: 567-573

    26. Changes in immune parameters seen in Gulf War veterans but not in civilians with chronic fatigue syndrome
      Zhang Q, Zhou XD, Denny T et al. - Clin Diagn Lab Immunol 1999; 6: 6-13

    27. Changing epidemiology of Ross River virus disease in South Australia
      Selden SM, Cameron AS - Med J Aust 1996; 165: 313-317

    28. Characteristics of fatigued persons associated with features of chronic fatigue syndrome
      Hartz AJ, Kuhn E M, Levine PH et al. - J Chron Fatigue Synd 1998; 4(3): 71-97
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    29. Children's somatization inventory - Psychometric properties of the Revised Form (CSI-24)
      Lynn S. Walker, PhD1, Joy E. Beck, PhD1,2, Judy Garber, PhD3 and Warren Lambert, PhD4 - 1Department of Pediatrics, Vanderbilt University School of Medicine - 2Department of Psychology, Vanderbilt University - 3Department of Psychology and Human Development, Vanderbilt University and - 4Vanderbilt Kennedy Center for Evaluation & Program Improvement - All correspondence concerning this article should be addressed to Lynn S. Walker, Division of Adolescent Medicine and Behavioral Science, Department of Pediatrics, Vanderbilt University School of Medicine, 11128 Doctors’ Office Tower, Nashville, TN 37232-3571 – E-mail : lynn.walker@vanderbilt.edu - Journal of Pediatric Psychology 2009 34(4):430-440 - © The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology
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    30. Chronic ciguatera - One cause of the chronic fatigue syndrome
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    31. Chronic disease self-management program - 2-Year health status and health care utilization outcomes
      Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW Jr, Bandura A, Gonzalez VM, Laurent DD, Holman HR, Stanford University School of Medicine, Stanford, California, USA - Med Care. 2001 Nov;39(11):1217-23 - PMID: 11606875
      Objectives
      - To assess the 1- and 2-year health status, health care utilization and self-efficacy outcomes for the Chronic Disease Self-Management Program (CDSMP).
      The major hypothesis is that during the 2-year period CDSMP participants will experience improvements or less deterioration than expected in health status and reductions in health care utilization.
      Design
      - Longitudinal design as follow-up to a randomized trial.
      Setting
      : Community.
      Participants
      - Eight hundred thirty-one participants 40 years and older with heart disease, lung disease, stroke or arthritis participated in the CDSMP.
      At 1- and 2-year intervals respectively 82% and 76% of eligible participants completed data.
      Main autcome measures
      - Health status (self-rated health, disability, social/role activities limitations, energy/fatigue and health distress), health care utilization (ER/outpatient visits, times hospitalized and days in hospital) and perceived self-efficacy were measured.
      Main results
      - Compared with baseline for each of the 2 years, ER/outpatient visits and health distress were reduced (P <0.05).
      Self-efficacy improved (P <0.05).
      The rate of increase is that which is expected in 1 year.
      There were no other significant changes.
      Conclusions
      - A low-cost program for promoting health self-management can improve elements of health status while reducing health care costs in populations with diverse chronic diseases.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11606875

    32. Chronic fatigue - Symptom and syndrome
      Wessely S - Ann Intern Med 2001; 134 Suppl: 838-843

    33. Chronic fatigue and chronic fatigue syndrome - Shifting boundaries and attributions [review]
      Lloyd AR - Am J Med 1998; 105: 7S-10S

    34. Chronic fatigue and its syndromes
      Wessely S, Hotopf M, Sharpe M - New York : Oxford University Press, 1998

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    36. Chronic fatigue following infection by Coxiella burnetii (Q fever) - Ten-year follow-up of the 1989 UK outbreak cohort
      Wildman MJ, Smith EG, Groves J, Beattie JM, Caul EO, Ayres JG, Department of Respiratory Medicine, Birmingham Heartlands Hospital, UK - QJM. 2002 Aug;95(8):527-38 - PMID: 12145392
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12145392
      Also read the comment on this article :
      Q fever - Still a mysterious disease
      Raoult D - QJM. 2002 Aug;95(8):491-2 - PMID: 12145387
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      http://www.ncbi.nlm.nih.gov/pubmed/12145387?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
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    37. Chronic fatigue report delayed as row breaks out over content
      Eaton L - BMJ 2002; 324: 7
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11777786?dopt=Abstract

    38. Chronic Fatigue Syndrome
      Natelson - JAMA 2001;285:2557-2559
      Cfr. : http://jama.ama-assn.org/cgi/content/extract/285/20/2557?hits=10&RESULTFORMAT=&FIRSTINDEX=0&maxtoshow=&HITS=10&fulltext=Chro
      nic+Fatigue%3A+Syndrome+or+Disease%3F+&searchid=1&resourcetype=HWCIT

    39. Chronic Fatigue Syndrome
      Riccardo Baschetti, Alexander C. Chester, Neal F. Devitt, and Anthony L. Komaroff - JAMA. 1998;279(6):431-433
      Cfr. : http://jama.ama-assn.org/cgi/content/extract/279/6/431

    40. Chronic fatigue syndrome - A 20th century illness ?
      Wessely S - Scand J Work Environ Health 1997; 23: 17-34

    41. Chronic Fatigue Syndrome - A Biological Approach
      Patrick Englebienne & Kenny De Meirleir – CRC, February 27, 2002 (1 edition) – ISBN-10 : 0849310466 – ISBN-13 : 978-0849310461
      Chronic Fatigue Syndrome (CFS) is a complex, debilitating disorder, yet few current scientific biomedical books are available on the subject.
      The nonspecific symptoms, lack of diagnostic tests and uncertainty as to the cause or causes of CFS make the disease that much more baffling.
      '
      Chronic Fatigue Syndrome - A Biological Approach' represents a monumental step in the journey to a unified understanding of CFS and establishes a scientific basis for treatment.
      The book provides a rare treatise on current state of the art with respect to the worldwide scientifically documented basis of CFS and acknowledges the many as yet undiscovered or undefined pathogenic mechanisms involved in the production of symptoms.
      The authors, reflecting their clinical and basic research backgrounds, outline future research imperatives and direct clinicians toward appropriate diagnostic and therapeutic strategies.
      Because of the multifactorial aspects of the disease, the book addresses various fields of the biomedical sciences, such as protein biochemistry, virology and pharmacology.
      Many recent, biological discoveries help us better understand the physiology of this disease and improve the specificity of its diagnosis by laboratory tests.
      This book summarizes these advances and discusses insights that support CFS as a distinct and specific physical disease.
      Overall, '
      Chronic Fatigue Syndrome - A Biological Approach
      ' provides a firm foundation understanding of CFS, opening the way for better diagnosis and design of new therapies
      Cfr. :
      http://www.amazon.com/Chronic-Fatigue-Syndrome-Biological-Approach/dp/0849310466

    42. Chronic fatigue syndrome - A clinical and laboratory study with a well matched control group
      Swanink CM, Vercoulen JH, Bleijenberg G et al. - J Intern Med 1995; 237: 499-506

    43. Chronic fatigue syndrome - A disorder of central cholinergic transmission
      Chaudhuri A, Majeed T, Dinan T, Behan PO - J Chronic Fatigue Syndr 1997; 3: 3-16

    44. Chronic fatigue syndrome - A new challenge for health care professionals
      Jason LA, Wagner L, Taylor R et al. - J Com Psych 1995; 23: 143-164
      Cfr. : http://www3.interscience.wiley.com/journal/112408431/abstract?CRETRY=1&SRETRY=0

    45. Chronic fatigue syndrome - A review
      N. Afari and D. Buchwald - Am J Psychiatry, February 1, 2003; 160(2): 221 – 236
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12562565
      Also read the comments on this article :
      -
      On chronic fatigue syndrome
      Bobo WV, Hall WC - Am J Psychiatry. 2004 Jun;161(6):1132-3; author reply 1133-4 - PMID: 15169716
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15169716?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      On chronic fatigue syndrome
      Berger J - Am J Psychiatry. 2004 Jun;161(6):1133; author reply 1133-4 - PMID: 15169718
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15169718?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    46. Chronic fatigue syndrome - A working case definition
      Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, Jones JF, Dubois RE, Cunningham-Rundles C, Pahwa S et al., Division of Viral Diseases, Centers for Disease Control, Atlanta, Georgia - Ann Intern Med. 1988 Mar;108(3):387-9 - PMID: 2829679
      The chronic Epstein-Barr virus syndrome is a poorly defined symptom complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including sore throat, lymph node pain and tenderness, headache, myalgia and arthralgias.
      Although the syndrome has received recent attention and has been diagnosed in many patients, the chronic Epstein-Barr virus syndrome has not been defined consistently.
      Despite the name of the syndrome, both the diagnostic value of Epstein-Barr virus serologic tests and the proposed causal relationship between Epstein-Barr virus infection and patients who have been diagnosed with the chronic Epstein-Barr virus syndrome remain doubtful.
      We propose a new name for the chronic Epstein-Barr virus syndrome--the chronic fatigue syndrome--that more accurately describes this symptom complex as a syndrome of unknown cause characterized primarily by chronic fatigue.
      We also present a working definition for the chronic fatigue syndrome designed to improve the comparability and reproducibility of clinical research and epidemiologic studies and to provide a rational basis for evaluating patients who have chronic fatigue of undetermined cause.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/2829679

    47. Chronic fatigue syndrome - Aetiology, diagnosis and treatment
      Avellaneda Fernández A, Pérez Martín A, Izquierdo Martínez M, Arruti Bustillo M, Barbado Hernández FJ, de la Cruz Labrado J, Díaz-Delgado Peñas R, Gutiérrez Rivas E, Palacín Delgado C, Rivera Redondo J, Ramón Giménez JR, Carlos III Health Institute, Sinesio Delgado, n degrees 6, 28029, Madrid, Spanish Society of Primary Care Physicians, Narváez, 15 1 degrees Izda, 28009, Madrid, Spain : alfavel@gmail.com - BMC Psychiatry. 2009 Oct 23;9 Suppl 1:S1 - PMID: 19857242
      Chronic fatigue syndrome is characterised by intense fatigue, with duration of over six months and associated to other related symptoms.
      The latter include asthenia and easily induced tiredness that is not recovered after a night's sleep.
      The fatigue becomes so severe that it forces a 50% reduction in daily activities.
      Given its unknown aetiology, different hypotheses have been considered to explain the origin of the condition (from immunological disorders to the presence of post-traumatic oxidative stress), although there are no conclusive diagnostic tests.
      Diagnosis is established through the exclusion of other diseases causing fatigue.
      This syndrome is rare in childhood and adolescence, although the fatigue symptom per se is quite common in paediatric patients.
      Currently, no curative treatment exists for patients with chronic fatigue syndrome.
      The therapeutic approach to this syndrome requires a combination of different therapeutic modalities.
      The specific characteristics of the symptomatology of patients with chronic fatigue require a rapid adaptation of the educational, healthcare and social systems to prevent the problems derived from current systems.
      Such patients require multidisciplinary management due to the multiple and different issues affecting them.
      This document was realized by one of the Interdisciplinary Work Groups from the Institute for Rare Diseases and its aim is to point out the main social and care needs for people affected with Chronic Fatigue Syndrome.
      For this, it includes not only the view of representatives for different scientific societies, but also the patient associations view, because they know the true history of their social and sanitary needs.
      In an interdisciplinary approach, this work also reviews the principal scientific, medical, socio-sanitary and psychological aspects of Chronic Fatigue Syndrome.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/19857242?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_PMC&linkpos=1&log$=citedinpmcreviews&logdbfrom=pub
      med

    48. Chronic fatigue syndrome - An immunological perspective
      Vollmer-Conna U, Lloyd A, Hickie I et al. - Aust N Z J Psychiatry 1998; 32: 523-527

    49. Chronic fatigue syndrome - An update
      Komaroff AL, Buchwald DS - Ann Rev Med 1998; 49: 1-13

    50. Chronic fatigue syndrome - Chronic ciguatera poisoning as a differential diagnosis
      Pearn JH - Med J Aust 1997; 166: 309-310

    51. Chronic fatigue syndrome - Clinical practice guidelines – 2002
      Produced by the Royal Australasian College of Physicians Working Group - Med J Aust 2002; 176 (9 Suppl): S17-S55
      Cfr. : http://www.mja.com.au/public/guides/cfs/cfs2.html -&- http://www.mja.com.au/public/issues/177_09_041102/hickie_041102.html

    52. Chronic fatigue syndrome - Clinical practice guidelines – Psychological factors
      - Chronic fatigue syndrome - Clinical practice guidelines – Psychological factors (letters)

      Ian B Hickie - Med J Aust 2002; 177 (9): 526
      To the editor - The process of destigmatising chronic fatigue syndrome (CFS) is not advanced by either limiting enquiry to "acceptable" sciences or increasing the stigma already experienced by people with other neuropsychiatric disorders.
      Contrary to its intent and in contrast to the recently published Royal Australasian College of Physicians (RACP) guidelines (cfr. '
      Chronic fatigue syndrome - Clinical practice guidelines – 2002' - Med J Aust 2002; 176 Suppl May 6: S17-S56 at : http://www.mja.com.au/public/guides/cfs/cfs2.html -) the recent statement by the immediate past president of the RACP and the Chairman of the ME/Chronic Fatigue Syndrome Association of Australia (cfr. 'Chronic fatigue syndrome clinical practice guidelines [letter]' - Larkins RG, Molesworth SR - Med J Aust 2002; 177: 51-52 at : http://www.mja.com.au/public/issues/177_01_010702/larkins_010702.html -) is in danger of increasing the stigma for both people with CFS and people with other common mental disorders.
      Unfortunately, key propositions in their letter ("There is no evidence that the illness is primarily psychological in origin") are clearly at variance with the tone of the guidelines (see Box 1.5, p.S31; Box 1.7, p.S32; and, "Management" summary, p.S38).
      Their letter reinforces the classical "dualistic" and rather simplistic "biological" approach (eg, "There is significant evidence of a range of biological abnormalities occurring in people with CFS").
      Unwittingly, it colludes with community-based beliefs that mental health problems are "not health" (cfr. '
      Monitoring awareness of and attitudes to depression in Australia' - Highet NJ, Hickie IB, Davenport TA - Med J Aust 2002; 176 Suppl May 20: S63-S68 at : http://www.mja.com.au/public/issues/176_10_200502/hig10079_fm.html -) and often imaginary or under the voluntary control of the patient (cfr. 'Exploring the perspectives of people whose lives have been affected by depression' - McNair BG, Highet NJ, Hickie IB, Davenport TA - Med J Aust 2002; 176 Suppl May 20: S69-S76 at : http://www.mja.com.au/public/issues/176_10_200502/mcn10080_fm.html -).
      There is no doubt that people with CFS share many experiences with people with other neuropsychiatric disorders.
      They both have daily experiences where their credibility is challenged, their disability is minimised and their needs for appropriate medical management are not met.
      Australian research and best practice have been recognised internationally for emphasising the integration of psychological, psychiatric and biological factors and respect for the experiences of persons with these debilitating disorders (cfr. '
      Illness or disease ? The case of chronic fatigue syndrome' - Lloyd AR, Hickie IB, Loblay RH - Med J Aust 2000; 172: 471-472 at : http://www.mja.com.au/public/issues/172_10_150500/lloyd/lloyd.html -).
      Unfortunately, the major advances captured in the guidelines may now be undermined if the RACP is perceived to be backing away from supporting appropriate psychological assessment and provision of effective "psychological" treatments (such as cognitive–behavioural therapy and physical rehabilitation approaches).
      Similar equivocation has left clinical guideline processes in the United Kingdom in disarray (cfr. '
      Chronic fatigue report delayed as row breaks out over content' - Eaton L - BMJ 2002; 324: 7 at : http://www.ncbi.nlm.nih.gov/pubmed/11777786?dopt=Abstract -).
      As demonstrated recently, prolonged fatigue syndromes are common in the Australian community and the vast majority of those who seek healthcare services have concurrent depression or anxiety (cfr. '
      Neurasthenia revisited' - Hickie I, Davenport T, Issakidis C, Andrews G - Br J Psychiatry 2002; 181: 56-61 at : http://www.ncbi.nlm.nih.gov/pubmed/12091264?dopt=Abstract -).
      Real progress towards destigmatisation, meaningful research progress and improved health services for people with CFS will only occur when the field is mature enough to deal with the clear relevance of psychological factors.
      Instead of rejecting "psychological factors" and associated treatments, relevant professional and consumer bodies should now join with the broader community movement towards increased community awareness of common neuropsychiatric disorders, genuine understanding of their (genetic, "biological", psychosocial and personal) causes and provision of effective (pharmacological and psychological) treatments (cfr. '
      Responding to the Australian experience of depression - Promotion of the direct voice of consumers is critical for reducing stigma' - Hickie IB - Med J Aust 2002; 176 Suppl May 20: S61-S62 at : http://www.ncbi.nlm.nih.gov/pubmed/12064999?dopt=Abstract.8
      Cfr. :
      http://www.mja.com.au/public/issues/177_09_041102/hickie_041102.html
      - Chronic fatigue syndrome - Clinical practice guidelines – Psychological factors (letters)
      James D Hundertmark - Med J Aust 2002; 177 (9): 525-527
      Cfr. :
      http://www.mja.com.au/public/issues/177_09_041102/hundertmark_041102.html
      -
      Chronic fatigue syndrome - Clinical practice guidelines – Psychological factors
      Donald D Beard - Med J Aust 2002; 177 (9): 526
      Cfr. :
      http://www.mja.com.au/public/issues/177_09_041102/beard_041102.html
      -
      Chronic fatigue syndrome - Clinical practice guidelines – Psychological factors (in reply)
      Richard G Larkins & Simon R Molesworth - Med J Aust 2002; 177 (9): 526-527
      Cfr. :
      http://www.mja.com.au/public/issues/177_09_041102/larkins_041102.html -&- http://www.mja.com.au/public/issues/177_01_010702/larkins_010702.html

    53. Chronic fatigue syndrome - Current perspectives on evaluation and management
      Hickie IB, Lloyd AR, Wakefield D - Med J Aust 1995; 163: 314-318

    54. Chronic fatigue syndrome - Is total body potassium important ?
      Burnet RB, Yeap BB, Chatterton BE, Gaffney RD - Med J Aust 1996; 164: 384

    55. Chronic fatigue syndrome - Oxidative stress and dietary modifications
      Logan AC, Wong C - Altern Med Rev ( 2001;) 6:: 450–9

    56. Chronic fatigue syndrome - Personality and attributional style of patients in comparison to healthy controls and depressed individuals
      Chubb, H.L., Sadler, S., Cole, T., Redman, K. & Farmer, A. (1999) - Journal of Mental Health (Uk), 8
      Cfr. : http://www.ingentaconnect.com/content/apl/cjmh/1999/00000008/00000004/art00004 -&- http://cat.inist.fr/?aModele=afficheN&cpsidt=1926206

    57. Chronic fatigue syndrome - Sufferers' evaluation of medical support
      Ax S, Gregg VH, Jones D - J R Soc Med 1997; 90: 250-254

    58. Chronic fatigue syndrome - The fundamentals still apply
      Manu P - Am J Med 2000; 108: 172-173

    59. Chronic fatigue syndrome - What's in a name ?
      Loblay RH - Med J Aust 1995; 163: 285-286

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel IV

    1. Chronic fatigue syndrome – The need for subtypes
      Jason LA, Corradi K, Torres-Harding S, Taylor RR, King C - DePaul University, Chicago, Illinois 60614, USA : ljason@depaul.edu - Neuropsychol Rev. 2005 Mar;15(1):29-58 - PMID: 15929497
      Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians and researchers.
      This article provides information concerning the need for appropriate diagnosis of CFS subtypes.
      We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress.
      Next, research involving the case definitions of CFS is reviewed.
      Findings suggest that whether a broad or more conservative case definition is employed and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected.
      Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS' characteristically confusing heterogeneous symptom profiles.
      Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS.
      This review suggests that there is a need for greater diagnostic clarity and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/15929497

    2. Chronic Fatigue Syndrome ??
      Perry et al. - Pediatrics 1999;104:130-131
      Cfr. : http://pediatrics.aappublications.org/cgi/content/extract/104/1/130

    3. Chronic fatigue syndrome and depression - Cause, effect or covariate
      Abbey SE, Garfinkel PE, Department of Psychiatry, Toronto Hospital, Ontario, Canada - Rev Infect Dis. 1991 Jan-Feb;13 Suppl 1:S73-83
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2020805

    4. Chronic fatigue syndrome and high allostatic load
      Maloney EM, Gurbaxani BM, Jones JF, de Souza Coelho L, Pennachin C, Goertzel BN - Pharmacogenomics. 2006;7 :467 –473
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/16610956

    5. Chronic fatigue syndrome and neurally mediated hypotension
      Baschetti - JAMA 1996;275:359-359
      Cfr. : http://jama.ama-assn.org/cgi/content/summary/275/5/359-a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Chronic+fatigue+syndro
      me+and+neurally+mediated+hypotension&searchid=1&FIRSTINDEX=0&resourcetype=
      H
      WCIT

    6. Chronic fatigue syndrome and other fatiguing illnesses in adolescents - A population-based study
      Jones JF, Nisenbaum R, Solomon L, Reyes M, Reeves WC, National Jewish Medical and Research Center, Denver, Colorado, USA - J Adolesc Health. 2004 Jul;35(1):34-40 - PMID: 15193572
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15193572

    7. Chronic fatigue syndrome as a delayed reaction to chronic low-dose organophosphate exposure
      Behan PO - J Nutr Med 1996; 6: 341-350

    8. Chronic fatigue syndrome comes of age
      Levine PH - Am J Med 1998; 105(3A): 2S-6S

    9. Chronic fatigue syndrome criteria - A critique of the requirement for multiple physical complaints
      Katon W, Russo J - Arch Intern Med. 1992 Aug;152(8):1604–1609
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1497394
      Also read the comment on this article :
      Defining the chronic fatigue syndrome
      Straus SE - Arch Intern Med. 1992 Aug;152(8):1569-70 - PMID: 1323245
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1323245?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    10. Chronic fatigue syndrome in children - A cross sectional survey
      Patel, M.X., Smith, D.G., Chalder, T. & Wessely,S. (2003) - Arch.Dis.Child, 88, 894-898
      Cfr. : http://adc.bmj.com/cgi/content/abstract/88/10/894

    11. Chronic fatigue syndrome in psychiatric patients - Lifetime and premorbid personal history of physical health
      Endicott NA - Psychosom Med 1998; 60: 744-751

    12. Chronic fatigue syndrome is an acquired neurological channelopathy
      Chaudhuri A, Behan PO - Hum Psychopharmacol Clin Exp 1999; 14: 7-17

    13. Chronic fatigue syndrome is not associated with expression of endogenous retroviral p15E
      Gelman IH, Unger ER, Mawle AC et al. - Mol Diagn 2000; 5: 155-1556
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11066017

    14. Chronic fatigue syndrome progression and self-defined recovery - Evidence from the CDC surveillance system
      Reyes M, Dobbins JG, Nisenbaum R et al. - J Chronic Fatigue Syndr 1999; 5: 7-17

    15. Chronic fatigue syndrome research - Definition and medical outcome assessment (NIH conference)
      Schluederberg A, Straus SE, Peterson P, Blumenthal S, Komaroff AL, Spring SB, Landay A, Buchwald D, National Institute of Allergy and Infectious Diseases, Bethesda, MD - Ann Intern Med. 1992 Aug 15;117(4):325-31 - PMID: 1322076
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1322076

    16. Chronic fatigue syndrome should not be diagnosed in children
      Plioplys - Pediatrics 1997;100:270-271
      Cfr. : http://pediatrics.aappublications.org/cgi/content/extract/100/2/270

    17. Chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms
      Jason LA, Taylor RR, Kennedy CL - Psychosom Med 2000; 62: 655-663

    18. Chronic fatigue syndrome - Circadian rhythm and hypothalamic-pituitary-adrenal axis impairment
      Racciatti D, Guagnano MT, Vecchiet J, De Remigis PL, Pizzigallo E, Della Vecchia R et al. - Int J Immunopathol Pharmacol ( 2001;) 14:: 11–5

    19. Chronic fatigue syndrome - Identification of distinct subgroups on the basis of allergy and psychologic variables
      Borish L, Schmaling K, DiClementi JD et al. - J Allergy Clin Immunol 1998; 102: 222-230

    20. Chronic Fatigue Syndromes - The Limbic Hypothesis
      Goldstein,J. (1993) - Howarth Medical Press - Routledge, June 10, 1993 - ISBN-10: 1560249048 - ISBN-13: 978-1560249047
      Cfr. :
      http://www.amazon.com/Chronic-Fatigue-Syndromes-Hypothesis-Neurobiology/dp/1560249048
      -&- http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T9T-4950SVV-B&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_search
      StrId=1024576495&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion
      =0&
      _userid=10&md5=6a4920f88d03e0852173fc38e3f55dbe

    21. Chronic fatigue syndromes in clinical practice
      Manu P, Lane TJ, Matthews DA, Department of Medicine, School of Medicine, University of Connecticut Health Center, Farmington - Psychother Psychosom. 1992;58(2):60-8
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1484921

    22. Chronic fatigue, chronic fatigue syndrome and fibromyalgia - Disability and health-care use
      Bombardier CH, Buchwald D - Med Care 1996; 34: 924-930

    23. Chronic fatigue, fibromyalgia and chemical sensitivity - Overlapping disorders
      Ziem G, Donnay A - Arch Intern Med 1995; 155: 1913

    24. Chronic multisymptom illness affecting Air Force veterans of the Gulf War
      Keiji Fukuda, MD, MPH; Rosane Nisenbaum, PhD; Geraldine Stewart, MA; William W. Thompson, PhD; Laura Robin, DO, MPH; Rita M. Washko, MD; Donald L. Noah, DVM, MPH; Drue H. Barrett, PhD, MS; Bonnie Randall, MCP; Barbara L. Herwaldt, MD, MPH; Alison C. Mawle, PhD; William C. Reeves, MD, MSPH – JAMA. 1998;280:981-988
      Cfr. : http://jama.ama-assn.org/cgi/content/full/280/11/981

    25. Chronic multisymptom illness complex in Gulf War I veterans 10 years later
      M. S. Blanchard, S. A. Eisen, R. Alpern, J. Karlinsky, R. Toomey, D. J. Reda, F. M. Murphy, L. W. Jackson and H. K. Kang - Am. J. Epidemiol., January 1, 2006; 163(1): 66 - 75
      Cfr. : http://aje.oxfordjournals.org/cgi/content/abstract/163/1/66
      Read also thje replu to this article :
      Chronic multisymptom illness complex in Gulf War I Veterans 10 years later – Reply
      S. C. Hunt, M. Jakupcak, M. McFall, M. Orsborn, B. Felker, S. Larson and M. Klevens - Am. J. Epidemiol., October 1, 2006; 164(7): 708 - 709
      Cfr. : http://aje.oxfordjournals.org/cgi/content/full/164/7/708-a

    26. Chronic orthostatic intolerance - Part of a spectrum of dysfunction in orthostatic cardiovascular homeostasis ?
      Narkiewicz and Somers - Circulation 1998;98:2105-2107
      Cfr. : http://circ.ahajournals.org/cgi/content/full/98/20/2105

    27. Clinical and biochemical characteristics differentiating Chronic Fatigue Syndrome from Major Depression and healthy control populations - Relation to dysfunction of RNase L pathway
      Suhadolnik, R.J., Peterson, D.L., Reichenbach, N.L., Roen, G., Metzher, M., McCahan, J., O'Brien, K., Welsch, S., Gabriel, J., Gaughan, J.P. & McGregor, N.R. (2004) - Journal of Chronic Fatigue Syndrome, 12, 5-35
      Cfr. : http://www.informaworld.com/smpp/content~db=all~content=a902836197

    28. Clinical and neurocognitive features of the post Lyme syndrome
      Bujak DI, Weinstein A, Dornbush RL - J Rheumatol 1996; 23: 1392-1397

    29. Clinical improvement in chronic fatigue syndrome is not associated with lymphocyte subsets of function or activation
      Peakman M, Deale A, Field R et al. - Clin Immunol Immunopathol 1997; 82: 83-91

    30. Clinical laboratory test findings in patients with chronic fatigue syndrome
      D. W. Bates, D. Buchwald, J. Lee, P. Kith, T. Doolittle, C. Rutherford, W. H. Churchill, P. H. Schur, M. Wener, D. Wybenga et al. - Arch Intern Med, January 9, 1995; 155(1): 97 – 103
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/7632202
      Also read the comment on this article :
      Clinical laboratory test findings in patients with chronic fatigue syndrome
      Golden HE - Arch Intern Med. 1995 Jun 26;155(12):1332 - PMID: 7778967

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/7778967?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    31. Clinical observation of the treatment of chronic fatigue syndrome by using Bu-Zhong-Yi-Qi decoction in combination with Xiao-Chai-Hu decoction
      Yang SH, Gao M, Yang XW, Chen DQ - J Beijing Univ TCM ( 2004;) 2:: 87–9

    32. Clinical, epidemiologic and virologic studies in four clusters of the chronic fatigue syndrome
      P. H. Levine, S. Jacobson, A. G. Pocinki, P. Cheney, D. Peterson, R. R. Connelly, R. Weil, S. M. Robinson, D. V. Ablashi, S. Z. Salahuddin et al. - Arch Intern Med, August 1,1992; 152(8): 1611 – 1616
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1323246
      Also read the comment on this article
      Human herpesvirus type 6 and chronic fatigue syndrome
      Levine PH, Komaroff AL - Arch Intern Med. 1993 Mar 8;153(5):661 - PMID: 8382470
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8382470?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    33. Cognitive and mood-state changes in patients with chronic fatigue syndrome
      Grafman J, Johnson R, Jr, Scheffers M - Rev Infect Dis. 1991 Jan–Feb;13 Suppl 1:S45–S52
      Cfr. :
      http://www.biomedexperts.com/Abstract.bme/1850543/Cognitive_and_mood-state_changes_in_patients_with_chronic_fatigue_syndrome

    34. Cognitive behavior therapy for chronic fatigue syndrome - A randomized controlled trial
      Deale A, Chalder T, Marks I, Wessely S, Academic Department of Psychological Medicine, King's College Hospital, London, United Kingdom - Am J Psychiatry. 1997 Mar;154(3):408-14 - PMID: 9054791
      Objective - Cognitive behavior therapy for chronic fatigue syndrome was compared with relaxation in a randomized controlled trial.
      Methods
      - Sixty patients with chronic fatigue syndrome were randomly assigned to 13 sessions of either cognitive behavior therapy (graded activity and cognitive restructuring) or relaxation.
      Outcome was evaluated by using measures of functional impairment, fatigue, mood and global improvement.
      Results
      - Treatment was completed by 53 patients.
      Functional impairment and fatigue improved more in the group that received cognitive behavior therapy.
      At final follow-up, 70% of the completers in the cognitive behavior therapy group achieved good outcomes (substantial improvement in physical functioning) compared with 19% of those in the relaxation group who completed treatment.
      Conclusions
      - Cognitive behavior therapy was more effective than a relaxation control in the management of patients with chronic fatigue syndrome.
      Improvements were sustained over 6 months of follow-up.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/9054791
      Also read the comment on this article :
      Cognitive behavior therapy for chronic fatigue syndrome
      Sharpe M - Am J Psychiatry. 1998 Oct;155(10):1461-2 - PMID: 9766788
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9766788?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    35. Cognitive behavior therapy for chronic fatigue syndrome - Efficacy and implications
      Sharpe M - Am J Med 1998; 105: 104S-109S

    36. Cognitive behaviour therapy for adolescents with chronic fatigue syndrome - Randomised controlled trial
      Stulemeijer M, de Jong LW, Fiselier TJ, Hoogveld SW, Bleijenberg G, Expert Centre Chronic Fatigue, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Netherlands - BMJ. 2005 Jan 1;330(7481):14. Epub 2004 Dec 7 - PMID: 15585538 (Erratum in : BMJ. 2005 Apr 9;330(7495):820)

      Objective - To evaluate the efficacy of cognitive behaviour therapy for adolescents aged 10-17 years with chronic fatigue syndrome.
      Design
      - Randomised controlled trial.
      Setting
      - Department of child psychology.
      Participants
      - 71 consecutively referred patients with chronic fatigue syndrome; 36 were randomly assigned to immediate cognitive behaviour therapy and 35 to the waiting list for therapy.
      Intervention
      - 10 sessions of therapy over five months.
      Treatment protocols depended on the type of activity pattern (relatively active or passive).
      All participants were assessed again after five months.
      Main outcome measures
      - Fatigue severity (checklist individual strength), functional impairment (SF-36 physical functioning) and school attendance.
      Results
      - 62 patients had complete data at five months (29 in the immediate therapy group and 33 on the waiting list).
      Patients in the therapy group reported significantly greater decrease in fatigue severity (difference in decrease on checklist individual strength was 14.5, 95% confidence interval 7.4 to 21.6) and functional impairment (difference in increase on SF-36 physical functioning was 17.3, 6.2 to 28.4) and their attendance at school increased significantly (difference in increase in percentage school attendance was 18.2, 0.8 to 35.5).
      They also reported a significant reduction in several accompanying symptoms.
      Self reported improvement was largest in the therapy group.
      Conclusion
      - Cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome in adolescents.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/15585538
      Also read the comment ons this article :
      Cognitive behaviour therapy for adolescents with chronic fatigue syndrome - Data are insufficient and conclusion inappropriate
      Chaudhuri A - BMJ. 2005 Apr 2;330(7494):789-90; author reply 790 - PMID: 15802727
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15802727?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    37. Cognitive behaviour therapy for chronic fatigue syndrome - A multicentre randomised controlled trial
      Prins JB, Bleijenberg G, Bazelmans E, Elving LD, de Boo TM, Severens JL, van der Wilt GJ, Spinhoven P, van der Meer JW, Department of Medical Psychology, University Medical Centre, Nijmegen, The Netherlands : j.prins@cksmps.azn.nl - Lancet. 2001 Mar 17;357(9259):841-7 - PMID: 11265953
      Background
      - Cognitive behaviour therapy (CBT) seems a promising treatment for chronic fatigue syndrome (CFS), but the applicability of this treatment outside specialised settings has been questioned.
      We compared CBT with guided support groups and the natural course in a randomised trial at three centres.
      Methods
      - Of 476 patients diagnosed with CFS, 278 were eligible and willing to take part. 93 were randomly assigned CBT (administered by 13 therapists recently trained in this technique for CFS), 94 were assigned the support-group approach and 91 the control natural course.
      Multidimensional assessments were done at baseline, 8 months and 14 months.
      The primary outcome variables were fatigue severity (on the checklist individual strength) and functional impairment (on the sickness impact profile) at 8 and 14 months.
      Data were analysed by intention to treat.
      Findings
      - 241 patients had complete data (83 CBT, 80 support groups, 78 natural course) at 8 months.
      At 14 months CBT was significantly more effective than both control conditions for fatigue severity (CBT vs support groups 5.8 [2.2-9.4]; CBT vs natural course 5.6 [2.1-9.0]) and for functional impairment (CBT vs support groups 263 [38-488]; CBT vs natural course 222 [3-441]).
      Support groups were not more effective for CFS patients than the natural course.
      Among the CBT group, clinically significant improvement was seen in fatigue severity for 20 of 58 (35%), in Karnofsky performance status for 28 of 57 (49%) and self-rated improvement for 29 of 58 (50%).
      Prognostic factors for outcome after CBT were a higher sense of control predicting more improvement, and a passive activity pattern and focusing on bodily symptoms predicting less improvement.
      Interpretation
      - CBT was more effective than guided support groups and the natural course in a multicentre trial with many therapists.
      Our study showed a lower proportion of patients with improvement than CBT trials with a few highly skilled therapists.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11265953
      Also read the comments on this article :
      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Vermeulen RC, Scholte HR, Bezemer PD - Lancet. 2001 Jul 21;358(9277):238; author reply 240-1 - PMID: 11480427
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11480427?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Chaudhuri A - Lancet. 2001 Jul 21;358(9277):238; author reply 240-1 - PMID: 11480426
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11480426?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Spence VA, Abbot NC - Lancet. 2001 Jul 21;358(9277):239-40; author reply 240-1 - PMID: 11480428
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11480428?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus
      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Lassesen KM - Lancet. 2001 Jul 21;358(9277):239; author reply 240-1 - PMID: 11480430
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11480430?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Shepherd C - Lancet. 2001 Jul 21;358(9277):239; author reply 240-1 - PMID: 11480429
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11480429?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus
      -
      Cognitive behaviour therapy for chronic fatigue syndrome
      Baschetti R - Lancet. 2001 Jul 21;358(9277):240; author reply 240-1 - PMID: 11480431
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11480431?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    38. Cognitive behaviour therapy for chronic fatigue syndrome - A multicentre randomized controlled trial
      Prins JB, Bleijenberg G, Bazelmans E et al. - Lancet 2001; 357: 841-847

    39. Cognitive behaviour therapy for chronic fatigue syndrome - A randomised controlled trial
      Deale A, Chalder T, Marks I, Wessely S - Am J Psychiatry 1997; 408-414
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11265953

    40. Cognitive behaviour therapy for chronic fatigue syndrome in adults
      Price JR, Mitchell E, Tidy E, Hunot V, Department of Psychiatry, University of Oxford, Warneford Hospital, Headington, Oxford, UK, OX3 7JX : jonathan.price@psych.ox.ac.uk - Cochrane Database Syst Rev. 2008 Jul 16;(3):CD001027 - PMID: 18646067
      This article is an update of '
      Cognitive behaviour therapy for adults with chronic fatigue syndrome' (Price JR, Couper J, Department of Psychiatry, University of Oxford, The Warneford Hospital, Oxford, UK, OX3 7JX : jonathan.price@psych.ox.ac.uk - Cochrane Database Syst Rev. 2000;(2):CD001027) at : http://www.ncbi.nlm.nih.gov/pubmed/10796733?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      Background - Chronic fatigue syndrome (CFS) is a common, debilitating and serious health problem.
      Cognitive behaviour therapy (CBT) may help to alleviate the symptoms of CFS.
      Objectives
      - To examine the effectiveness and acceptability of CBT for CFS, alone and in combination with other interventions, compared with usual care and other interventions.
      Search strategy
      - CCDANCTR-Studies and CCDANCTR-References were searched on 28/3/2008.
      We conducted supplementary searches of other bibliographic databases.
      We searched reference lists of retrieved articles and contacted trial authors and experts in the field for information on ongoing/completed trials.
      Selection criteria
      - Randomised controlled trials involving adults with a primary diagnosis of CFS, assigned to a CBT condition compared with usual care or another intervention, alone or in combination.
      Data collection and analysis
      - Data on patients, interventions and outcomes were extracted by two review authors independently and risk of bias was assessed for each study.
      The primary outcome was reduction in fatigue severity, based on a continuous measure of symptom reduction, using the standardised mean difference (SMD) or a dichotomous measure of clinical response, using odds ratios (OR), with 95% confidence intervals (CI).
      Main results
      - Fifteen studies (1043 CFS participants) were included in the review.
      When comparing CBT with usual care (six studies, 373 participants), the difference in fatigue mean scores at post-treatment was highly significant in favour of CBT (SMD -0.39, 95% CI -0.60 to -0.19), with 40% of CBT participants (four studies, 371 participants) showing clinical response in contrast with 26% in usual care (OR 0.47, 95% CI 0.29 to 0.76).
      Findings at follow-up were inconsistent.
      For CBT versus other psychological therapies, comprising relaxation, counselling and education/support (four studies, 313 participants), the difference in fatigue mean scores at post-treatment favoured CBT (SMD -0.43, 95% CI -0.65 to -0.20).
      Findings at follow-up were heterogeneous and inconsistent.
      Only two studies compared CBT against other interventions and one study compared CBT in combination with other interventions against usual care.
      Authors' conclusions
      - CBT is effective in reducing the symptoms of fatigue at post-treatment compared with usual care and may be more effective in reducing fatigue symptoms compared with other psychological therapies.
      The evidence base at follow-up is limited to a small group of studies with inconsistent findings.
      There is a lack of evidence on the comparative effectiveness of CBT alone or in combination with other treatments and further studies are required to inform the development of effective treatment programmes for people with CFS.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/18646067?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed

      Also read the comment on this article :
      CBT reduces fatigue in adults with chronic fatigue syndrome but effects at follow-up unclear (review)
      Santhouse AM, South London and Maudsley NHS Foundation Trust, London, UK - Evid Based Ment Health. 2009 Feb;12(1):16 - PMID: 19176775

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/19176775?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    41. Cognitive behaviour therapy for the chronic fatigue syndrome - A randomised controlled trial
      Sharpe M, Hawton K, Simkin S et al. - BMJ 1996; 312: 22-26

    42. Cognitive behaviour therapy for the chronic fatigue syndrome - A randomized controlled trial
      Sharpe M, Hawton K, Simkin S, Surawy C, Hackmann A, Klimes I, Peto T, Warrell D, Seagroatt V, University Department of Psychiatry, Warneford Hospital, Oxford - BMJ. 1996 Jan 6;312(7022):22-6 - PMID: 8555852
      Objective
      - To evaluate the acceptability and efficacy of adding cognitive behaviour therapy to the medical care of patients presenting with the chronic fatigue syndrome.
      Design - Randomised controlled trial with final assessment at 12 months.
      Setting - An infectious diseases outpatient clinic.
      Subjects - 60 consecutively referred patients meeting consensus criteria for the chronic fatigue syndrome.
      Interventions - Medical care comprised assessment, advice and follow up in general practice.
      Patients who received cognitive behaviour therapy were offered 16 individual weekly sessions in addition to their medical care.
      Main outcome measures - The proportions of patients (a) who achieved normal daily functioning (Karnofsky score 80 or more) and (b) who achieved a clinically significant improvement in functioning (change in Karnofsky score 10 points or more) by 12 months after randomisation.
      Results - Only two eligible patients refused to participate.
      All randomised patients completed treatment.
      An intention to treat analysis showed that 73% (22/30) of recipients of cognitive behaviour therapy achieved a satisfactory outcome as compared with 27% (8/30) of patients who were given only medical care (difference 47 percentage points; 95% confidence interval 24 to 69).
      Similar differences were observed in subsidiary outcome measures.
      The improvement in disability among patients given cognitive behaviour therapy continued after completion of therapy.
      Illness beliefs and coping behaviour previously associated with a poor outcome changed more with cognitive behaviour therapy than with medical care alone.
      Conclusion - Adding cognitive behaviour therapy to the medical care of patients with the chronic fatigue syndrome is acceptable to patients and leads to a sustained reduction in functional impairment.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8555852
      Also read the comments on this article :
      -
      Cognitive behaviour therapy for the chronic fatigue syndrome. Patients were not representative of all patients with the syndrome
      Gibbons R, Macintyre A, Richards C - BMJ. 1996 Apr 27;312(7038):1096-7; author reply 1098 - PMID: 8616426
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616426?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      - Cognitive behaviour therapy for the chronic fatigue syndrome. Evening primrose oil and magnesium have been shown to be effective
      Chilton SA - BMJ. 1996 Apr 27;312(7038):1096; author reply 1098 - PMID: 8616424
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616424?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus
      - Cognitive behaviour therapy for the chronic fatigue syndrome. Good general care may offer as much benefit as cognitive behaviour therapy
      Shepherd C - BMJ. 1996 Apr 27;312(7038):1096; author reply 1098 - PMID: 8616425
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616425?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      - Cognitive behaviour therapy for the chronic fatigue syndrome. Patients' beliefs about their illness were probably not a major factor
      Ho-Yen DO - BMJ. 1996 Apr 27;312(7038):1097-8 - PMID: 8616430
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616430?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      - Cognitive behaviour therapy for the chronic fatigue syndrome. Essential elements of the treatment must be identified
      Lawrie SM - BMJ. 1996 Apr 27;312(7038):1097; author reply 1098 - PMID: 8616428
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616428?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      - Cognitive behaviour therapy for the chronic fatigue syndrome. Cognitive behavior therapy should be compared with placebo treatments
      Pearce J - BMJ. 1996 Apr 27;312(7038):1097; author reply 1098 - PMID: 8616427
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616427?ordinalpos=7&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

      - Cognitive behaviour therapy for the chronic fatigue syndrome. Use an interdisciplinary approach
      Eaton KK - BMJ. 1996 Apr 27;312(7038):1097; author reply 1098 - PMID: 8616429
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8616429?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Disco
      veryPanel.Pubmed_RVAbstractPlus

    Lees verder : Deel V


    08-04-2010 om 23:19 geschreven door Jules

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel V

    1. Cognitive behavioural therapy in chronic fatigue syndrome - A randomised controlled trial of an outpatient group programme
      O'Dowd H, Gladwell P, Rogers CA, Hollinghurst S, Gregory A, Pain Management Centre, Frenchay Hospital, Bristol, UK - Health Technol Assess. 2006 Oct;10(37):iii-iv, ix-x, 1-121 - PMID: 17014748
      Objectives - To test the hypothesis that group cognitive behavioural therapy (CBT) will produce an effective and cost-effective management strategy for patients in primary care with chronic fatigue syndrome/myalgic encephalopathy (CFS/ME).
      Design
      - A double-blind, randomised controlled trial was adopted with three arms.
      Outcomes were assessed at baseline and 6 and 12 months after first assessment and results were analysed on an intention-to-treat basis.
      Setting
      - A health psychology department for the management of chronic illness in a general hospital in Bristol, UK.
      Participants
      - Adults with a diagnosis of CFS/ME referred by their GP.
      Interventions
      - The three interventions were group CBT incorporating graded activity scheduling, education and support group (EAS) and standard medical care (SMC).
      Outcome measures - The primary outcome measure was the Short Form with 36 Items (SF-36) physical and mental health summary scales.
      Other outcome measures included the Chalder fatigue scale, Hospital Anxiety and Depression Scale, General Health Questionnaire, physical function (shuttles walked, walking speed and perceived fatigue), health utilities index and cognitive function (mood, recall and reaction times).
      Results
      - A total of 153 patients were recruited to the trial and 52 were randomised to receive CBT, 50 to EAS and 51 to SMC.
      Twelve patients failed to attend for the 12-month follow-up and 19 patients attended one follow-up, but not both.
      The sample was found to be representative of the patient group and the characteristics of the three groups were similar at baseline.
      Three outcome measures, SF-36 mental health score, Chalder fatigue scale and walking speed, showed statistically significant differences between the groups.
      Patients in the CBT group had significantly higher mental health scores [difference +4.35, 95% confidence interval (CI) +0.72 to +7.97, p = 0.019], less fatigue (difference -2.61, 95% CI -4.92 to -0.30, p = 0.027) and were able to walk faster (difference +2.83 shuttles, 95% CI +1.12 to +5.53, p = 0.0013) than patients in the SMC group.
      CBT patients also walked faster and were less fatigued than those randomised to EAS (walking speed : difference +1.77, 95% CI +0.025 to +3.51, p = 0.047; fatigue : difference -3.16, 95% CI -5.59 to -0.74, p = 0.011).
      Overall, no other statistically significant difference across the groups was found, although for many measures a trend towards an improved outcome with CBT was seen.
      Except for walking speed, which, on average, increased by +0.87 shuttles (95% CI +0.09 to +1.65, p = 0.029) between the 6- and 12-month follow-ups, the scores were similar at 6 and 12 months.
      At baseline, 30% of patients had an SF-36 physical score within the normal range and 52% had an SF-36 mental health score in the normal range.
      At 12 months, the physical score was in the normal range for 46% of the CBT group, 26% of the EAS group and 44% of SMC patients.
      For mental health score the percentages were CBT 74%, EAS 67% and SMC 70%.
      Of the CBT group, 32% showed at least a 15% increase in physical function and 64% achieved a similar improvement in their mental health.
      For the EAS and SMC groups, this improvement in physical and mental health was achieved for 40 and 60% (EAS) and 49 and 53% (SMC), respectively.
      The cost-effectiveness of the intervention proved very difficult to assess and did not yield reliable conclusions.
      Conclusions
      - Group CBT did not achieve the expected change in the primary outcome measure as a significant number did not achieve scores within the normal range post-intervention.
      The treatment did not return a significant number of subjects to within the normal range on this domain; however, significant improvements were evident in some areas.
      Group CBT was effective in treating symptoms of fatigue, mood and physical fitness in CFS/ME.
      It was found to be as effective as trials using individual therapy in these domains.
      However, it did not bring about improvement in cognitive function or quality of life.
      There was also evidence of improvement in the EAS group, which indicates that there is limited value in the non-specific effects of therapy.
      Further research is needed to develop better outcome measures, assessments of the broader costs of the illness and a clearer picture of the characteristics best fitted to this type of intervention.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/17014748?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed

    2. Cognitive deficits in patients suffering from chronic fatigue syndrome, acute infective illness or depression
      Vollmer-Conna U, Wakefield D, Lloyd A et al. - Br J Psychiatry 1997; 171: 377-381

    3. Cognitive deficits in patients with chronic fatigue syndrome
      Marcel B, Komaroff AL, Fagioli LR et al. - Biol Psychiatry 1996; 40: 535-541

    4. Cognitive deficits in spinal cord injury - Epidemiology and outcome
      Davidoff GN, Roth EJ, Richards JS - Arch Phys Med Rehabil. 1992 Mar;73(3):275–284
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1543433

    5. Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis
      Krupp LB, Sliwinski M, Masur DM, Friedberg F, Coyle PK - Arch Neurol. 1994 Jul;51(7):705–710
      Cfr. : http://www.find-health-articles.com/rec_pub_8018045-cognitive-functioning-depression-patients-chronic-fatigue-syndrome.htm

    6. Cognitive functioning and magnetic resonance imaging in chronic fatigue
      Cope H, Pernet A, Kendall B, David A - Br J Psychiatry. 1995 Jul;167(1):86–94
      Cfr. : http://bjp.rcpsych.org/cgi/content/abstract/167/1/86

    7. Cognitive functioning in patients with chronic fatigue syndrome
      Michiels V, Cluydts R, Fischler B et al. - J Clin Exp Neuropsychol 1996; 18: 666-677

    8. Cognitive functioning is impaired in patients with chronic fatigue syndrome devoid of psychiatric disease
      DeLuca, J., Johnson, S.K., Ellis, S.P. & Natelson, B.H. (1997) - Journal of Neurology, Neurosurgery & Psychiatry, 62, 151-155
      Cfr. : http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=486726

    9. Cognitive impairment in patients with chronic fatigue - A preliminary study
      McDonald E, Cope H, David A - J Neurol Neurosurg Psychiatry. 1993 Jul;56(7):812–815
      Cfr. : http://jnnp.bmj.com/cgi/content/abstract/56/7/812

    10. Cognitive impairments in depression
      Golinkoff M, Sweeney JA - J Affect Disord. 1989 Sep–Oct;17(2):105–112
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2527885

    11. Cognitive performance and complaints of cognitive impairment in chronic fatigue syndrome (CFS)
      Wearden A, Appleby L - Psychol Med 1997; 27: 81-90

    12. Cognitive slowing and working memory difficulties in chronic fatigue syndrome
      Marshall PS, Forstot M, Callies A et al. - Psychosom Med 1997; 59: 58-66

    13. Combinations of single nucleotide polymorphisms in neuroendocrine effector and receptor genes predict chronic fatigue syndrome
      Goertzel BN, Pennachin C, de Souza Coehlo L, Gurbaxani B, Maloney EM, Jones JF - Pharmacogenomics. 2006;7 :475 –483
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/16610957

    14. Comorbid depression and anxiety in fibromyalgia syndrome - Relationship to somatic and psychosocial variables
      Thieme, K., Turk, D.C. & Flor, H. (2004) – Psychosom.Med., 66, 837-844
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/66/6/837

    15. Comorbid illness in women with chronic fatigue syndrome - A test of the single syndrome hypothesis
      Donald S. Ciccone, PhD and Benjamin H. Natelson, MD, from the Departments of Psychiatry (D.S.C) and Neuroscience (B.H.N.), University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey - Address reprint requests to : Donald S. Ciccone, Department of Psychiatry, BHSB Room E-1563, 183 South Orange Ave., Newark, NJ 07107 – E-mail : cicconds@umdnj.edu - Psychosomatic Medicine 65:268-275 (2003) - © 2003 American Psychosomatic Society
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/65/2/268

    16. Comorbidity of common mental disorders and alcohol or other substance misuse in Australian general practice
      Hickie IB, Koschera A, Davenport TA et al. - Med J Aust 2001; 175 Suppl Jul 16: S31-S36

    17. Comorbidity of fibromyalgia and psychiatric disorders
      Arnold LM, Hudson JI, Keck PE, Auchenbach MB, Javaras KN, Hess EV, Women's Health Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio 45219, USA : Lesley.Arnold@uc.edu - J Clin Psychiatry. 2006 Aug;67(8):1219-25
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/16965199

    18. Comorbidity of fibromyalgia and psychiatric disorders
      Buskila D, Cohen H, Department of Medicine H, Soroka Medical Center, POB 151, Beer Sheva 84101, Israel : dbuskila@bgumail.bgu.ac.il - Curr Pain Headache Rep. 2007 Oct;11(5):333-8 - PMID: 17894922
      There are mounting data supporting comorbidity of fibromyalgia syndrome (FMS) and psychiatric conditions.
      These include depression, panic disorders, anxiety and post-traumatic stress disorder (PTSD).
      The nature of the relationship between depression and FMS is not fully understood and it was hypothesized that chronic pain causes depression or vice versa and that chronic pain syndromes are variants of depression.
      A link between PTSD symptoms and FMS has been reported and both conditions share similar symptomatology and pathogenetic mechanisms.
      Assessment of comorbid psychiatric disorders in FMS patients has clinical implications because treatment in these patients should focus both on physical and emotional dimensions of dysfunction.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/17894922

    19. Comparing the Fukuda et al. Criteria and the Canadian Case Definition for Chronic Fatigue Syndrome
      Jason, L.A., Torres-Harding, S., Jurgens, A. & Helgerson, J. (2004) - Journal of Chronic Fatigue Syndrome, 12, 37-52

      Cfr. : http://www.theoneclickgroup.co.uk/documents/ME-CFS_res/Comparing%20the%20Fukuda%20et%20al%20Criteria%20and%20the%20Canadian%20Case%20Definition%20-%20CFS.pdf

    20. Comparison of 99m Tc HMPAO SPECT scan between chronic fatigue syndrome, major depression and healthy controls - An exploratory study of clinical correlates of regional cerebral blood flow
      Fischler, B., D'Haenen, H., Cluydts, R., Michiels, V., Demets, K., Bossuyt, A., Kaufman, L. & De Meirleir, K. (1996) - Neuropsychobiology, 34, 175-183
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9121617

    21. Comparison of heart rate variability in patients with chronic fatigue syndrome and controls
      Yataco A, Talo H, Rowe P et al. - Clin Autonom Res 1997; 7: 293-297

    22. Comparison of oral nicotinamide adenine dinucleotide (NADH) versus conventional therapy for chronic fatigue syndrome
      Santaella ML, Font I, Disdier OM - P R Health Sci J ( 2004;) 23:: 89–93

    23. Comparison of SPET brain perfusion and 18F-FDG brain metabolism in patients with chronic fatigue syndrome
      Abu-Judeh HH, Levine S, Kumar M et al. - Nucl Med Commun 1998; 19: 1056-1071

    24. Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States
      Jones JF, Maloney EM, Boneva RS, Jones AB, Reeves WC - Division of Viral and Rickettsial Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA : jaj9@cdc.gov - BMC Complement Altern Med. 2007 Apr 25;7:12 - PMID: 17459162

      Background - Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS), pose a diagnostic and therapeutic challenge.
      Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM) therapies used.
      This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population.
      Methods
      - During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based and energy modalities.
      Results
      - Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening.
      Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue and 49 with CFS-like illness.
      Mind-body therapy (primarily personal prayer and prayer by others) was the most frequently used CAM across all groups.
      Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003).
      All categories of CAM use were associated with significantly poorer physical health scores and all but one (alternative medicine systems) were associated with significantly poorer mental health scores.
      People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage) than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82).
      Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued and CFS-like subjects (p-trend = 0.002).
      People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1.07, 2.16) and mind-body (excluding prayer) therapy than non-fatigued participants (OR = 1.73, CI = 1.20 - 2.48).
      Conclusion
      - Utilization of CAM was common in fatiguing illnesses and was largely accounted for by the presence of underlying conditions and poor physical and mental health.
      Compared to non-fatigued persons, those with CFS-like illness or chronic fatigue were most likely to use body-based and mind-body therapies.
      These observations have important implications for provider education programs and development of intervention strategies for CFS.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/17459162?dopt=Abstract

    25. Complex genetic and environmental relationships between psychological distress, fatigue and immune functioning - A twin study
      Hickie I, Bennett B, Lloyd A et al. - Psychol Med 1999; 29: 269-277

    26. Concerns about data and methodology in multiple chemical sensitivity paper
      Dieter Eis, MD and Dieter Helm, PhD, Robert Koch Institute; Department of Environmental Medicine; Berlin, Germany - Psychosomatic Medicine 69:292-293 (2007) - © 2007 American Psychosomatic Society
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/full/69/3/292

    27. Conclusions about the assessment and management of common mental disorders in Australian general practice
      Hickie IB, Davenport TA, Naismith SL, Scott EM on behalf of the SPHERE National Secretariat - Med J Aust 2001; 175 Suppl Jul 16: S52-S55

    28. Contrasting neuroendocrine responses in depression and chronic fatigue syndrome
      Cleare AJ, Bearn J, McGregor A et al. - J Affect Disord 1995; 35: 283-289

    29. Coping and other predictors of outcome in chronic fatigue syndrome - A 1-year follow-up
      Ray C, Jefferies S, Weir WRC - J Psychosom Res 1997; 43: 405-415

    30. Coping strategies in twins with chronic fatigue and chronic fatigue syndrome
      Afari N, Schmaling KB, Herrell R et al. - J Psychosom Res 2000; 48: 547-554

    31. Coping with chronic fatigue syndrome – Illness responses and their relationship with fatigue, functional impairment and emotional status
      Ray, C., Jefferies, S. & Weir, W.R. (1995) - Psychological Medicine, 25, 937-945
      Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=3688724

    32. Cortical motor potential alterations in chronic fatigue syndrome
      Gordon R, Michalewski HJ, Nguyen T et al. - Int J Molec Med 1999; 4: 493-499

    33. Couples' perceptions of wives' CFS symptoms, symptom change and impact on the marital relationship
      Goodwin SS - Issues Mental Health Nursing 2000; 21: 347-363

    34. Course and outcome of chronic fatigue in children and adolescents
      Krilov LR, Fisher M, Friedman SB et al. - Pediatrics 1998: 102; 360-366
      Cfr. : http://pediatrics.aappublications.org/cgi/content/abstract/102/2/360

    35. Critical life events, infections and symptoms during the year preceding chronic fatigue syndrome (CFS) - An examination of CFS patients and subjects with a nonspecific life crisis
      Theorell T, Blomkvist V, Lindh G, Evengard B - Psychosom Med 1999; 61: 304-310

    36. Cytokine and other immunologic markers in chronic fatigue syndrome and their relation to neuropsychological factors
      Patarca-Montero R, Antoni M, Fletcher MA et al. - Appl Neuropsychol 2001; 8: 51-64

    37. Daily affect relations in fibromyalgia patients reveal positive affective disturbance
      Patrick H. Finan, MA, Alex J. Zautra, PhD and Mary C. Davis, PhD, Department of Psychology, Arizona State University, Tempe, Arizona : patrick.finan@asu.edu - Psychosomatic Medicine 71:474-482 (2009) - © 2009 American Psychosomatic Society
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/71/4/474

    38. Death of a lifestyle – The effects of social support and healthcare support on the quality of life of persons with fibromyalgia and/or chronic fatigue syndrome
      Schoofs, N., Bambini, D., Ronning, P., Bielak, E. & Woehl, J. (2004) - Orthop.Nurs., 23, 364-374
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15682879

    39. Decreased bone mineral density during low dose glucocorticoid administration in a randomized, placebo controlled trial
      McKenzie R, Reynolds JC, O'Fallon A et al. - J Rheumatol 2000; 27: 2222-2226

    40. Decreased nitric oxide-mediated natural killer cell activation in chronic fatigue syndrome
      Ogawa, M., Nishiura, T., Yoshimura, M., Horikawa, Y., Yoshida, H., Okajima, Y., Matsumura, I., Ishikawa, J., Nakao, H., Tomiyama,Y., Kanayama,Y., Kanakura,Y. & Matsuzawa,Y. (1998) - Eur.J Clin.Invest, 28, 937-943
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9824439

    41. Decreased vagal power during treadmill walking in patients with chronic fatigue syndrome
      Cordero, D.L., Sisto, S.A., Tapp, W.N., LaManca, J.J., Pareja, J.G. & Natelson, B.H. (1996) - Clinical Autonomic Research , 6, 329-333
      Cfr. : http://www.springerlink.com/content/al7220t85056t678/

    42. Defensive coping styles in chronic fatigue syndrome
      Creswell C, Chalder T - J Psychosom Res 2001; 51: 607-610

    43. Defining and managing chronic fatigue syndrome - Evidence Report/Technology Assessment No. 42 (Prepared by San Antonio Evidence-based Practice Centre at The University of Texas Health Science Center at San Antonio). AHRQ Publication No. 02-E001
      Mulrow CD, Ramirez G, Cornell JE, Allsup K - Rockville (MD) : Agency for Healthcare Research and Quality; October 2001
      Cfr. : http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hserta&part=A58979 -&- http://www.ahrq.gov/clinic/cfssum.htm

    44. Defining exercise capacity, exercise performance and a sedentary lifestyle
      Sargent C, Scroop GC - Med Sci Sports Exerc 2002; 34: 1692-1693

    45. Demonstration of borna disease virus RNA in peripheral blood mononuclear cells derived from Japanese patients with chronic fatigue syndrome
      Nakaya T, Takahashi H, Nakamura Y et al. - FEBS Lett 1996; 378: 145-149

    46. Demonstration of delayed recovery from fatiguing exercise in chronic fatigue syndrome
      Paul, L., Wood, L., Behan, W.M. & Maclaren, W.M. (1999) - European Journal of Neurology, 6, 63-69
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10209352

    47. Depressed Australians - Should we worry ? (letter)
      Hickie IB - Med J Aust 2001; 174: 425-426

    48. Depression and the community
      Ian B Hickie
      Cfr. : http://www.mja.com.au/public/issues/176_10_200502/hic10078_fm.html

    49. Depression in fatiguing illness - Comparing patients with chronic fatigue syndrome, multiple sclerosis and depression
      Johnson SK, DeLuca J, Natelson BH - J Affect Disord. 1996 Jun 20;39(1):21–30
      Cfr. : http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T2X-497C849-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_search
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    50. Depression, pain and aging
      Jordan F. Karp, M.D. and Charles F. Reynolds III, M.D., Correspondence: Address correspondence to Jordan F. Karp, M.D., Western Psychiatric Institute and Clinic, 3811 O'Hara St., Pittsburgh, PA 15213. E-mail: karpjf@upmc.edu - Focus 7:17-27, Winter 2009 - © 2009 American Psychiatric Association
      Cfr. : http://focus.psychiatryonline.org/cgi/content/abstract/7/1/17

    51. Detection of borna disease virus-reactive antibodies from patients with psychiatric disorders and from horses by electrochemiluminescence immunoassay
      Yamaguchi K, Sawada T, Naraki T et al. - Clin Diagn Lab Immunol 1999; 6: 696-700

    52. Detection of enterovirus-specific RNA in serum - The relationship to chronic fatigue
      Clements GB, McGarry F, Nairn C, Galbraith DN - J Med Virol 1995; 45: 156-161

    53. Detection of immunologically significant factors for chronic fatigue syndrome using neural-network classifiers
      Hanson SJ, Gause W, Natelson B - Clin Diag Lab Immunol 2001; 8: 658-662

    54. Detection of intracranial abnormalities in patients with chronic fatigue syndrome - Comparison of MR imaging and SPECT
      Schwartz RB, Garada BM, Komaroff AL, Tice HM, Gleit M, Jolesz FA, Holman BL - AJR Am J Roentgenol. 1994 Apr;162(4):935–941
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8141020

    55. Detection of Mycoplasma genus and Mycoplasma fermentans by PCR in patients with chronic fatigue syndrome
      Vojdani A, Choppa PC, Tagle C et al. - FEMS Immunol Med Microbiol 1998; 22: 355-365

    56. Developing case definitions for symptom-based conditions - The problem of specificity
      Hyams KC - Epidemiol Rev 1998; 20: 148-156

    57. Development of a simple screening tool for common mental disorders in general practice
      Hickie IB, Davenport TA, Hadzi-Pavlovic D, Koschera A, Naismith SL, Scott EM, Wilhelm KA, School of Psychiatry, University of New South Wales, Sydney : ian.hickie@beyondblue.org.au - Med J Aust. 2001 Jul 16;175 Suppl:S10-7 - PMID: 11556430
      Objective - To develop and validate a self-report screening tool for common mental disorders.
      Design and setting
      - Sequential development and validation studies in three cohorts of patients in general practice and one cohort of patients in a specialist psychiatry clinic.
      Participants
      - 1585 patients in general practice examined cross-sectionally and longitudinally; 46515 patients attending 386 general practitioners nationwide; 364 patients participating in a longitudinal study of psychiatric disorders in general practice; and 522 patients attending a specialist psychiatry clinic.
      Main outcome measures
      - Performance of the 12 items from the 34-item SPHERE questionnaire against DSM-III-R and DSM-IV diagnoses of psychiatric disorder, self-reported Brief Disability Questionnaire findings, GPs' ratings of patients' needs for psychological care and degree of risk resulting from mental disorder and patients' and GPs' reports of reasons for presentation.
      Results
      - Six somatic and six psychological questions identify two levels (and three types) of mental disorder: patients reporting both characteristic psychological and somatic symptoms (Level 1, Type 1) and patients reporting either psychological symptoms (Level 2, Type 2) or somatic symptoms (Level 2, Type 3).
      This classification system predicts disability ratings (Level 1, 8.2 "days out of role in the last month" and Level 2, 4.1 and 5.4 "days out of role in the last month" for Types 2 and 3, respectively), rates of lifetime psychiatric diagnoses (Level 1, 63% and Level 2, 59% and 48%, respectively), both patients' and GPs' report of reasons for presentation and doctors' ratings of risk as a result of mental disorder.
      There are important and differing sociodemographic correlates for the three types of mental disorders.
      Conclusion
      - A classification system based on the 12 items from the 34-item SPHERE questionnaire can be used to identify common mental disorders.
      This system has acceptable validity and reliability and is suited specifically for general practice settings.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11556430?dopt=Abstract
      Also read the comment on this article :
      Mental distress or disorder ?
      Harris MF, Penrose-Wall J, School of Community Medicine, University of New South Wales, Sydney - Med J Aust. 2001 Jul 16;175 Suppl:S6-7 - PMID: 11556439
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11556439?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    58. Diagnose and be damned - Management of CFS in children is not contentious [letter]
      Wessely S - BMJ 2000; 320: 1004

    59. Diagnosis and management of chronic fatigue syndrome
      Loblay RH, for the Clinical and Laboratory Practices Committee, Australasian Society of Clinical Immunology and Allergy - R Australas Coll Physicians Fellowship Affairs 1994; 13: 27-31

    60. Diagnosis in chronic illness - Enabling or disabling - The case of chronic fatigue syndrome
      Woodward RV, Broom DH, Legge DG - J R Soc Med 1995; 88: 325-329

    61. Diagnosis of chronic fatigue syndrome in children and adolescents - Special considerations
      Bell DS - J Chronic Fatigue Syndr 1995; 1: 9-33

    62. Diagnosis, disease and illness
      Mayou R, Sharpe M - QJM 1995; 88: 827-831

    63. Diagnostic structured interviews in child and adolescent's psychiatry
      Renou S, Hergueta T, Flament M, Mouren-Simeoni MC, Lecrubier Y, Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, 48, boulevard Serurier, 75019 Paris, France - Encephale. 2004 Mar-Apr; 30(2):122-34
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15107714?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedreviews&logdbfrom=pubmed

    64. Differential diagnosis of chronic fatigue in children - Behavioral and emotional dimensions
      Carter BD, Kronenberger WG, Edwards JF et al. - J Dev Behav Pediatr 1996; 17: 16-21

    65. Defining melancholia - Properties of a refined sign-based measure
      Parker G, Hadzi-Pavlovic D, Wilhelm K et al. - Br J Psychiatry 1994; 164: 316-326
      Cfr. : http://bjp.rcpsych.org/cgi/content/abstract/164/3/316

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel VI

    1. Discomfort of patient power - Power sharing is not a takeover bid
      White PD - BMJ 2002; 324; 1214
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12018217?dopt=Abstract

    2. Dissociation of body-temperature and melatonin secretion circadian rhythms in patients with chronic fatigue syndrome
      Williams G, Pirmohamed J, Minors D et al. - Clin Physiol 1996; 16: 327-337

    3. Disturbed neuroendocrine-immune interactions in chronic fatigue syndrome
      Kavelaars A, Kuis W, Knook L et al. - J Clin Endocrinol Metab 2000; 85: 692-696

    4. Diurnal variation of adrenocortical activity in chronic fatigue syndrome
      MacHale SM, Cavanagh JTO, Bennie J et al. - Neuropsychobiology 1998; 38: 213-217

    5. Divided attention deficits in patients with chronic fatigue syndrome
      Ross S, Fantie B, Straus SF et al. - Applied Neuropsychology 2001; 8: 4-11

    6. Does high "action-proneness" make people more vulnerable to chronic fatigue syndrome ? - A controlled psychometric study
      Van Houdenhove B, Onghena P, Neerinckx E, Hellin J - J Psychosom Res 1995; 39: 633-640

    7. Does the chronic fatigue syndrome involve the autonomic nervous system ?
      Freeman R, Komaroff AL - Am J Med 1997; 102: 357-364

    8. Double-blind randomized controlled trial to assess the efficacy of intravenous gammaglobulin for the management of chronic fatigue syndrome in adolescents
      Rowe KS - J Psychiatr Res 1997; 133-147

    9. DSM-IV pain disorder in the general population - An exploration of the structure and threshold of medically unexplained pain symptoms
      Fröhlich Christine; Jacobi Frank; Wittchen Hans-Ulrich - Eur Arch Psychiatry Clin Neurosci. 2006 Apr; 256(3):187-96. Epub 2005 Nov 18
      Cfr. : http://www.biomedexperts.com/Abstract.bme/16328107/DSM-IV_pain_disorder_in_the_general_population_An_exploration_of_the_structure_and_thres
      hold_of_medically_unexplained_p

    10. Dysautonomias - Clinical disorders of the autonomic nervous system
      Goldstein et al. - Ann Intern. Med. 2002;137:753-763
      Cfr. :
      http://www.annals.org/content/137/9/753.abstract

    11. Dysfunction of natural killer activity in a family with chronic fatigue syndrome
      Levine PH, Whiteside TL, Friberg D et al. - Clin Immunol Immunopathol 1998; 88: 96-104

    12. Educational strategies for chronically ill students - Chronic fatigue syndrome
      Rowe KS, Fitzgerald P - Aust Educat Developmental Psychologist 1999; 16: 5-21

    13. Effect of a self-management program on patients with chronic disease
      Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M, Stanford University School of Medicine, Calif, USA : lorig@stanford.edu - Eff Clin Pract. 2001 Nov-Dec;4(6):256-62 - PMID: 11769298
      Context : For patients with chronic disease, there is growing interest in "self-management" programs that emphasize the patients' central role in managing their illness.
      A recent randomized clinical trial demonstrated the potential of self-management to improve health status and reduce health care utilization in patients with chronic diseases.
      Objective
      - To evaluate outcomes of a chronic disease self-management program in a real-world" setting.
      Study design
      - Before-after cohort study.
      Patients and setting
      - Of the 613 patients from various Kaiser Permanente hospitals and clinics recruited for the study, 489 had complete baseline and follow-up data.
      Intervention
      - The Chronic Disease Self-Management Program is a 7-week, small-group intervention attended by people with different chronic conditions.
      It is taught largely by peer instructors from a highly structured manual.
      The program is based on self-efficacy theory and emphasizes problem solving, decision making and confidence building.
      Main outcome measures
      - Health behavior, self-efficacy (confidence in ability to deal with health problems), health status and health care utilization, assessed at baseline and at 12 months by self-administered questionnaires.
      Results
      - At 1 year, participants in the program experienced statistically significant improvements in health behaviors (exercise, cognitive symptom management and communication with physicians), self-efficacy and health status (fatigue, shortness of breath, pain, role function, depression and health distress) and had fewer visits to the emergency department (ED) (0.4 visits in the 6 months prior to baseline, compared with 0.3 in the 6 months prior to follow-up; P = 0.05).
      There were slightly fewer outpatient visits to physicians and fewer days in hospital, but the differences were not statistically significant.
      Results were of about the same magnitude as those observed in a previous randomized, controlled trial.
      Program costs were estimated to be about $200 per participant.
      Conclusions - We replicated the results of our previous clinical trial of a chronic disease self-management program in a "real-world
      " setting.
      One year after exposure to the program, most patients experienced statistically significant improvements in a variety of health outcomes and had fewer ED visits.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11769298

    14. Effect of bojungikki-tang on lipopolysaccharide-induced cytokine production from peripheral blood mononuclear cells of chronic fatigue syndrome patients
      Shin HY, Shin CH, Shin TY, Lee EJ, Kim HM - Immunopharmacol Immunotoxicol ( 2003;) 25:: 491–501

    15. Effect of Hochu-ekki-to (TJ-41), a Japanese herbal medicine, on daily activity in a Murine model of chronic fatigue syndrome
      Wang XQ, Takahashi T, Zhu SJ, Moriya J, Saegusa S, Yamakawa J et al. - Evid Based Complement Altern Med ( 2004;) 1:: 203–6

    16. Effect of Kuibitang on lipopolysaccharide-induced cytokine production in peripheral blood mononuclear cells of chronic fatigue syndrome patients
      Shin HY, An NH, Cha YJ, Shin EJ, Shin TY, Baek SH et al. - J Ethnopharmacol ( 2004;) 90:: 253–9

    17. Effect of natural and synthetic antioxidants in a mouse model of chronic fatigue syndrome
      Singh A, Naidu PS, Gupta S, Kulkarni SK - J Med Food ( 2002;) 5:: 211–20

    18. Effectiveness of complementary and self-help treatments for depression
      Jorm AF, Christensen H, Griffiths KM, Rodgers B - Med J Aust 2002; 176 Suppl May 20: S97-S104

    19. Effects of exercise on cognitive and motor function in chronic fatigue syndrome and depression
      Blackwood, S.K., MacHale, S.M., Power, M.J., Goodwin, G.M. & Lawrie, S.M. (1998a) - Journal of Neurology, Neurosurgery & Psychiatry, 65, 541-546
      Cfr. : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170292/

    20. Effects of mental health training and clinical audit on general practitioners' management of common mental disorders
      Naismith SL, Hickie IB, Scott EM, Davenport TA - Med J Aust 2001; 175 Suppl Jul 16: S42-S47

    21. Effects of mild exercise on cytokines and cerebral blood flow in chronic fatigue syndrome patients
      Peterson, P.K., Sirr, S.A., Grammith, F.C., Schenck, C.H., Pheley, A.M., Hu, S., Chao & CC. (1994) - Clinical & Diagnostic Laboratory Immunology, 1, 222-226
      Cfr. : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC368231/

    22. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained ‘mentally demanding’ tasks
      Reay JL, Kennedy DO, Scholey AB - J Psychopharmacol ( 2006;) 20:: 771–81

    23. Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia
      Passard A, Attal N, Benadhira R, Brasseur L, Saba G, Sichere P, Perrot S, Januel D, Bouhassira D - INSERM U-792, Boulogne-Billancourt F-92100 France - Brain. 2007 Oct;130(Pt 10):2661-70. Epub 2007 Sep 14
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/17872930

    24. Efficacy of cognitive behavioral therapy for adolescents with chronic fatigue syndrome - Long-term follow-up of a randomized, controlled trial
      Hans Knoop, MSca, Maja Stulemeijer, MSca, Lieke W. A. M. de Jong, MScb, Theo J. W. Fiselier, MD, PhDc and Gijs Bleijenberg, PhDa - a Expert Centre Chronic Fatigue
      b Department of Medical Psychology - c Department of Pediatrics, Radboud University, Nijmegen Medical Centre, Nijmegen, Netherlands - PEDIATRICS Vol. 121 No. 3 March 2008, pp. e619-e625

      Cfr. : http://pediatrics.aappublications.org/cgi/content/abstract/121/3/e619

    25. Electrodermal dissociation of chronic fatigue and depression - Evidence for distinct physiological mechanisms
      Pazderka-Robinson,H., Morrison,J.W. & Flor-Henry,P. (2004) - Int. J Psychophysiol., 53,171-182
      Cfr. : http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T3M-4CHHSTT-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_search
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    26. Elevated apoptotic cell population in patients with chronic fatigue syndrome - The pivotal role of protein kinase RNA
      Vojdani M, Ghoneum M, Choppa PC et al. - J Intern Med 1997; 242: 465-478

    27. Elevated MMPI scores for hypochondriasis, depression and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status
      Pincus, T., Callahan, L.F., Bradley, L.A., Vaughn, W.K. & Wolfe, F. (1986) - Arthritis Rheum., 29, 1456-1466
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/3801070

    28. Elevation of bioactive transforming growth factor-B in serum from patients with chronic fatigue syndrome
      Bennett AL, Chao CC, Hu S et al. - J Clin Immunol 1997; 17: 160-166

    29. Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome
      Gow JW, Behan WMH, Clements GB et al. - BMJ 1991; 302: 692-696

    30. Epidemiology of unexplained fatigue and major depression in the community - The Baltimore ECA follow-up 1981-1994
      Addington AM, Gallo JJ, Ford DE, Eaton WW - Psychol Med 2001; 31: 1037-1044

    31. Estimating rates of chronic fatigue syndrome from a community-based sample - A pilot study
      Jason LA, Taylor R, Wagner L et al. - Am J Community Psychol 1995; 23: 557-568

    32. Estimating the prevalence of chronic fatigue syndrome among nurses
      Jason LA, Wagner L, Rosenthal S et al. - Am J Med 1998; 105: 91S-93S

    33. Evaluating cognitive impairment in depression with the Luria-Nebraska Neuropsychological Battery - Severity correlates and comparisons with nonpsychiatric controls
      Miller LS, Faustman WO, Moses JA, Jr, Csernansky JG - Psychiatry Res. 1991 Jun;37(3):219–227
      Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=5597127

    34. Evidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome
      Demitrack MA, Crofford LJ, Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, Indiana 46285, USA - Ann N Y Acad Sci. 1998 May 1;840:684-97 - PMID: 9629295

      Chronic fatigue syndrome (CFS) is characterized by profound fatigue and an array of diffuse somatic symptoms.
      Our group has established that impaired activation of the hypothalamic-pituitary-adrenal (HPA) axis is an essential neuroendocrine feature of this condition.
      The relevance of this finding to the pathophysiology of CFS is supported by the observation that the onset and course of this illness is excerbated by physical and emotional stressors.
      It is also notable that this HPA dysregulation differs from that seen in melancholic depression, but shares features with other clinical syndromes (e.g., fibromyalgia).
      How the HPA axis dysfunction develops is unclear, though recent work suggests disturbances in serotonergic neurotransmission and alterations in the activity of AVP, an important co-secretagogue that, along with CRH, influences HPA axis function.
      In order to provide a more refined view of the nature of the HPA dusturbance in patients with CFS, we have studied the detailed, pulsatile characteristics of the HPA axis in a group of patients meeting the 1994 CDC case criteria for CFS.
      Results of that work are consistent with the view that patients with CFS have a reduction of HPA axis activity due, in part, to impaired central nervous system drive.
      These observations provide an important clue to the development of more effective treatment to this disabling condition.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/9629295?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedreviews&logdbfrom=pubmed

    35. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization - A randomized trial
      Lorig KR, Sobel DS, Stewart AL, Brown BW Jr, Bandura A, Ritter P, Gonzalez VM, Laurent DD, Holman HR, Stanford University School of Medicine, California, USA : lorig@leland.Stanford.edu - Med Care. 1999 Jan;37(1):5-14 - PMID: 10413387
      Objectives - This study evaluated the effectiveness (changes in health behaviors, health status and health service utilization) of a self-management program for chronic disease designed for use with a heterogeneous group of chronic disease patients.
      It also explored the differential effectiveness of the intervention for subjects with specific diseases and comorbidities.
      Methods
      - The study was a six-month randomized, controlled trial at community-based sites comparing treatment subjects with wait-list control subjects.
      Participants were 952 patients 40 years of age or older with a physician-confirmed diagnosis of heart disease, lung disease, stroke or arthritis.
      Health behaviors, health status and health service utilization, as determined by mailed, self-administered questionnaires, were measured.
      Results
      - Treatment subjects, when compared with control subjects, demonstrated improvements at 6 months in weekly minutes of exercise, frequency of cognitive symptom management, communication with physicians, self-reported health, health distress, fatigue, disability and social/role activities limitations.
      They also had fewer hospitalizations and days in the hospital.
      No differences were found in pain/physical discomfort, shortness of breath or psychological well-being.
      Conclusions
      - An intervention designed specifically to meet the needs of a heterogeneous group of chronic disease patients, including those with comorbid conditions, was feasible and beneficial beyond usual care in terms of improved health behaviors and health status.
      It also resulted in fewer hospitalizations and days of hospitalization.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/10413387

    36. Examining the temporal stability of prolonged fatigue - A 12 month longitudinal study
      Hickie I, Koschera A, Bennett B, Hadzi-Pavlovic D - Australasian Society for Psychiatric Research : Annual Scientific Meeting 1996. Program and Abstracts. Melbourne: ASPR, 1996

    37. Exercise capacity in chronic fatigue syndrome
      De Becker, P., Roeykens, J., Reynders, M., McGregor, N. & De Meirleir,K. (2000) - Arch.Intern.Med., 160, 3270-3277
      Cfr. : http://archinte.ama-assn.org/cgi/content/full/160/21/3270

    38. Exercise lowers pain threshold in chronic fatigue syndrome
      Whiteside, A., Hansen, S. & Chaudhuri, A. (2004a) - Pain, 109, 497-499
      Cfr. : http://linkinghub.elsevier.com/retrieve/pii/S0304395904001216

    39. Exercise therapy for chronic fatigue syndrome
      Edmonds, M., McGuire, H. & Price,J. (2004) - Cochrane.Database.Syst.Rev., CD003200
      Cfr. : http://www.cochrane.org/reviews/en/ab003200.html

    40. Exploring the perspectives of people whose lives have been affected by depression
      McNair BG, Highet NJ, Hickie IB, Davenport TA – Beyondblue - The national depression initiative, Melbourne, VIC, Australia - Med J Aust. 2002 May 20;176 Suppl:S69-76 - PMID: 12065001
      Objectives - To describe the experiences of people whose lives have been affected by depression.
      Design, setting and particiapants - Thematic review of data collected from 21 community meetings (1529 people, providing 911 evaluation forms) and nine focus groups (69 individuals) held nationally and written feedback and website-based interactions with 'Beyondblue (the national depression initiative)
      ' between April and December 2001.
      Main oucome measures
      - Barriers to social participation experienced by people whose lives have been affected by depression and their interactions with the healthcare system.
      Results
      - The key theme was the experience of stigma, which was evident in healthcare settings and in barriers to social participation, particularly regarding employment.
      Inadequacies of primary care and specialist treatment systems were highlighted.
      Particular emphasis was placed on limited access to high-quality primary care and non-pharmacological care.
      The stigmatising attitudes of many healthcare providers were notable.
      Within society, lack of access to knowledge and self-care or mutual support services was evident.
      Lack of support both from and for people in caring roles was also emphasised.
      Conclusions
      - People with depression are subject to many of the same attitudes, inadequate healthcare and social barriers reported by people with psychotic disorders.
      Consumers and carers prioritise certain notions of illness, recovery and quality of healthcare and expect healthcare providers to respond to these concerns.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12065001?dopt=Abstract -&- http://www.mja.com.au/public/issues/176_10_200502/mcn10080_fm.html

    41. Extracts from "Clinical Evidence" - Chronic fatigue syndrome
      Reid et al. - BMJ 2000;320:292-296
      Cfr. : http://www.bmj.com/cgi/content/extract/320/7230/292

    42. Factor analysis of unexplained severe fatigue and interrelated symptoms - Overlap with criteria for chronic fatigue syndrome
      Nisenbaum R, Reyes M, Mawle AC, Reeves WC - Am J Epidemiol 1998; 148: 72-77

    43. Factors explaining variance in perceived pain in women with fibromyalgia
      Eva Albertsen Malt,1 Snorri Olafsson,2 Anders Lund,1 and Holger Ursin3 - 1Department of Psychiatry, University of Bergen Haukeland University Hospital, N-5022 Bergen, Norway - 2Department of Internal Medicine, University of Bergen Haukeland University Hospital, N-5022 Bergen, Norway - 3Department of Biological And Medical Psychology, Division of Physiological Psychology University of Bergen, N-5022 Bergen, Norway - Corresponding author : Eva Albertsen Malt : eva.albertsen@psych.uib.no - ; Snorri Olafsson : olafsson@online.no -; Anders Lund : anders.lund@psyk.uib.no -; Holger Ursin : Holger.Ursin@psych.uib.no - BMC Musculoskelet Disord. 2002; 3: 12.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC113754/
      - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC113754/?log%24=activity

    44. Familial aggregation of fainting in a case-control study of neurally mediated hypotension patients who present with unexplained chronic fatigue
      Lucas et al. - Europace 2006;8:846-851
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/16920765

    45. Fatigue in primary Sjogren's syndrome
      Barendregt et al. - Ann Rheum Dis 1998;57:291-295
      Cfr. : http://ard.bmj.com/cgi/content/abstract/57/5/291

    46. Fatigue in selected primary care settings - Sociodemographic and psychiatric correlates
      Hickie I, Hooker AW, Hadzi-Pavlovic D et al. - Med J Aust 1996; 164: 585-588

    47. Fatigue is significant in vasovagal syncope and is associated with autonomic symptoms
      H. Legge, M. Norton and J. L. Newton - Europace, September 1, 2008; 10(9): 1095 – 1101
      Cfr. : http://europace.oxfordjournals.org/cgi/content/abstract/eun164

    48. Fibromyalgia and chronic fatigue syndrome - Similarities and differences
      Buchwald D - Rheum Dis Clin North Am 1996; 22: 219-243

    49. Fibromyalgia and physical and emotional trauma - How are they related ? -Comment on the article by Aaron et al.
      Robert Ferrari, MD, O. Kwan, MD, Edmonton, Alberta, Canada - Arthritis Rheum. 1999 Apr; 42(4):828-30

      Cfr. : http://www3.interscience.wiley.com/journal/79503587/abstract?CRETRY=1&SRETRY=0
      This article is a comment on :
      -
      Perceived physical and emotional trauma as precipitating events in fibromyalgia - Associations with health care seeking and disability status but not pain severity
      Aaron LA, Bradley LA, Alarcón GS, Triana-Alexander M, Alexander RW, Martin MY, Alberts KR, Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham 35294-0012, USA - Arthritis Rheum. 1997 Mar;40(3):453-60

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9082933?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Neck injury and chronic pain syndromes - Comment on the article by Buskila et al.
      Ferrari R, Russell AS - Arthritis Rheum. 1998 Apr;41(4):758-9 - PMID: 9550497
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9550497?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    50. Fibromyalgia is common and adversely affects pain and fatigue perception in North Indian patients with rheumatoid arthritis
      V. Dhir, A. Lawrence, A. Aggarwal and R. Misra - J Rheumatol, November 1, 2009; 36(11): 2443 – 2448
      Cfr. : http://www.jrheum.org/content/36/11/2443.abstract

    51. Fibromyalgia syndrome a decade later - What have we learned ?
      Goldenberg - Arch Intern Med 1999;159:777-785
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10219923
      Also read the comments on this article :
      -
      Patients with fibromyalgia must be treated fairly
      Romano TJ - Arch Intern Med. 1999 Nov 8;159(20):2481-3 - PMID: 10665899
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10665899?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Fibromyalgia, chronic fatigue syndrome and Addison disease
      Baschetti R - Arch Intern Med. 1999 Nov 8;159(20):2481; author reply 2482-3 - PMID: 10665898
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10665898?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Fibromyalgia - Is recovery impeded by the internet ?
      Armstrong R, Arch Intern Med. 2000 Apr 10;160(7):1039-40 - PMID: 10761971
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10761971?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    52. Fibromyalgia, chronic fatigue syndrome and myofascial pain [review]
      Goldenberg DL - Curr Opin Rheumatol 1996; 8: 113-123

    53. Fibromyalgia, chronic fatigue syndrome and myofascial pain syndrome
      Buskila D - Curr Opin Rheumatol 2001; 13: 117-127

    54. Fifty years of treatments for bipolar disorder - A celebration of John Cade's discovery
      Mitchell PB, Hadzi-Pavlovic D, Manji K, editors - Aust N Z J Psychiatry 1999; 33 Suppl S1-S122

    55. Five-year follow-up of young people with chronic fatigue syndrome following the double blind randomised controlled intravenous gammaglobulin trial
      Rowe KS - J Chronic Fatigue Syndr 1999; 5: 97-107

    56. Fludrocortisone acetate to treat neurally mediated hypotension in chronic fatigue syndrome - A randomized controlled trial
      Rowe PC, Calkins, H, DeBusk K et al. - JAMA 2001;285:52-59
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11150109
      Also read the comments on this article :
      -
      Orthostatic hypotension and chronic fatigue syndrome
      Baschetti R - JAMA. 2001 Mar 21;285(11):1441-2; author reply 1443 - PMID: 11255414
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11255414?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      - Orthostatic hypotension and chronic fatigue syndrome
      Jay SJ - JAMA. 2001 Mar 21;285(11):1442-3 - PMID: 11255416
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11255416?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      - Orthostatic hypotension and chronic fatigue syndrome
      Friedman TC, Echeverry D, Poland RE, JAMA. 2001 Mar 21;285(11):1442; author reply 1443 - PMID: 11255415
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11255415?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    57. Follicular phase hypothalamic-pituitary-gonadal axis function in women with fibromyalgia and chronic fatigue syndrome
      Korszun A, Young EA, Engleberg NC et al. - J Rheumatol 2000; 27: 1526-1530

    58. Follow up of 200 young people with CFS - Relationship of functional outcomes to symptom patterns and psychological features
      Rowe KS, Rowe KJ - Proceedings of the 5th International Conference of the American Association of Chronic Fatigue Syndrome, Seattle Washington Jan 24-26, 2001: A92

    59. Form and frequency of mental disorders across centres
      Goldberg, DP, Lecrubier Y – In : 'Mental illness in general health care: an international study' - Ustun TB, Sartorius N (editors) – Chicester : John Wiley and Sons, 1995: 323-334

    60. Frequent HHV-6 reactivation in multiple sclerosis (MS) and chronic fatigue syndrome (CFS) patients
      Ablashi, D.V., Eastman, H.B., Owen, C.B., Roman, M.M., Friedman, J., Zabriskie, J.B., Peterson, D.L., Pearson, G.R. & Whitman, J.E. (2000) - Journal of Clinical Virology, 16, 179-191
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10738137

    61. Functional somatic syndromes
      Barsky, A.J. & Borus, J.F. (1999) - Annals of Internal Medicine, 130, 910-921

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10375340
      Also read the comments on this article :
      -
      Functional somatic syndromes
      Clemenger K - Ann Intern Med. 2000 Feb 15;132(4):327-8; author reply 329-30 - PMID: 10681292
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681292?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      McSherry J - Ann Intern Med. 2000 Feb 15;132(4):327; author reply 329-30 - PMID: 10681291
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681291?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Hedrick TE - Ann Intern Med. 2000 Feb 15;132(4):327; author reply 329-30 - PMID: 10681290

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681290?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Albrecht F - Ann Intern Med. 2000 Feb 15;132(4):328-9; author reply 329-30 - PMID: 10681296

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681296?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Goudsmit E - Ann Intern Med. 2000 Feb 15;132(4):328; author reply 329-30 - PMID: 10681294
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681294?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Clemenger A - Ann Intern Med. 2000 Feb 15;132(4):328; author reply 329-30 - PMID: 10681293

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681293?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Heard M - Ann Intern Med. 2000 Feb 15;132(4):328; author reply 329-30 - PMID: 10681295

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681295?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Functional somatic syndromes
      Kurt TL - Ann Intern Med. 2000 Feb 15;132(4):329; author reply 329-30 - PMID: 10681298
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10681298?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    62. Functional somatic syndromes - One or many ?
      Wessely S, Nimnuan C, Sharpe M - Lancet 1999; 354: 936-939

    63. Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses and healthy individuals
      Buchwald D, Pearlman T, Umali J et al. - Am J Med 1996; 171: 364-370

    64. Functional status, neuropsychological functioning and mood in chronic fatigue syndrome (CFS) - Relationship to psychiatric disorder
      Tiersky, L.A., Matheis, R.J., DeLuca, J., Lange, G. & Natelson, B.H. (2003) - J.Nerv.Ment.Dis., 191, 324-331
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12819552

    65. Gastric emptying is slow in chronic fatigue syndrome
      Burnet RB, Chatterton BE - BMC Gastroenterol ( 2004;) 4:: 32–5

    66. Gender biases underlying the social construction of illness states - The case of chronic fatigue syndrome
      J. A. Richman and L. A. Jason - Current Sociology, May 1, 2001; 49(3): 15 – 29
      Cfr. : http://csi.sagepub.com/cgi/content/abstract/49/3/15

    67. General practitioners and young suicide - A preventative role for primary care
      Appleby L, Amos T, Doyle U et al. - Br J Psychiatry 1996; 168: 330-333

    68. Generalized anxiety disorder in chronic fatigue syndrome
      Fischler B, Cluydts R, De Gucht V et al. - Acta Psychiatr Scand 1997; 95: 405-413

    69. Generation of classification criteria for chronic fatigue syndrome using an artificial neural network and traditional criteria set
      Linder R, Dinser R, Wagner M et al. - In vivo 2002; 16: 37-44
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11980359

    70. Genetic basis for individual variation in pain perception and the development of a chronic pain condition
      Diatchenko L, Slade GD, Nackley AG et al. - Hum Mol Genet. 2005;14 :135 –143
      Cfr. :
      http://hmg.oxfordjournals.org/cgi/content/abstract/14/1/135

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel VII

    1. Growth hormone as concomitant treatment in severe fibromyalgia associated with low IGF-1 serum levels - A pilot study
      Cuatrecasas G, Riudavets C, Güell MA, Nadal A, Servicio de Endocrinología y Nutrición, Centro Médico Teknon, Vilana 12, E-08022 Barcelona, Spain : endocrinologia@teknon.es - BMC Musculoskelet Disord. 2007 Nov 30;8:119 - PMID: 18053120 – Trial registration : NCT00497562 (ClinicalTrials.gov)
      Background - There is evidence of functional growth hormone (GH) deficiency, expressed by means of low insulin-like growth factor 1 (IGF-1) serum levels, in a subset of fibromyalgia patients.
      The efficacy of GH versus placebo has been previously suggested in this population.
      We investigated the efficacy and safety of low dose GH as an adjunct to standard therapy in the treatment of severe, prolonged and well-treated fibromyalgia patients with low IGF-1 levels.
      Methods
      - Twenty-four patients were enrolled in a randomized, open-label, best available care-controlled study.
      Patients were randomly assigned to receive either 0.0125 mg/kg/d of GH subcutaneously (titrated depending on IGF-1) added to standard therapy or standard therapy alone during one year.
      The number of tender points, the Fibromyalgia Impact Questionnaire (FIQ) and the EuroQol 5D (EQ-5D), including a Quality of Life visual analogic scale (EQ-VAS) were assessed at different time-points.
      Results
      - At the end of the study, the GH group showed a 60% reduction in the mean number of tender points (pairs) compared to the control group (p < 0.05; 3.25 +/- 0.8 vs. 8.25 +/- 0.9).
      Similar improvements were observed in FIQ score (p < 0.05) and EQ-VAS scale (p < 0.001).
      There was a prompt response to GH administration, with most patients showing improvement within the first months in most of the outcomes.
      The concomitant administration of GH and standard therapy was well tolerated and no patients discontinued the study due to adverse events.
      Conclusion
      - The present findings indicate the advantage of adding a daily GH dose to the standard therapy in a subset of severe fibromyalgia patients with low IGF-1 serum levels.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/18053120?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_PMC&linkpos=3&log$=citedinpmcarticles&logdbfrom=pubmed

    2. Guidelines for the development and implementation of clinical practice guidelines
      National Health and Medical Research Council - Canberra: NHMRC, Oct 1995

    3. Gulf War syndrome, chronic fatigue syndrome and the multiple chemical sensitivity syndrome - Stirring the cauldron of confusion
      Meggs WJ - Arch Environ Health 1999; 54: 309-311

    4. Gulf War veterans' health - Medical evaluation of a U.S. cohort
      S. A. Eisen, H. K. Kang, F. M. Murphy, M. S. Blanchard, D. J. Reda, W. G. Henderson, R. Toomey, L. W. Jackson, R. Alpern, B. J. Parks et al. - Ann Intern Med, June 7, 2005; 142(11): 881 - 890
      Cfr. :
      http://www.annals.org/cgi/content/abstract/142/11/881

    5. Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups
      Komaroff AL, Fagioli LR, Doolittle TH et al. - Am J Med 1996; 101: 281-290

    6. Helpfulness of interventions for mental disorders - Beliefs of health professionals compared with the general public
      Jorm AF, Korten AE, Jacomb PA et al. - Br J Psychiatry 1997; 171: 233-237

    7. High frequency of autoantibodies to insoluble cellular antigens in patients with chronic fatigue syndrome
      von Mikecz A, Konstantinov K, Buchwald DS et al. - Arthritis Rheum 1997; 40: 295-305

    8. Hormonal influences on stress-induced neutrophil mobilization in health and chronic fatigue syndrome
      Cannon JG, Angel JB, Abad LW et al. - J Clin Immunol 1998; 18: 291-298

    9. Hormonal responses to exercise in chronic fatigue syndrome- Defining melancholia - Properties of a refined sign-based measure
      Ottenweller JE, Sisto SA, McCarty RC et al. - Neuropsychobiology 2001; 43: 34-41

    10. How many functional somatic syndromes ?
      Nimnuan C, Rabe-Hesketh S, Wessely S, Hotopf M - J Psychosom Res 2001; 51: 549-557

    11. How significant are primary sleep disorders and sleepiness in the chronic fatigue syndrome ?
      Le Bon O, Hoffmann G, Murphy J et al. - Sleep Res Online 2000; 3: 43-48

    12. Human herpesvirus 6 and human herpesvirus 7 in chronic fatigue syndrome
      DiLuca D, Zorzenon M, Mirandola P et al. - J Clin Microbiol 1995; 33: 1660-1661

    13. Human herpesvirus type 6 and chronic fatigue syndrome
      P. H. Levine and A. L. Komaroff - Arch Intern Med, March 8, 1993; 153(5): 661 – 661

      Cfr. : http://archinte.ama-assn.org/cgi/content/summary/153/5/661

    14. Human herpesviruses 6 and 7 in chronic fatigue syndrome - A case-control study
      Reeves WC, Stamey FR, Black JB et al. - Clin Infect Dis 2000; 31: 48-52

    15. Human herpesviruses in chronic fatigue syndrome
      Wallace HL 2nd, Natelson B, Gause W et al. - Clin Diagn Lab Immunol 1999; 6: 216-223

    16. Hypothalamic-pituitary-adrenal axis reactivity in chronic fatigue syndrome and health under psychological, physiological and pharmacological stimulation
      Gaab J, Hüster D, Peisen R, Engert V, Heitz V, Schad T, Schürmeyer TH, Ehlert U, Center for Psychobiological and Psychosomatic Research, University of Trier, Trier, Germany : jgaab@klipsy.unizh.ch - Psychosom Med. 2002 Nov-Dec;64(6):951-62 - PMID: 12461200
      Objectives - Subtle alterations of the hypothalamic-pituitary-adrenal (HPA) axis in chronic fatigue syndrome (CFS) have been proposed as a shared pathway linking numerous etiological and perpetuating processes with symptoms and observed physiological abnormalities.
      Because the HPA axis is involved in the adaptive responses to stress and CFS patients experience a worsening of symptoms after physical and psychological stress, we tested HPA axis functioning with three centrally acting stress tests.
      Methods
      - We used two procedures mimicking real-life stressors and compared them with a standardized pharmacological neuroendocrine challenge test.
      CFS patients were compared with healthy control subjects regarding their cardiovascular and endocrine reactivity in a psychosocial stress test and a standardized exercise test and their endocrine response in the insulin tolerance test (ITT).
      Results
      - Controlling for possible confounding variables, we found significantly lower ACTH response levels in the psychosocial stress test and the exercise test and significantly lower ACTH responses in the ITT, with no differences in plasma total cortisol responses.
      Also, salivary-free cortisol responses did not differ between the groups in the psychosocial stress test and the exercise test but were significantly higher for the CFS patients in the ITT.
      In all tests CFS patients had significantly reduced baseline ACTH levels.
      Conclusions
      - These results suggest that CFS patients are capable of mounting a sufficient cortisol response under different types of stress but that on a central level subtle dysregulations of the HPA axis exist.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12461200?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed

    17. Hypothalamic-pituitary-gonadal axis hormones and cortisol in both menstrual phases of women with chronic fatigue syndrome and effect of depressive mood on these hormones
      Cevik R, Gur A, Acar S, Nas K, Sarac AJ - BMC Musculoskelet Disord ( 2004;) 5:: 47–53

    18. Hypothalamo-pituitary-adrenal axis dysfunction in chronic fatigue syndrome and the effects of low-dose hydrocortisone therapy
      Cleare AJ, Miell J, Heap E et al. - J Clin Endocrinol Metab 2001; 86: 3545-3554

    19. Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution
      Reeves WC, Lloyd A, Vernon SD, Klimas N, Jason LA, Bleijenberg G et al. (International Chronic Fatigue Syndrome Study Group) - BMC Health Serv Res ( 2003;) 3:: 25–34

    20. Identification of responsible volatile chemicals that induce hypersensitive reactions to multiple chemical sensitivity patients
      Shinohara N, Mizukoshi A, Yanagisawa Y - J Expo Anal Environ Epidemiol 2004;14:84–91
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/14726947?dopt=Abstract

    21. Identification of suicide risk factors using epidemiologic studies
      Moscicki EK - Psychiatr Clin North Am 1997; 20: 499-518

    22. Identification of the ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution
      Reeves WC, Lloyd A, Vernon SD for the International Chronic Fatigue Syndrome Study Group - BMC Health Serv Res 2003; 3: 25

    23. IgE levels are the same in chronic fatigue syndrome (CFS) and control subjects when stratified by allergy skin test results and rhinitis types
      Repka-Ramirez MS, Naranch K, Park YJ et al. - Ann Allergy Asthma Immunol 2001; 87: 218-221

    24. IgM serum antibodies to Epstein-Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome
      Lerner, A.M., Beqaj, S.H., Deeter, R.G. & Fitzgerald, J.T. (2004) - In Vivo, 18, 101-106
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15113035

    25. Illness beliefs and treatment outcome in chronic fatigue syndrome
      Deale, A., Chalder, T. & Wessely, S. (1998) - Journal of Psychosomatic Research, 45, 77-83
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9720857

    26. Illness from low levels of environmental chemicals - Relevance to chronic fatigue syndrome and fibromyalgia
      Bell IR, Baldwin CM, Schwartz GE - Am J Med 1998; 105: 74S-82S

    27. Illness onset characteristics in children with CFS and idiopathic chronic fatigue
      Bell DS - J Chronic Fatigue Syndr 1997; 3: 43-51

    28. Illness or disease ? - The case of chronic fatigue syndrome
      Lloyd AR, Hickie IB, Loblay RH - Med J Aust 2000; 172: 471-472
      Cfr. : http://www.mja.com.au/public/issues/172_10_150500/lloyd/lloyd.html

    29. Illness or disease ? The case of chronic fatigue syndrome
      Lloyd AR, Hickie IB, Loblay RH - Med J Aust 2000; 172: 471-472
      Cfr. :
      http://www.mja.com.au/public/issues/172_10_150500/lloyd/lloyd.html

    30. Illness perceptions and mood in chronic fatigue syndrome
      Edwards R, Suresh R, Lynch S et al. - J Psychosom Res 2001; 50: 65-68

    31. Immune responses associated with chronic fatigue syndrome - A case-control study
      Mawle AC, Nisenbaum R, Dobbins JG et al. - J Infect Dis 1997; 175: 136-141

    32. Immunoglobulin subclass levels in chronic fatigue syndrome
      Bennett AL, Fagioli LR, Schur PH et al. - J Clin Immunol 1996; 16: 315-320

    33. Immunologic and psychologic therapy for patients with chronic fatigue syndrome - A double blind, placebo controlled trial
      Lloyd, A., Hickie, I., Brockman, A., Hickie, C., Wilson, A., Dryer, J. & Wakefield, D. (1993) - American Journal of Medicine, 94, 197-203
      Cfr. : http://linkinghub.elsevier.com/retrieve/pii/000293439390183P

    34. Immunologic aspects of chronic fatigue syndrome
      Gerrity TR, Papanicolaou DA, Amsterdam JD, Bingham S, Grossman A, Hedrick T et al. - Neuroimmunomodulation ( 2004;) 11:: 351–57

    35. Immunologic parameters in chronic fatigue syndrome, major depression and multiple sclerosis
      Natelson BH, LaManca JJ, Denny TN et al. - Am J Med 1998; 105: 43S-49S

    36. Immunological response in chronic fatigue syndrome following a graded exercise test to exhaustion
      LaManca JJ, Sisto SA, Zhou XD et al. - J Clin Immunol 1999; 19: 135-142

    37. Impaired effortful cognition in depression
      Tancer ME, Brown TM, Evans DL, Ekstrom D, Haggerty JJ, Jr, Pedersen C, Golden RN - Psychiatry Res. 1990 Feb;31(2):161–168
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2326395

    38. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo
      I. R. Bell1,2,3,4,6,8, D. A. Lewis, II9, A. J. Brooks3, G. E. Schwartz3,5,6, S. E. Lewis9, B. T. Walsh4 and C. M. Baldwin3,4,7,8 - 1Program in Integrative Medicine - 2Departments of Psychiatry – 3Psychology – 4Medicine – 5Neurology - 6Surgery, the - 7Arizona Respiratory Center and the - 8Mel and Enid Zuckerman Arizona College of Public Health at the University of Arizona, Tucson, Arizona and - 9Saybrook Graduate School and Research Institute, San Francisco, California, USA - Correspondence to : I. R. Bell, Program in Integrative Medicine, The University of Arizona Health Sciences Center, 1249 N. Mountain Avenue, Tucson, AZ 85719, USA : IBELL@U.ARIZONA.EDU - Rheumatology 2004; 43: 577-582 - Rheumatology Vol. 43 No. 5 (c) British Society for Rheumatology 2004

      Cfr. : http://rheumatology.oxfordjournals.org/cgi/content/abstract/43/5/577

    39. Improving the quality of reporting of randomized controlled trials
      Begg C, Cho M, Eastwood S, Horton R et al. - JAMA 1996; 276: 637-639

    40. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients
      See DM, Broumand N, Sahl L, Tilles JG. - Immunopharmacology ( 1997;) 35:: 229–35

    41. Incidence, prognosis and risk factors for fatigue and chronic fatigue syndrome in adolescents – A prospective community study
      K. A. Rimes, R. Goodman, M. Hotopf, S. Wessely, H. Meltzer and T. Chalder - Pediatrics, March 1, 2007; 119(3): e603 – e609
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/17332180

    42. Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever
      White PD, Thomas JM, Amess J et al. - Br J Psychiatry 1998; 173: 475-481

    43. Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever
      White, P.D., Thomas, J.M., Amess ,J., Crawford, D.H., Grover, S.A., Kangro, H.O. & Clare, A.W. (1998) - British Journal of Psychiatry, 173, 475-481
      Cfr. : http://bjp.rcpsych.org/cgi/content/abstract/173/6/475

    44. Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome
      F. P. de Lange, A. Koers, J. S. Kalkman, G. Bleijenberg, P. Hagoort, J. W. M. van der Meer and I. Toni - Brain, August 1, 2008; 131(8): 2172 – 2180
      Cfr. : http://brain.oxfordjournals.org/cgi/content/abstract/131/8/2172

    45. Increased brain serotonin function in men with chronic fatigue syndrome
      Sharpe M, Hawton K, Clements A et al. - BMJ 1997; 315: 164-165

    46. Increased prolactin response to buspirone in chronic fatigue syndrome
      Sharpe M, Clements A, Hawton K et al. - J Affect Disord 1996; 41: 71-76

    47. Influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome
      LaManca, J.J., Sisto, S.A., DeLuca, J., Johnson, S.K., Lange, G., Pareja,J ., Cook, S. & Natelson, B.H. (1998) - American Journal of Medicine, 105, 59S-65S
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/9790484

    48. Information processing efficiency in chronic fatigue syndrome and multiple sclerosis
      DeLuca J, Johnson SK, Natelson BH - Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark - Arch Neurol. 1993 Mar;50(3):301-4
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8442710

    49. Information processing in chronic fatigue syndrome - A preliminary investigation of suggestibility
      DiClementi JD, Schmaling KB, Jones JF - J Psychosom Res 2001; 51: 679-686

    50. Insulin-like growth factor-I (somatomedin C) levels in chronic fatigue syndrome and fibromyalgia
      Buchwald D, Umali J, Stene M - J Rheumatol 1996; 23: 739-742

    51. Interferon-induced proteins are elevated in blood samples of patients with chemically or virally induced chronic fatigue syndrome
      Vojdani A, Lapp CW - Immunopharmacol Immunotoxicol 1999; 21: 175-202

    52. Interleukin-1 beta, Interleukin-1 receptor antagonist and soluble Interleukin-1 receptor type II secretion in chronic fatigue syndrome
      Cannon JG, Angel JB, Abad LW et al. - J Clin Immunol 1997; 17: 253-261

    53. International Mid-Term Review of the Second National Mental Health Plan for Australia. Canberra
      Thornicroft G, Betts V - Mental Health and Special Programs Branch, Department of Health and Ageing, 2002

    54. Interventions for the treatment and management of chronic fatigue syndrome - A systematic review
      Whiting P, Bagnall A, Sowden AJ et al. - JAMA 2001; 286: 1360-1368
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11560542?dopt=Abstract

    55. Intravenous immunoglobulin is ineffective in the treatment of patients with chronic fatigue syndrome
      Vollmer-Conna U, Hickie I, Hadzi-Pavlovic D et al. - Am J Med 1997; 103: 38-43

    56. Intravenous immunoglobulin is ineffective in the treatment of patients with chronic fatigue syndrome
      Vollmer-Conna U, Hickie I, Hadzi-Pavlovic D, Tymms K, Wakefield D, Dwyer J et al. - Am J Med ( 1997;) 103:: 38–43

    57. Investigation by polymerase chain reaction of enteroviral infection in patients with chronic fatigue syndrome
      McArdle A, McArdle M, Jackson MJ et al. - Clin Sci 1996; 90: 295-300

    58. Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women
      Brutsaert TD, Hernandez-Cordero S, Rivera J, Viola T, Hughes G, Haas JD - Am J Clin Nutr ( 2003;) 77:: 441–8

    59. Is chronic fatigue syndrome (CFS/ME) heritable in children and if so, why does it matter ?
      E. Crawley and G. Davey Smith - Arch. Dis. Child., December 1, 2007; 92(12): 1058 – 1061
      Cfr. : http://adc.bmj.com/cgi/content/extract/92/12/1058/?precisblog

    60. Is perfectionism associated with fatigue ?
      Magnusson AE, Nias DKB, White PD - J Psychosom Res 1996; 41: 377-383

    61. Is there a postinfection fatigue syndrome ?
      Hickie I, Lloyd A, Wakefield D, Ricci C - Aust Fam Physician 1996; 25: 1847-1852

    62. It's not all in ME mind, doc
      E. Crawley and T. Chambers - Arch. Dis. Child. Ed. Pract., December 1, 2005; 90(4): ep92 - ep97
      Cfr. : http://ep.bmjjournals.com/cgi/content/extract/90/4/ep92

    63. Lack of association between HLA genotype and chronic fatigue syndrome
      Underhill JA, Mahalingam M, Peakman M, Wessely S - Eur J Immunogen 2001; 28: 425-428

    64. Life-events and the course of chronic fatigue syndrome
      Ray C, Jefferies S, Weir WRC - Br J Med Psychol 1995; 68: 323-331

    65. Living a healthy life with chronic conditions
      Lorig, K., Halsted, H., Sobel, D., Laurent, D., Gonzalez, V. & Minor, M. (2000) - Bull Publishing, Boulder CO
      Cfr. : http://www.bullpub.com/chronic.html

    66. Living a healthy life with chronic conditions - Self-management of heart disease, arthritis, diabetes, asthma, bronchitis, emphysema & others
      Halsted, M.D. Holman, David Sobel, Diana Laurent, Virginia Gonzalez, Marian, Ph.D. Minor, Kate Lorig - Publishers Group West (2 edition), August 15, 2000 – ISBN-10 : 0923521534 – ISBN-13 : 978-0923521530
      Drawing on input from people with long-term ailments, this book points the way to achieving the best possible life under the circumstances.
      Cfr. :
      http://www.amazon.com/Living-Healthy-Life-Chronic-Conditions/dp/0923521534

    67. Long-and short-term blood pressure and RR-interval variability and psychosomatic distress in chronic fatigue syndrome
      Duprez DA, De Buyzere ML, Drieghe B et al. - Clin Sci 1998; 94: 57-63

    68. Longitudinal analysis of symptoms reported by patients with chronic fatigue syndrome
      Nisenbaum R, Jones A, Jones J et al. - Ann Epidemiol 2000; 10: 458

    69. Longitudinal assessment of neuropsychological functioning, psychiatric status, functional disability and employment status in chronic fatigue syndrome
      Tiersky LA, DeLuca J, Hill N et al. - Appl Neuropsych 2001; 8: 41-50

    70. Low-dose hydrocortisone for chronic fatigue syndrome
      Baschetti et al. - JAMA 1999;281:1887-1889
      Cfr. : http://jama.ama-assn.org/cgi/content/extract/281/20/1887

    71. Low-dose hydrocortisone for treatment of chronic fatigue syndrome - A randomized controlled trial
      McKenzie R, O'Fallen A, Dale J et al. - JAMA 1998; 280: 1061-1066

    72. Low-dose hydrocortisone in chronic fatigue syndrome - A randomised crossover trial
      Cleare AJ, Heap E, Malhi GS, Wessely S, O’Keane V, Miell J - Lancet ( 1999;) 353:: 455–8

    73. Lower ambulatory blood pressure in chronic fatigue syndrome
      J. L. Newton, A. Sheth, J. Shin, J. Pairman, K. Wilton, J. A. Burt and D. E. J. Jones - Psychosom Med, April 1, 2009; 71(3): 361 – 365
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/19297309

    74. Lower standing systolic blood pressure as a predictor of falls in the elderly: a community-based prospective study
      Kario et al. - J Am Coll Cardiol 2001;38:246-252
      Cfr. : http://content.onlinejacc.org/cgi/content/abstract/38/1/246

    75. Lymphocyte subsets, apoptosis and cytokines in patients with chronic fatigue syndrome
      Swanink CMA, Vercoulen JHMM, Galama JMD et al. - J Infect Dis 1996; 173: 460-463

    76. Malgic Encephalitis/Chronic Fatigue Syndrome - Clinical working case definition diagnostic and treatment protocols - A consensus document
      Carruthers, B.M., Jain, A.K., De Meirleir, K., Peterson, D.L., Klimas, N., Lerner, A.M., Bested, A.C., Flor-Henry, P., Joshi, P., Powles, A.C.P., Sherkey, J.A. & van de Sande, M.I. (2003) - Journal of Chronic Fatigue Syndrome 11[1], 7-116
      Cfr. : http://www.mefmaction.net/Portals/0/docs//psychiatricguidelinesstein.pdf

    77. Managing chronic fatigue syndrome in children - Liaise with family and teachers to keep morale high and minimise disability
      Marcovitch H - BMJ 1997; 314: 1635-1636

    78. Markers of inflammation and immune activation in chronic fatigue and chronic fatigue syndrome
      Buchwald D, Wener MH, Pearlman T, Kith P - J Rheumatol 1997; 24: 372-376

    79. Maximal oxygen uptake and lactate metabolism are normal in chronic fatigue syndrome
      Sargent C, Scroop GC, Nemeth PM et al. - Med Sci Sports Exerc 2002; 34: 51-56

    80. Medical evaluation of Persian Gulf veterans with fatigue and/or chemical sensitivity
      Pollet C, Natelson BH, Lange G et al. - J Med 1998; 29: 101-113

    81. Medicalisation reconsidered - Toward a collaborative approach to care
      Broom DH, Woodward R - Soc Health Illness 1996; 18: 357-378

    82. Melatonin levels in women with fibromyalgia and chronic fatigue syndrome
      Korszun A, Sackett-Lundeen L, Papadopoulos E et al. - J Rheumatol 1999; 26: 2675-2680

    83. Memory deficits associated with chronic fatigue immune dysfunction syndrome
      Sandman CA, Barron JL, Nackoul K, Goldstein J, Fidler F - Biol Psychiatry. 33(8-9):618–623
      Cfr. : http://www.journals.elsevierhealth.com/periodicals/bps/article/PII000632239390100R/ab
      stract

    84. Memory functioning in patients with primary fibromyalgia and major depression and healthy controls
      Landro NI, Stiles TC, Sletvold H - J Psychosom Res 1997; 42: 297-306

    85. Mental disorders in a population sample with musculoskeletal disorders
      Patten SB, Williams JV, Wang J. BMC Musculoskelet Disord. 2006 Apr 25; 7:37. Epub 2006 Apr 25
      Cfr. : http://www.biomedcentral.com/1471-2474/7/37

    86. Mental health - Statement of rights and responsibilities
      Mental Health Consumer Outcomes Task Force - Canberra: AGPS, 1991

    87. Mental health literacy - An impediment to the optimum treatment of major depression in the community
      Goldney RD, Fisher LJ, Wilson DH - J Affect Disord 2001: 64; 277-284

    88. Mental health literacy - Public knowledge and beliefs about mental disorders
      Jorm AF - Br J Psychiatry 2000; 177: 396-401

    89. Mental health literacy - An impediment to the optimum treatment of major depression in the community
      Goldney RD, Fisher LJ, Wilson DH - J Affect Disord 2001; 64: 277-284

    90. Mental health literacy" - A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment
      Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P, NHMRC Social Psychiatry Research Unit, Australian National University, Canberra, ACT : Anthony.Jorm@anu.edu.au - Med J Aust. 1997 Feb 17;166(4):182-6 - PMID: 9066546

      Objectives - To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy").
      Design
      - A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia.
      Participants
      - A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette.
      Results
      - Most of the participants recognised the presence of some sort of mental disorder : 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%).
      When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so.
      Corresponding data for the schizophrenia vignette were : counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%).
      Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems).
      Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics.
      Conclusion
      - If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised.
      Further, public understanding of psychiatric treatments can be considerably improved.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/9066546?dopt=Abstract

    91. Midodrine treatment for chronic fatigue syndrome
      Naschitz et al. - Postgrad. Med. J. 2004;80:230-232
      Cfr. : http://pmj.bmj.com/cgi/content/abstract/80/942/230

    92. Mirrored symptoms in mother and child with chronic fatigue syndrome
      E. M. van de Putte, L. J. P. van Doornen, R. H. H. Engelbert, W. Kuis, J. L. L. Kimpen and C. S. P. M. Uiterwaal - Pediatrics, June 1, 2006; 117(6): 2074 - 2079
      Cfr. : http://pediatrics.aappublications.org/cgi/content/abstract/117/6/2074

    93. Monitoring awareness of and attitudes to depression in Australia
      Highet NJ, Hickie IB, Davenport TA - Med J Aust 2002; 176 Suppl May 20: S63-S68
      Cfr. : http://www.mja.com.au/public/issues/176_10_200502/hig10079_fm.html

    94. Monozygotic twins discordant for chronic fatigue syndrome - Regional cerebral blood flow spect
      Lewis DH, Mayberg HS, Fischer ME et al. - Radiology 2001; 219: 766-773

    95. Multi-symptom illnesses, unexplained illness and Gulf War Syndrome
      K. Ismail and G. Lewis - Phil Trans R Soc B, April 29, 2006; 361(1468): 543 – 551
      Cfr. : http://rstb.royalsocietypublishing.org/content/361/1468/543.abstract

    96. Multiple chemical sensitivity - A 1999 consensus
      Arch.Environ.Health, 54, 147-149
      Cfr. : http://www.mindfully.org/Health/MCS-1999-Definition.htm

    97. Multiple chemical sensitivity and chronic fatigue syndrome in British Gulf War veterans
      Reid S, Hotopf M, Hull L et al. - Am J Epidemiol 2001; 153: 604-609

    98. Multiple chemical sensitivity/idiopathic environmental intolerance
      Sparks PJ, editor - Occupational Medicine - State of the Art Reviews. Vol. 15. Philadelphia: Hanley & Belfus Medical Publishers, 2000

    99. Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients - Association with signs and symptoms
      Nicolson,G.L., Gan,R. & Haier,J. (2003) - APMIS, 111, 557-566
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12887507

    100. Multiple mycoplasmal infections detected in blood of patients with chronic fatigue syndrome and/or fibromyalgia syndrome
      Nasralla M, Haier J, Nicolson GL - Eur J Clin Microbiol Infect Dis 1999; 18: 859-865

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel VIII

    1. Multiplex PCR for the detection of Mycoplasma fermentans, M. hominis and M. penetrans in cell cultures and blood samples of patients with chronic fatigue syndrome
      Choppa, P.C., Vojdani, A., Tagle, C., Andrin, R. & Magtoto, L. (1998) - Molecular & Cellular Probes, 12, 301-308
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9778455

    2. Muscle endurance, twitch properties, voluntary activation and perceived exertion in normal subjects and patients with chronic fatigue syndrome
      Lloyd AR, Gandevia SC, Hales JP - Brain 1991; 114: 85-98

    3. Muscle fibre characteristics and lactate responses to exercise in chronic fatigue syndrome
      Lane RJM, Barrett MC, Woodrow D et al. - J Neurol Neurosurg Psychiatry 1998; 64: 362-367

    4. Myalgic encephalomyelitis/ chronic fatigue syndrome - Clinical working case definition, diagnostic and treatment protocols
      Carruthers BM, Jain AK, De Meirleir KL et al. - J Chron Fatigue Synd 2003; 11(1): 7-115
      Cfr. :
      -
      http://www.cfids-cab.org/MESA/ccpccd.pdf
      - www.mefmaction.net/documents/journal.pdf

    5. Naloxone-mediated activation of the hypothalamic-pituitary-adrenal axis in chronic fatigue syndrome
      Scott LV, Burnett F, Medbak S et al. - Psychol Med 1998; 28: 285-292

    6. Natural history of severe chronic fatigue syndrome
      Hill NF, Tiersky LA, Scavalla VR et al. - Arch Phys Med Rehabil 1999; 80: 1090-1094

    7. Natural killer cells and natural killer cell activity in chronic fatigue syndrome
      Whiteside, T.L. & Friberg, D. (1998) - American Journal of Medicine, 105, 27S-34S
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9790479

    8. Neurally mediated hypotension and chronic fatigue syndrome
      Rowe, P.C. & Calkins, H. (1998) - American Journal of Medicine, 105, 15S-21S
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9790477

    9. Neurally mediated hypotension in systemic lupus erythematosus patients with fibromyalgia
      Tang et al. - Rheumatology (Oxford) 2004;43:609-614
      Cfr. : http://rheumatology.oxfordjournals.org/cgi/content/abstract/43/5/609

    10. Neurasthenia - Prevalence, disability and health care characteristics in the Australian community
      Hickie I, Davenport T, Issakidis C, Andrews G, School of Psychiatry, University of New South Wales, Sydney, Australia : ian.hickie@beyondblue.org.au - Br J Psychiatry. 2002 Jul;181:56-61 - PMID: 12091264
      Background - Neurasthenia imposes a high burden on primary medical health care systems in all societies.
      Aims
      - To determine the prevalence of ICD-10 neurasthenia and associated comorbidity, disability and health care utilisation.
      Method
      - Utilisation of a national sample of Australian households previously surveyed using the Composite International Diagnostic Interview and other measures.
      Results
      - Prolonged and excessive fatigue was reported by 1465 people (13.29% of the sample).
      Of these, one in nine people meet current ICD-10 criteria for neurasthenia.
      Comorbidity was associated with affective, anxiety and physical disorders.
      People with neurasthenia alone (<0.5% of the population) were less disabled and used less services than those with comorbid disorders.
      Conclusions
      - Fatigue is frequent in the Australian community and is common in people attending general practice.
      Neurasthenia is disabling and demanding of services largely because of its comorbidity with other mental and physical disorders.
      Until a remedy for persistent fatigue is provided, doctors should take an active psychological approach to treatment.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12091264?dopt=Abstract
      Also read the comment on this article :
      Chronic fatigue syndrome or neurasthenia ?
      Bailly L - Br J Psychiatry. 2002 Oct;181:350-1 - PMID: 12356666
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12356666?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    11. Neurasthenia and chronic fatigue syndrome - The role of culture in the making of a diagnosis
      Abbey, S.E. & Garfinkel, P.E. (1991) - American Journal of Psychiatry, 148, 1638-1646
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1957925
      Also read the comments on this article :
      -
      Taking chronic fatigue syndrome seriously
      Goodrich W - Am J Psychiatry. 1992 Dec;149(12):1753; author reply 1756-7 - PMID: 1443259
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1443259?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Bell DS - Am J Psychiatry. 1992 Dec;149(12):1753; author reply 1756-7 - PMID: 1294140
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1294140?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Kaplan KH, Goldenberg DL, Galvin-Nadeau M - Am J Psychiatry. 1992 Dec;149(12):1754; author reply 1756-7 - PMID: 1443261
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1443261?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Apfelbaum B - Am J Psychiatry. 1992 Dec;149(12):1754; author reply 1756-7 - PMID: 1443260
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1443260?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Hickie I, Lloyd A, Wilson A, Wakefield D - Am J Psychiatry. 1992 Dec;149(12):1755-6; author reply 1756-7 - PMID: 1294141

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1294141?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Saltzstein B, Gurwitt A, Webster W, Barrett SN - Am J Psychiatry. 1992 Dec;149(12):1755; author reply 1756-7 - PMID: 1443262

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1443262?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Taking chronic fatigue syndrome seriously
      Fallon BA, Liebowitz MR, Klein DF - Am J Psychiatry. 1992 Dec;149(12):1756; author reply 1756-7 - PMID: 1443263

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1443263?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    12. Neurasthenia in a longitudinal cohort study of young adults
      Merikangas K, Angst J - Psychol Med 1994; 24: 1013-1024

    13. Neurasthenia revisited
      Hickie I, Davenport T, Issakidis C, Andrews G - Br J Psychiatry 2002; 181: 56-61
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12091264?dopt=Abstract

    14. Neurobehavioral properties of chemical sensitivity syndromes
      Weiss B - Neurotoxicology 1998; 19: 259-268

    15. Neurocognitive abilities for a clinically depressed sample versus a matched control group of normal individuals
      Grossman I, Kaufman AS, Mednitsky S, Scharff L, Dennis B - Psychiatry Res. 1994 Mar;51(3):231–244
      Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=3977145

    16. Neuroedocrine aspects of chronic fatigue syndrome - A commentary
      Demitrack MA - Am J Med 1998; 105: 11S-14S

    17. Neuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome
      Neeck G, Crofford LJ, Department of Rheumatology, University of Giessen, Bad Nauheim, Germany : gunther.neeck@kerckhoff.med.uni-giessen.de - Rheum Dis Clin North Am. 2000 Nov;26(4):989-1002 - PMID: 11084955
      A large body of data from a number of different laboratories worldwide has demonstrated a general tendency for reduced adrenocortical responsiveness in CFS.
      It is still not clear if this is secondary to CNS abnormalities leading to decreased activity of CRH- or AVP-producing hypothalamic neurons.
      Primary hypofunction of the CRH neurons has been described on the basis of genetic and environmental influences.
      Other pathways could secondarily influence HPA axis activity, however.
      For example, serotonergic and noradrenergic input acts to stimulate HPA axis activity.
      Deficient serotonergic activity in CFS has been suggested by some of the studies as reviewed here.
      In addition, hypofunction of sympathetic nervous system function has been described and could contribute to abnormalities of central components of the HPA axis.
      One could interpret the clinical trial of glucocorticoid replacement in patients with CFS as confirmation of adrenal insufficiency if one were convinced of a positive therapeutic effect.
      If patient symptoms were related to impaired activation of central components of the axis, replacing glucocorticoids would merely exacerbate symptoms caused by enhanced negative feedback.
      Further study of specific components of the HPA axis should ultimately clarify the reproducible abnormalities associated with a clinical picture of CFS.
      In contrast to CFS, the results of the different hormonal axes in FMS support the assumption that the distortion of the hormonal pattern observed can be attributed to hyperactivity of CRH neurons.
      This hyperactivity may be driven and sustained by stress exerted by chronic pain originating in the musculoskeletal system or by an alteration of the CNS mechanism of nociception.
      The elevated activity of CRH neurons also seems to cause alteration of the set point of other hormonal axes.
      In addition to its control of the adrenal hormones, CRH stimulates somatostatin secretion at the hypothalamic level, which, in turn, causes inhibition of growth hormone and thyroid-stimulating hormone at the pituitary level.
      The suppression of gonadal function may also be attributed to elevated CRH because of its ability to inhibit hypothalamic luteinizing hormone-releasing hormone release; however, a remote effect on the ovary by the inhibition of follicle-stimulating hormone-stimulated estrogen production must also be considered.
      Serotonin (5-HT) precursors such as tryptophan (5-HTP), drugs that release 5-HT or drugs that act directly on 5-HT receptors stimulate the HPA axis, indicating a stimulatory effect of serotonergic input on HPA axis function.
      Hyperfunction of the HPA axis could also reflect an elevated serotonergic tonus in the CNS of FMS patients.
      The authors conclude that the observed pattern of hormonal deviations in patients with FMS is a CNS adjustment to chronic pain and stress, constitutes a specific entity of FMS and is primarily evoked by activated CRH neurons.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11084955?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=3&log$=relatedreviews&logdbfrom=pubmed

    18. Neuroendocrine responses to d-fenfluramine and insulin-induced hypoglycemia in chronic fatigue syndrome
      Bearn J, Allain T, Coskeran P et al. - Biol Psychiatry 1995; 37: 245-252

    19. Neurological disorders in Gulf War veterans
      M. R Rose and K. A. Brix - Phil Trans R Soc B, April 29, 2006; 361(1468): 605 - 618
      Cfr. : http://rstb.royalsocietypublishing.org/content/361/1468/605.abstract

    20. Neuropsychological and psychological functioning in chronic fatigue syndrome
      Kane RL, Gantz NM, Dipino RK - Neuropsychiatr Neuropsychol Behav Neurol 1997; 10: 25-31

    21. Neuropsychological deficits in chronic fatigue syndrome - Artifact or reality ?
      Moss-Morris R, Petrie KJ, Large RG, Kydd RR - J Neurol Neurosurg Psychiatry 1996; 60: 474-477

    22. Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis and depression
      DeLuca J, Johnson SK, Beldowicz D, Natelson BH - J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):38–43
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/7823065

    23. New classification of haemodynamics of vasovagal syncope: beyond the VASIS classification - Analysis of the pre-syncopal phase of the tilt test without and with nitroglycerin challenge
      Brignole et al. - Europace 2000;2:66-76
      Cfr. : http://europace.oxfordjournals.org/cgi/content/abstract/2/1/66

    24. NIH conference - Chronic fatigue syndrome research - Definition and medical outcome assessment
      Schluederberg A, Straus SE, Peterson P, Blumenthal S, Komaroff AL, Spring SB, Landay A, Buchwald D - Ann Intern Med. 1992 Aug 15;117(4):325–331
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1322076

    25. No evidence of active infection with human herpesvirus 6 (HHV-6) or HHV-8 in chronic fatigue syndrome
      Enbom M, Linde A, Evengard B - J Clin Microbiol 2000; 38: 2457

    26. No findings of enteroviruses in Swedish patients with chronic fatigue syndrome
      Lindh G, Samuelson A, Hedlund K et al. - Scan J infect Dis 1996; 28: 305-307

    27. Nutritional strategies for treating chronic fatigue syndrome
      Werbach MR - Altern Med Rev ( 2000;) 5:: 93–108

    28. Odor perception - Multiple chemical sensitivities, chronic fatigue and asthma
      Caccappolo E, Kipen H, Kelly-McNeil K et al. - J Occup Environ Med 2000; 42: 629-638

    29. Oriental medicine - An introduction
      Ehling D - Altern Ther Health Med ( 2001;) 7:: 71–82

    30. Orthostatic hypotension and chronic fatigue syndrome
      Baschetti et al. - JAMA 2001;285:1441-1443
      Cfr. : http://jama.ama-assn.org/cgi/content/extract/285/11/1441

    31. Orthostatic intolerance in adolescent chronic fatigue syndrome
      Stewart JM, Gewitz MH, Weldon A et al. - Pediatrics 1999; 103: 116-121
      Cfr. : http://pediatrics.aappublications.org/cgi/content/abstract/103/1/116

    32. Outcome and prognosis of patients with chronic fatigue vs chronic fatigue syndrome
      Bombardier CH, Buchwald D - Arch Intern Med 1995; 155: 2105-2110

    33. Outcome measures for health education and other health care interventions
      Dr. Kate Lorig, Dr. Anita Stewart, Philip Ritter, Dr. Virginia M. Gonzalez, Dr. Diana Laurent, Dr. John Lynch - Sage Publications, Inc. (1 edition), January 15, 1996 – ISBN-10 : 0761900675 – ISBN-13 : 978-0761900672
      '
      Although Outcome Measurement' has become an important tool in the evaluation of health promotion patient education and other health services interventions, problems remain in locating reliable measurements and scales.
      This book provides a unique compilation of more than 50 self-administered scales for measuring health behaviors, health status, self-efficacy and health-care utilization.
      Cfr. :
      http://www.amazon.com/Outcome-Measures-Health-Education-Interventions/dp/0761900675

    34. Outcomes focussed service delivery - Developing an academic-management partnership
      Tobin MJ, Hickie I - Aust N Z J Psychiatry 1998; 32: 327-336

    35. Over-the-counter sleeping pills - A survey of use in Hong Kong and a review of their constituents
      Yang SH, Gao M, Yang XW, Chen DQ - Gen Hosp Psychiatry ( 2002;) 24:: 430–5

    36. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia and temporomandibular disorder
      Aaron L, Burke M, Buchwald D - Arch Int Med 2000; 160: 221-227

    37. Parental bonding and alexithymia in adults with fibromyalgia
      Francisco Pedrosa Gil, M.D., Martin Weigl, M.D., M.P.H., Tina Wessels, Ph.D., Dominik Irnich, M.D., Eva Baumüller, M.D., and Andreas Winkelmann, M.D., from the Psychosomatic Outpatient Clinic, Dept. of Internal Medicine, Ludwig-Maximilian-University, Pettenkoferstr. 10, 80336 Munich, Germany; the Dept. of Physical Medicine and Rehabilitation, Ludwig-Maximilian-University, Ziemssenstrasse 1, 80336 Munich, Germany; and the Dept. of Anesthesiology, Ludwig-Maximilian-University, Pettenkoferstr. 8a, 80336 Munich, Germany - Send correspondence and reprint requests to : Francisco Pedrosa Gil, M.D., Psychosomatic Outpatient Clinic, Dept. of Internal Medicine; Ludwig-Maximilian-University; Pettenkoferstrasse 10; D-80336 Munich, Germany – E-mail : Francisco.Pedrosa.Gil@med.uni-muenchen.de - Psychosomatics 49:115-122, March-April 2008 - © 2008 Academy of Psychosomatic Medicine
      Cfr. : http://psy.psychiatryonline.org/cgi/content/abstract/49/2/115

    38. Patient organisations are denied a voice [letter]
      Jacobs G - BMJ 1997; 315: 949

    39. Patterns of comorbidity in chronic fatigue syndrome
      Joel Yager, MD - Published in Journal Watch Psychiatry May 7, 2003 (covering Psychosom Med 2003 Mar/Apr; 65:268-75)
      Cfr. : http://psychiatry.jwatch.org/cgi/content/citation/2003/507/5

    40. Patterns of utilization of medical care and perceptions of the relationship between doctor and patient with chronic illness including chronic fatigue syndrome
      Twemlow SW, Bradshaw SL, Coyne L, Lerma BH - Psychol Rep 1997; 80: 643-658

    41. Perceived need for mental health care - Influences of diagnosis, demography and disability
      Meadows G, Burgess P, Bobevski I et al. - Psychol Med 2002; 32: 299-309

    42. Perceived physical and emotional trauma as precipitating events in fibromyalgia - Associations with health care seeking and disability status but not pain severity
      Aaron LA, Bradley LA, Alarcón GS, Triana-Alexander M, Alexander RW, Martin MY, Alberts KR, Division of Clinical Immunology and Rheumatology, University of Alabama, Birmingham 35294-0012, USA - Arthritis Rheum. 1997 Mar;40(3):453-60

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9082933?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    43. Personality and social attitudes in chronic fatigue syndrome
      Wood B, Wessely S - J Psychosom Res 1999; 47: 385-397

    44. Personality dimensions in the chronic fatigue syndrome - A comparison with multiple sclerosis and depression
      Johnson SK, DeLuca J, Natelson BH - J Psychiatr Res. 1996 Jan–Feb;30(1):9–20
      Cfr. : http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8T-3VXNH2N-2&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_search
      StrId=1091952654&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion
      =0&
      _userid=10&md5=eeb83d8cb2221fa370fbb4fb6af106f3

    45. Personality styles in patients with fibromyalgia, major depression and healthy controls
      Nordahl HM, Stiles TC. Ann Gen Psychiatry. 2007 Mar 9; 6:9. Epub 2007 Mar 9
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/17349053

    46. Personality, mental distress and subjective health complaints among persons with environmental annoyance
      K Österberg, Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Sweden; Department of Occupational and Environmental Medicine, Lund University Hospital, SE-22185 Lund, Sweden :
      kai.osterberg@med.lu.se - R Persson, National Institute of Occupational Health, Copenhagen, Denmark - B Karlson & F Carlsson Eek, Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Sweden - P Ørbæk, National Institute of Occupational Health, Copenhagen, Denmark

      Cfr. : http://het.sagepub.com/cgi/content/abstract/26/3/231

    47. Phylogenic analysis of short enteroviral sequences from patients with chronic fatigue syndrome
      Galbraith DN, Nairn C, Clements GB. - J Gen Virol 1995; 76: 1701-1707

    48. Physical performance and prediction of 2-5A synthetase/RNase L antiviral pathway activity in patients with chronic fatigue syndrome
      Snell, C.R., Vanness,J .M., Strayer, D.R. & Stevens, S.R. (2002) - In Vivo, 16, 107-109
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12073768

    49. Physical, psychological and functional comorbidities of multisymptom illness in australian male veterans of the 1991 Gulf War
      H. L. Kelsall, D. P. McKenzie, M. R. Sim, K. Leder, A. B. Forbes and T. Dwyer - Am. J. Epidemiol., October 15, 2009; 170(8): 1048 – 1056
      Cfr. : http://aje.oxfordjournals.org/cgi/content/abstract/170/8/1048

    50. Population-based care of depression - Effective disease management strategies to decrease prevalence
      Katon W, Von Korff M, Lin E et al. - Gen Hosp Psychiatry 1997; 19: 169-178

    51. Possible concomitant fibromyalgia in systemic lupus erythematosus patients with overt central nervous system disease but with cognitive deficits - Comment on the article by Kozora et al.
      Romano TJ - Arthritis Rheum. 1997 Aug;40(8):1544-5 - PMID: 9259439
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9259439
      This article is a comment on :
      -
      Analysis of cognitive and psychological deficits in systemic lupus erythematosus patients without overt central nervous system disease
      Kozora E, Thompson LL, West SG, Kotzin BL, National Jewish Center for Immunology and Respiratory Medicine, Denver, CO 80206, USA - Arthritis Rheum. 1996 Dec;39(12):2035-45
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8961909?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    52. Possible correlation between Borna disease virus infection and Japanese patients with chronic fatigue syndrome
      Kitani T, Kuratsune H, Fuke I et al. - Microbiol Immunol 1996; 40: 459-462

    53. Possible relationship between chronic fatigue and postural tachycardia syndromes
      De Lorenzo F, Hargreaves J, Kakkar VV - Clin Autonom Res 1996; 6: 263-264

    54. Post-infection fatigue syndrome following Q fever
      Ayres, J.G., Flint, N., Smith, E.G., Tunnicliffe, W.S., Fletcher, T.J., Hammond, K., Ward, D. & Marmion, B.P. (1998) - QJM., 91, 105-123
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9578893

    55. Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War veterans - A population-based survey of 30,000 veterans
      Kang HK, Natelson BH, Mahan CM et al. - Am J Epidemiol 2003;157:141–8
      Cfr. : http://aje.oxfordjournals.org/cgi/content/abstract/157/2/141

    56. Postinfectious fatigue - Prospective cohort study in primary care
      Wessely S, Chalder T, Hirsch et al. - Lancet 1995; 345: 1333-1338

    57. Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome
      A. Hoad, G. Spickett, J. Elliott and J. Newton - QJM, December 1, 2008; 101(12): 961 – 965
      Cfr. : http://qjmed.oxfordjournals.org/cgi/content/abstract/hcn123

    58. Potential polygenic influences on chronic fatigue syndrome
      K. N. Schikler - Pediatrics, October 1, 2006; 118(4): 1799 – 1800
      Cfr. : http://pediatrics.aappublications.org/cgi/content/full/118/4/1799

    59. Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis
      White PD, Thomas JM, Kangro HO et al. - Lancet 2001; 358: 1946-1954

    60. Predictors of outcome following treatment for chronic fatigue
      Darbishire, L., Seed, P. & Ridsdale, L. (2005) - Br.J Psychiatry, 186:350-351., 350-351
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15802694

    61. Predictors of persistent and new-onset fatigue in adolescent girls
      Maike ter Wolbeek, PhDa,b, Lorenz J. P. van Doornen, PhDb, Annemieke Kavelaars, PhDa and Cobi J. Heijnen, PhDa - a Laboratory of Psychoneuroimmunology, University Medical Center Utrecht, Utrecht, Netherlands - b Department of Health Psychology, Utrecht University, Utrecht, Netherlands - PEDIATRICS Vol. 121 No. 3 March 2008, pp. e449-e457
      Cfr. : http://pediatrics.aappublications.org/cgi/content/abstract/121/3/e449

    62. Preliminary determination of a molecular basis to chronic fatigue syndrome
      McGregor NR, Dunstan RH, Zerbes M et al. - Biochem Mol Med 1996; 57: 73-80

    63. Preliminary determination of the association between symptom expression and urinary metabolites in subjects with chronic fatigue syndrome
      McGregor NR, Dunstan RH, Zerbes M et al. - Biochem Mol Med 1996; 58: 85-92

    64. Premorbid "overactive" lifestyle in chronic fatigue syndrome and fibromyalgia - An etiological factor of proof of good citizenship ?
      Van Houdenhove B, Neerinckx E, Onghena P et al. - J Psychosom Res 2001; 51: 571-576

    65. Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas
      Reyes, M., Nisenbaum, R., Hoaglin, D.C., Unger, E.R., Emmons, C., Randall, B., Stewart, J.A., Abbey, S., Jones, J.F., Gantz, N., Minden, S. & Reeves, W.C. (2003) - Arch.Intern.Med., 163, 1530-1536
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12860574

    66. Prevalence and patterns of Gulf War illness in Kansas veterans - Association of symptoms with characteristics of person, place and time of military service
      Steele L - Am J Epidemiol 2000;152:992–1002
      Cfr. : http://aje.oxfordjournals.org/cgi/content/abstract/152/10/992

    67. Prevalence of chronic fatigue and chemical sensitivities in Gulf Registry Veterans
      Kipen HM, Hallman W, Kang H et al. - Arch Environ Health 1999; 54: 313-318

    68. Prevalence of chronic fatigue syndrome in a community population in Japan
      Kawakami N, Iwata N, Fujihara S et al. - Tohoku J Exp Med 1998; 186: 33-41

    69. Prevalence of IgM antibodies to human herpesvirus 6 (HHV-6) early antigen (P41/38) in patients with chronic fatigue syndrome
      Patnaik M, Komaroff AL, Conley E et al. - J Infect Dis 1995; 172: 1364-1367 (published erratum appears in J Infect Dis 1995; 172: 1643)

    70. Prevalence of irritable bowel syndrome in chronic fatigue
      Gomborone JE, Gorard DA, Dewsnap PA et al. - J R Coll Physicians Lond 1996; 30: 512-513

    71. Prevalence, comorbidity, disability and service utilisation - Overview of the Australian National Mental Health Survey
      Andrews G, Henderson S, Hall W - Br J Psychiatry 2001; 178: 145-153

    72. Prevention of suicide and attempted suicide in Denmark - Epidemiological studies of suicide and intervention studies in selected risk groups
      Merete Nordentoft - Danish Medical Bulletin - No. 4. November 2007. Vol. 54 Pages 306-69
      Cfr. : http://www.danmedbul.dk/DMB_2007/0407/04-07-disputatser/DMB3963.htm

    73. Problem solving in clinical practice - It's not all in ME mind, doc
      E. Crawley and T. Chambers - Arch. Dis. Child. Ed. Pract., December 1, 2005; 90(4): ep92 - ep97

      Cfr. : http://ep.bmjjournals.com/cgi/content/extract/90/4/ep92

    74. Prognosis in chronic fatigue syndrome - A prospective study on the natural course
      Vercoulen JHMM, Swanink CMA, Fennis JFM et al. - J Neurol Neurosurg Psychiatry 1996; 60: 489-494

    75. Promoting evidence-based non-drug interventions - Time for a non-pharmacopoeia ?
      Paul P Glasziou - Med J Aust 2009; 191 (2): 52-53

      In 2004, the Journal published a randomised controlled trial of graded exercise for chronic fatigue syndrome (CFS).
      As with several similar trials, this trial found that graded exercise was an effective intervention.
      But what is graded exercise ?
      In response to numerous emails from both doctors and CFS patients who wanted further details of the exercise program, the authors of the study published a second article that provided the additional “
      how to” details and addressed different scenarios.
      I now keep the pdf file of this second article on my general practice computer to give to and discuss with, CFS patients.
      The difficulties in accessing information on this simple, non-drug intervention are in stark contrast to the helpful tools available for prescribing pharmaceuticals : formularies, prescription pads and pharmacies.
      Cfr. :
      http://www.mja.com.au/public/issues/191_02_200709/gla10407_fm.html

    76. Pros and cons of exercise in fighting CFS
      Maegraith D - The Weekend Australian 2004; Jul 3-4: C32
      Cfr. '
      To exercise or not to exercise in chronic fatigue syndrome ?' at : http://www.mja.com.au/public/issues/181_10_151104/letters_151104-6.html

    77. Protracted debility and fatigue after acute Q fever [letter]
      Marmion BP, Shannon M, Maddocks I et al. - Lancet 1996; 347: 977-978

    78. Protracted fatigue and debility after acute Q fever [letter]
      Eltumi M, Mathieson DM, Brueton MJ, Kovar IZ - Lancet 1996; 347: 978-979

    79. Psychiatric comorbidity in persons with chronic fatigue wyndrome identified from the Georgia population
      Urs M. Nater, PhD, Jin-Mann S. Lin, PhD, Elizabeth M. Maloney, DrPH, James F. Jones, MD, Hao Tian, PhD, Roumiana S. Boneva, MD, PhD, Charles L. Raison, MD, William C. Reeves, MD, MSc and Christine Heim, PhD, from the Chronic Viral Diseases Branch (U.M.N., J.-M.L., E.M.M., J.F.J., H.T., R.S.B., W.C.R.), National Center for Zoonotic, Vector-borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Psychiatry and Behavioral Sciences (U.M.N., C.L.R., C.H.), Emory University School of Medicine, Atlanta, Georgia - Address correspondence and reprint requests to William C. Reeves, Centers for Disease Control and Prevention, Mail Stop A-15, Atlanta, GA 30333 – E-mail : wcr1@cdc.gov - Psychosomatic Medicine 71:557-565 (2009) - © 2009 American Psychosomatic Society
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/71/5/557

    80. Psychiatric diagnoses in Gulf War veterans with fatiguing illness
      Lange G, Tiersky L, DeLuca J et al. - Psychiatry Res 1999; 89: 39-48

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel IX

    1. Psychiatric diagnoses in patients with fibromyalgia are related to health care-seeking behavior rather than to illness
      Aaron LA, Bradley LA, Alarcón GS, Alexander RW, Triana-Alexander M, Martin MY, Alberts KR, School of Medicine, The University of Alabama at Birmingham, 35294-0006, USA - Arthritis Rheum. 1996 Mar;39(3):436-45
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8607892
      Also read the comment on this article :
      -
      Psychiatric diagnoses in patients with fibromyalgia - Comment on the article by Aaron et al.
      Ruderman EM, Golden HE - Arthritis Rheum. 1996 Dec;39(12):2086-7 - PMID: 8961920
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/8961920?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    2. Psychiatric diagnosis, sexual and physical victimization and disability in patients with irritable bowel syndrome or inflammatory bowel disease
      Walker EA, Gelfand AN, Gelfand MD, Katon WJ - Psychol Med 1995; 25: 1259-1267

    3. Psychiatric illness in patients with chronic fatigue and those with rheumatoid arthritis
      Katon WJ, Buchwald DS, Simon GE et al. - J Gen Int Med 1991; 6: 277-285
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1890495

    4. Psychiatric morbidity and illness experience of primary care patients with chronic fatigue in Hong Kong
      Lee S, Yu H, Wing YK et al. - Am J Psychiatry 2000; 157: 380-384

    5. Psychiatric status of patients with primary fibromyalgia, patients with rheumatoid arthritis and subjects without pain - A blind comparison of DSM-III diagnoses
      Ahles TA, Khan SA, Yunus MB, Spiegel DA, Masi AT, Behavioral Medicine Section, Dartmouth Medical School, Lebanon, NH - Am J Psychiatry. 1991 Dec;148(12):1721-6
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1957937?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

    6. Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome
      Blakely, A.A., Howard, R.C., Sosich, R.M., Murdoch, J.C., Menkes, D.B. & Spears, G.F. (1991) - Psychological Medicine, 21, 347-362
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/1876640

    7. Psychological symptoms and psychiatric diagnosis in patients with fibromyalgia
      Goldenberg,D.L. (1989) - J.Rheumatol.Suppl, 19:127-30., 127-130
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2607508

    8. Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder and stress-related bodily disorders - The role of the hypothalamus-pituitary-adrenal axis
      Ehlert U, Gaab J, Heinrichs M, Department of Clinical Psychology, University of Zurich, Zurichbergstrasse 43, CH-8044, Zurich, Switzerland : ehlertu@klipsy.unizh.ch - Biol Psychol. 2001 Jul-Aug;57(1-3):141-52 - PMID: 11454437
      Following the assumption that stressors play an important part in the etiology and maintenance of psychiatric disorders, it is necessary to evaluate parameters reflecting stress-related physiological reactions.
      Results from these examinations may help to deepen the insight into the etiology of psychiatric disorders and to elucidate diagnostic uncertainties.
      One of the best-known stress-related endocrine reactions is the hormonal release of the hypothalamic-pituitary-adrenal (HPA) axis.
      Dysregulations of this axis are associated with several psychiatric disorders.
      Profound hyperactivity of the HPA-axis has been found in melancholic depression, alcoholism and eating disorders.
      In contrast, posttraumatic stress disorder, stress-related bodily disorders like idiopathic pain syndromes and chronic fatigue syndrome seem to be associated with diminished HPA activity (lowered activity of the adrenal gland).
      Hypotheses referring to (a) the psychophysiological meaning and (b) the development of these alterations are discussed.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11454437?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed

    9. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis – I. - Psychiatric diagnoses and functional disability
      EA Walker, D Keegan, G Gardner, M Sullivan, WJ Katon and D Bernstein, Department of Psychiatry, University of Washington, Seattle 98195, USA : edwalker@u.washington.edu - Psychosomatic Medicine, Vol 59, Issue 6 565-571, Copyright © 1997 by American Psychosomatic Society
      Cfr. : http://www.psychosomaticmedicine.org/cgi/content/abstract/59/6/565

    10. Public beliefs about the helpfulness of interventions for depression - Effects on actions taken when experiencing anxiety and depression symptoms
      Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B, Centre for Mental Health Research, Australian National University, Canberra : Anthony.Jorm@anu.edu.au - Aust N Z J Psychiatry. 2000 Aug;34(4):619-26 - PMID: 10954393
      Objective - Previous research has shown that the public have different beliefs to mental health professionals about the helpfulness of interventions for mental disorders.
      However, it is not known whether the public's beliefs actually influence their behaviour when they develop psychiatric symptoms.
      Method
      - A postal survey of 3,109 Australian adults was used to assess beliefs about the helpfulness of a broad range of interventions for depression, as well as respondents' current level of anxiety and depression symptoms and any history of treated depression.
      A follow-up survey of 422 persons who had a high level of symptoms at baseline was conducted 6 months later.
      These people were asked which interventions they had used to reduce their symptoms.
      An analysis was carried out to see whether beliefs and other factors at baseline predicted subsequent use of interventions.
      Results
      - There were some major discrepancies between the ranking of interventions as likely to be helpful and the ranking of how frequently they were actually used.
      Interventions involving mental health professionals were often rated as likely to be helpful, but were rarely used in practice.
      Other simple, cheap and readily available interventions were used the most frequently, but were not the most likely to be rated as helpful.
      The most consistent predictors across all interventions used were gender, history of treatment, current symptoms and belief in a particular intervention.
      Of particular interest was the finding that beliefs in the helpfulness of antidepressants predicted their use.
      However, beliefs were not predictors of use for all interventions.
      Conclusions
      - Beliefs about the helpfulness of an intervention did not always predict actual use of that intervention, although beliefs did predict use of antidepressants.
      Therefore, campaigns that change public beliefs about effective treatments may also influence actual use of treatments.
      Interventions preferred by professionals are not frequently used at present.
      Most people with anxiety and depression symptoms rely primarily on simple self-help interventions, the effectiveness of which has been little researched.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/10954393?dopt=Abstract

    11. Putting the rest cure to rest – again - Rest has no place in treating chronic fatigue
      Sharpe M, Wessely S - BMJ 1998; 316: 796

    12. Quality of attention in chronic fatigue syndrome - Subjective reports of everyday attention and cognitive difficulty and performance on tasks of focused attention
      Ray C, Phillips L, Weir WR - Br J Clin Psychol. 1993 Sep;32 (:357–364
      Patients with chronic fatigue syndrome (also known as post-viral fatigue syndrome or myalgic encephalomyelitis) commonly report cognitive difficulties concerning attention, concentration and memory.
      In this study, patients were compared with matched controls on two questionnaires which assess subjective difficulties with attention and general cognitive functioning and on two tasks requiring focused attention.
      Patients reported significantly greater difficulty with attention on the Everyday Attention Questionnaire and more cognitive symptoms on the Profile of Fatigue-Related Symptoms.
      The objective tests did not clearly indicate a deficit in patients' focused attention; patients tended to perform less well on the Embedded Figures Test and the Stroop Colour-Word Interference Test, but these differences were not significant.
      There was, however, evidence of psychomotor retardation, with patients having longer response times for word reading and colour naming in the Stroop test. Difficulties in interpreting findings for both subjective and objective cognitive measures are discussed.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/8251968

    13. Randomised controlled trial of graded exercise in chronic fatigue syndrome
      Wallman KE, Morton AR, Goodman C, Grove R, Guilfoyle AM, School of Human Movement and Exercise Science, University of Western Australia, Stirling Highway, Nedlands, WA 6009, Australia : kwallman@cyllene.uwa.edu.au - Med J Aust. 2004 May 3;180(9):444-8 - PMID: 15115421

      Objective - To investigate whether 12 weeks of graded exercise with pacing would improve specific physiological, psychological and cognitive functions in people with chronic fatigue syndrome (CFS).
      Design
      - Randomised controlled trial.
      Setting
      - Human performance laboratory at the University of Western Australia.
      Participants
      - 61 patients aged between 16 and 74 years diagnosed with CFS.
      Interventions
      - Either graded exercise with pacing (32 patients) or relaxation/flexibility therapy (29 patients) performed twice a day over 12 weeks.
      Main outcome measures
      - Changes in any of the physiological, psychological or cognitive variables assessed.
      Results
      - Following the graded exercise intervention, scores were improved for resting systolic blood pressure (P = 0.018), work capacity (W.kg(-1)) (P = 0.019), net blood lactate production (P = 0.036), depression (P = 0.027) and performance on a modified Stroop Colour Word test (P = 0.029).
      Rating of perceived exertion scores, associated with an exercise test, was lower after graded exercise (P = 0.013).
      No such changes were observed in the relaxation/flexibility condition, which served as an attention-placebo control.
      Conclusions
      - Graded exercise was associated with improvements in physical work capacity, as well as in specific psychological and cognitive variables.
      Improvements may be associated with the abandonment of avoidance behaviours.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/15115421
      Also read the comments on this article :
      -
      To exercise or not to exercise in chronic fatigue syndrome ? - No longer a question
      Lloyd AR - Med J Aust. 2004 May 3;180(9):437-8 - PMID: 15115418
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15115418?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      To exercise or not to exercise in chronic fatigue syndrome ?
      Scroop GC, Burnet RB - Med J Aust. 2004 Nov 15;181(10):578-9; author reply 579-80 - PMID: 15540976
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15540976?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    14. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome
      Fulcher, K.Y. & White, P.D. (1997) - BMJ, 314, 1647-1652

      Cfr. : http://www.bmj.com/cgi/content/abstract/314/7095/1647

    15. Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome
      Powell P, Bentall RP, Nye FJ, Edwards RHT - BMJ 2001; 322: 1-5
      Objective - To assess the efficacy of an educational intervention explaining symptoms to encourage graded exercise in patients with chronic fatigue syndrome.
      Design - Randomised controlled trial.
      Setting - Chronic fatigue clinic and infectious diseases outpatient clinic.
      Subject - 148 consecutively referred patients fulfilling Oxford criteria for chronic fatigue syndrome.
      Interventions
      - Patients randomised to the control group received standardised medical care.
      Patients randomised to intervention received two individual treatment sessions and two telephone follow up calls, supported by a comprehensive educational pack, describing the role of disrupted physiological regulation in fatigue symptoms and encouraging home based graded exercise.
      The minimum intervention group had no further treatment, but the telephone intervention group received an additional seven follow up calls and the maximum intervention group an additional seven face to face sessions over four months.
      Main outcome measure
      - A score of >/=25 or an increase of >/=10 on the SF-36 physical functioning subscale (range 10 to 30) 12 months after randomisation.
      Results
      - 21 patients dropped out, mainly from the intervention groups.
      Intention to treat analysis showed 79 (69%) of patients in the intervention groups achieved a satisfactory outcome in physical functioning compared with two (6%) of controls, who received standardised medical care (P<0.0001).
      Similar improvements were observed in fatigue, sleep, disability and mood.
      No significant differences were found between the three intervention groups.
      Conclusions
      - Treatment incorporating evidence based physiologicalexplanations for symptoms was effective in encouraging self managed graded exercise.
      This resulted in substantial improvement compared with standardised medical care.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11179154
      Also read the comment on this article :
      Patient education to encourage graded exercise in chronic fatigue syndrome - Trial has too many shortcomings
      Chaudhuri A - BMJ. 2001 Jun 23;322(7301):1545-6 - PMID: 11439997
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11439997?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    16. Randomised, double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome
      Vercoulen JH, Swanink CM, Zitman FG, Vreden SG, Hoofs MP, Fennis JF et al. - Lancet ( 1996;) 347:: 858–61

    17. Randomised, double-blind, placebo-controlled treatment trial of fluoxetine and graded exercise for chronic fatigue syndrome
      Wearden AJ, Morriss RK, Mullis R, Strickland PL, Pearson DJ, Appleby L, Campbell IT, Morris JA, University of Manchester, Department of Psychiatry, Withington Hospital. - Br J Psychiatry. 1998 Jun;172:485-90
      Cfr. :
      -
      http://bjp.rcpsych.org/cgi/content/abstract/172/6/485
      - http://www.ncbi.nlm.nih.gov/pubmed/9828987

    18. Randomised, doubleblind, placebo-controlled study of fluoxetine in chronic fatigue syndrome
      Vercoulen, J.H., Swanink, C.M., Zitman, F.G., Vreden, S.G., Hoofs, M.P., Fennis, J.F., Galama, J.M., van der Meer, J.W. & Bleijenberg, G. (1996) – Lancet, 347, 858-861
      Cfr. : http://linkinghub.elsevier.com/retrieve/pii/S0140673696913458

    19. Randomized controlled trial of Siberian ginseng for chronic fatigue
      Hartz AJ, Bentler S, Noyes R, Hoehns J, Logemann C, Sinift S et al. - Psychol Med ( 2004;) 34:: 51–61

    20. Recent developments in chronic fatigue syndrome (symposium supplement)
      Levine PH (editor) - Am J Med 1998; 105 (3A)

    21. Recent trends in the use of antidepressant drugs in Australia, 1990-1998
      McManus P, Mant A, Mitchell PB et al. - Med J Aust 2000; 173: 458-461

    22. Reduced oxidative muscle metabolism in chronic fatigue syndrome
      McCully KK, Natelson BH, Lotti S et al. - Muscle Nerve 1996; 19: 621-625

    23. Reducing heterogeneity in chronic fatigue syndrome - A comparison with depression and multiple sclerosis
      Natelson BH, Johnson SK, DeLuca J, Sisto S, Ellis SP, Hill N, Bergen MT - Clin Infect Dis. 1995 Nov;21(5):1204–1210
      Cfr. : http://www.jstor.org/pss/4459037

    24. Relationship of brain MRI abnormalities and physical functional status in chronic fatigue syndrome
      Cook DB, Lange G, DeLuca J et al. - Int J Neuroscience 2001; 107: 1-6

    25. Relationship of physical symptoms to posttraumatic stress disorder among veterans seeking care for Gulf War related health concerns
      Engel CC Jr, Liu X, McCarthy BD et al., Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC, USA : cengel@pobox.com - Psychosom Med 2000;62:739–45
      Objectives -
      Studies of the relationship of posttraumatic stress disorder (PTSD) to physical symptoms in war veterans consistently show a positive relationship.
      However, traumatic experiences causing PTSD may correlate with other war exposures and medical illnesses potentially accounting for those symptoms.
      Methods
      - We analyzed data obtained from 21,244 Gulf War veterans seeking care for war-related health concerns to assess the relationship of PTSD to physical symptoms independent of environmental exposure reports and medical illness.
      At assessment, veterans provided demographic information and checklists of 15 common physical symptoms and 20 wartime environmental exposures.
      Up to seven ICD-9 provider diagnoses were ranked in order of estimated clinical significance.
      The relationship of provider-diagnosed PTSD to various physical symptoms and to the total symptom count was then determined in bivariate and multivariate analyses.
      Results - Veterans diagnosed with PTSD endorsed an average of 6.7 (SD = 3.9) physical symptoms, those with a non-PTSD psychological condition endorsed 5.3 (3.5), those with medical illness endorsed 4.3 (3.4) and a group diagnosed as "healthy
      " endorsed 1.2 (2.2).
      For every symptom, the proportion of veterans reporting the symptom was highest in those with PTSD, second highest in those with any psychological condition, third highest in those with any medical illness and lowest in those labeled as healthy.
      The PTSD-symptom count relationship was independent of demographic characteristics, veteran-reported environmental exposures and comorbid medical conditions, even when symptoms overlapping with those of PTSD were excluded.
      Conclusions
      - PTSD diminishes the general health perceptions of care-seeking Gulf War veterans.
      Clinicians should carefully consider PTSD when evaluating Gulf War veterans with vague, multiple or medically unexplained physical symptoms.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11138991

    26. Report of a workshop on the epidemiology, natural history and pathogenesis of chronic fatigue syndrome in adolescents
      Marshall GS - J Pediatr 1999; 134: 395-405

    27. Report to the Chief Medical Officer of an independent working group - A Report of the CFS/ME Working Group
      London : Department of Health, 2001 (accessed 18 Jan 2002)
      Cfr. : http://www.doh.gov.uk/cmo/cfsmereport/index.htm

    28. Research on cognitive complaints and cognitive functioning in patients with chronic fatigue syndrome (CFS) - What conclusions can we draw ?
      Wearden AJ, Appleby L - J Psychosom Res 1996; 41: 197-211

    29. Responding to the Australian experience of depression - Promotion of the direct voice of consumers is critical for reducing stigma
      Hickie IB - Med J Aust 2002; 176 Suppl May 20: S61-S62
      Cfr. :
      -
      http://www.mja.com.au/public/issues/176_10_200502/hic10078_fm.html
      - http://www.ncbi.nlm.nih.gov/pubmed/12064999?dopt=Abstract

    30. Responses to controlled diesel vapor exposure among chemically sensitive Gulf War veterans
      Fiedler N, Giardino N, Natelson B, Ottenweller JE, Weisel C, Lioy P, Lehrer P, Ohman-Strickland P, Kelly-McNeil K, Kipen H, Department of Environmental and Community Medicine of UMDNJ-RWJ Medical School, Piscataway, NJ 08854, USA : nfiedler@eohsi.rutgers.edu - Psychosom Med. 2004 Jul-Aug;66(4):588-98 - PMID: 15272108
      Objective -
      A significant proportion of Gulf War veterans (GWVs) report chemical sensitivity, fatigue and unexplained symptoms resulting in ongoing disability.
      GWVs frequently recall an association between diesel and petrochemical fume exposure and symptoms during service.
      The purpose of the present study among GWVs was to evaluate the immediate health effects of acute exposure to chemicals (diesel vapors with acetaldehyde) with and without stress.
      Methods
      - In a single, controlled exposure to 5 parts per million (ppm) diesel vapors, symptoms, odor ratings, neurobehavioral performance and psychophysiologic responses of 12 ill GWVs (GWV-I) were compared with 19 age- and gender-matched healthy GWVs (GWV-H).
      Results
      - Relative to baseline and to GWV-H, GWV-I reported significantly increased symptoms such as disorientation and dizziness and displayed significantly reduced end-tidal CO(2) just after the onset of exposure.
      As exposure increased over time, GWV-I relative to GWV-H reported significantly increased symptoms of respiratory discomfort and general malaise.
      GWV-I were also physiologically hyporeactive in response to behavioral tasks administered during but not before exposure.
      Conclusions
      - Current symptoms among GWV-I may be exacerbated by ongoing environmental chemical exposures reminiscent of the Gulf War. Both psychologic and physiologic mechanisms contribute to current symptomatic responses of GWV-I.
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15272108

    31. Results of Isoproterenol Tilt Table Testing in Monozygotic Twins Discordant for Chronic Fatigue Syndrome
      Poole et al. - Arch Intern Med 2000;160:3461-3468
      Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=855300

    32. Reviving the diagnosis of neurasthenia
      Hickie I, Hadzi-Pavlovic D, Ricci C - Psychol Med 1997; 27: 989-994

    33. Rheumatic disorders in patients with silicone implants - A critical review
      Bridges AJ - J Biomater Sci Polymer Ed 1995; 7: 147-157

    34. Rheumatic fibromyalgia - Psychiatric features (article in Spanish)
      Sarró Alvarez S, Centro de Salud Mental. Martí i Julià. Sta. Coloma de Gramanet. Barcelona. Spain - Actas Esp Psiquiatr. 2002 Nov-Dec;30(6):392-6 - PMID: 12487950
      Rheumatic fibromyalgia, also known as fibrositis or myofascial pain, is a common syndrome whose diagnoses, founded mainly on physical examination, usually delays due to symptom unspecificity, amount of complementary tests requested and intercourse with psychiatric disorders.
      Psychyatrists and psychologists get often involved in fibromyalgia treatment.
      Its proper knowledge prevents not only physicians and patients' psychological discourage but also development of depression and mental health expenses, as well as allows designing a treatment plan according to the main symptoms which may offer improvement chances to fibromyalgia patients.
      This article intends to offer an up-to-date and complete information about this entity, focused on psychiatric aspects, to better identify and manage such a puzzling disease.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12487950

    35. Role of impaired lower-limb venous innervation in the pathogenesis of the chronic fatigue syndrome
      Streeten DH, Department of Medicine, SUNY Upstate Medical University, Syracuse, New York 13210, USA - Am J Med Sci. 2001 Mar;321(3):163-7 - PMID: 11269790
      Background
      - In patients with acute orthostatic hypotension, there is excessive pooling of blood in the legs, which may result from the strikingly subnormal compliance that is demonstrable in the pedal veins during norepinephrine infusion.
      The common occurrence of delayed orthostatic hypotension and/or tachycardia in the chronic fatigue syndrome (CFS) led to the present studies of foot vein compliance in CFS patients with a linear variable differential transformer.
      Methods
      - Seven patients with CFS were compared with 7 age- and gender matched healthy control subjects in their blood pressure, heart-rate and plasma norepinephrine responses to prolonged standing and in measurements of their foot vein contractile responses to intravenous norepinephrine infusions with the linear variable differential transformer.
      Results
      - Excessive, delayed (usually after 10 min) orthostatic reductions in systolic and diastolic blood pressure (P < 0.01) and inconsistently excessive increases in heart rate were found in the CFS patients, in whom venous compliance in response to infused norepinephrine was significantly reduced (P < 0.05).
      Conclusions
      - In these patients with CFS, delayed orthostatic hypotension was clearly demonstrable and, as in previously reported patients with orthostatic hypotension of acute onset, this was associated with reduced pedal vein compliance during norepinephrine infusion, implying impaired sympathetic innervation of foot veins.
      The rapid symptomatic improvement demonstrated in previous studies of CFS patients during correction of orthostatic venous pooling by inflation of military antishock trousers (MAST) to 35 mm Hg may suggest that excessive lower body venous pooling, perhaps by reducing cerebral perfusion, is involved in the orthostatic component of fatigue in these patients.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11269790?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

    36. Ross River virus infection on the North Coast of New South Wales
      Westley-Wise VJ, Beard JR et al. - Aust N Z J Public Health 1996; 20: 87-92

    37. Screening for prolonged fatigue syndromes - Validation of the SOFA scale
      Hadzi-Pavlovic D, Hickie IB, Wilson AJ, Davenport TA, Lloyd AR, Wakefield D, Mood Disorders Unit, Prince of Wales Hospital, Randwick, NSW, Australia : D.Hadzi-Pavlovic@unsw.edu.au - Soc Psychiatry Psychiatr Epidemiol. 2000 Oct;35(10):471-9 - PMID: 11127722
      Background -
      The identification of syndromes characterised by persistent and disabling mental and/or physical fatigue is of renewed interest in psychiatric epidemiology.
      This report details the development of two specific instruments : the SOFA/CFS for identification of patients with chronic fatigue syndrome (CFS) in specialist clinics and the SOFA/GP for identification of prolonged fatigue syndromes (PFS) in community and primary care settings.
      Methods
      - Patients with clinical diagnoses of CFS (n = 770) and consecutive attenders at primary care (n = 1593) completed various self-report questionnaires to assess severity of current fatigue-related symptoms and other common somatic and psychological symptoms.
      Quality receiver operating characteristic curves were used to derive appropriate cut-off scores for each of the instruments.
      Comparisons with other self-report measures of anxiety, depression and somatic distress are noted.
      Various multivariate statistical modelling techniques [latent class analysis (LCA), longitudinal LCA] were utilised to define the key features of PFS and describe its longitudinal characteristics.
      Results
      - The SOFA/CFS instrument performs well in specialist samples likely to contain a high proportion of patients with CFS disorders.
      Cut-off scores of either 1/2 or 2/3 can be used, depending on whether the investigators wish to preferentially emphasise false-negatives or false-positives.
      Patients from these settings can be thought of as consisting not only of those with a large number of unexplained medical symptoms, but also those with rather specific musculoskeletal and pain syndromes.
      The SOFA/GP instrument has potential cut-off scores of 1/2 or 2/3, with the latter preferred as it actively excludes all non-PFS cases (sensitivity = 81%, specificity = 100%).
      Patients with these syndromes in the community represent broader sets of underlying classes, with the emergence of not only musculoskeletal and multisymptomatic disorders, but also persons characterised by significant cognitive subjective impairment.
      Twelve-month longitudinal analyses of the primary care sample indicated that the underlying class structure was preserved over time.
      Comparisons with other measures of psychopathology indicated the relative independence of these constructs from conventional notions of anxiety and depression.
      Conclusions
      - The SOFA/GP instrument (which is considerably modified from the SOFA/CFS in terms of anchor points for severity and chronicity) is preferred for screening in primary care and community settings.
      Patients with PFS and CFS present a range of psychopathology that differs in its underlying structure, cross-sectionally and longitudinally, from coventional notions of anxiety and depression.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11127722

    38. Screening for psychiatric disorders in chronic fatigue and chronic fatigue syndrome
      Buchwald D, Pearlman T, Kith P et al. - J Psychosom Res 1997; 42: 87-94

    39. Secondary gain concept - A review of the scientific evidence
      Fishbain DA, Rosomoff HL, Cutler RB, Rosomoff RS - Clin J Pain 1995; 11: 6-21

    40. Seeking answers to chronic fatigue syndrome
      Marsha T. Wallace, David S. Svahn, Michael Loudon and Floyd Skloot - JAMA. 1998;279(21):1697-1698
      Cfr. : http://jama.ama-assn.org/cgi/content/extract/279/21/1697

    41. Selective impairment of auditory processing in chronic fatigue syndrome - A comparison with multiple sclerosis and healthy controls
      Johnson SK, DeLuca J, Diamond BJ, Natelson BH - Percept Motor Skills 1996; 83: 51-62

    42. Self-reported sensitivity to chemical exposures in five clinical populations and healthy controls
      Nawab SS, Miller CS, Dale JK et al. - Psychiatry Res 2000; 95: 67-74

    43. Seroepidemiology of chronic fatigue syndrome – A case-control study
      Mawle AC, Nisenbaum R, Dobbins JG et al. - Clin Infect Dis 1995; 21: 1386-1389

    44. Seronegative' Sjogren's syndrome manifested as a subset of chronic fatigue syndrome
      Nishikai M, Akiya K, Tojo T et al. - Br J Rheumatol 1996; 35: 471-474

    45. Serum neopterin and somatization in women with chemical intolerance, depressives and normals
      Bell IR, Patarca R, Baldwin CM et al. - Neuropsychobiology 1998; 38: 13-18

    46. Serum neuropeptides in patients with both fibromyalgia (FM) and chronic fatigue syndrome (CFS)
      Clauw DJ, Sabol M, Radulovic D et al. - J Musculoskel Pain 1995; 3 Suppl 1: S79

    47. Sexual abuse, physical abuse, chronic fatigue and chronic fatigue syndrome - A community-based study
      Taylor RR, Jason LA - J Nerv Ment Dis 2001; 189: 709-715

    48. SF-36 Health Survey - Manual and Interpretation Guide
      Ware JE, Snow KK, Kosinski M et al. Lincoln, RI : Quality Metric Incorporated, 2003 - ISBN-10 : 1891810065 – ISBN-13 : 978-1891810060
      Cfr. : http://www.amazon.com/SF-36-health-survey-Manual-interpretation/dp/1891810065
      Cfr. also '
      Interpreting the SF-36 Health Survey' (Barbara Gandek, M.S., Scientist, Health Assessment Lab, Boston, MA) at : http://www.cacr.ca/information_for_public/archived_issues/2000s/Newsbeat10(1)0204Gandek.pdf

    49. Short-term night shift working mimics the pituitary-adrenocortical dysfunction in chronic fatigue syndrome
      Leese G, Chattington P, Fraser W et al. - J Clin Endocrinol Metab 1996; 81: 1867-1870

    50. Should depression be managed as a chronic disease ?
      Andrews G, WHO Collaborating Centre for Mental Health and, School of Psychiatry, UNSW at St Vincent's Hospital, 299 Forbes Street, Sydney, 2010, Australia : gavina@crufad.unsw.edu.au - BMJ. 2001 Feb 17;322(7283):419-21 - PMID: 11179166
      Cf. : http://www.ncbi.nlm.nih.gov/pubmed/11179166?dopt=Abstract
      Also read the comment on this article :
      Patients with depression can be taught how to improve recovery
      Fava GA, Ruini C, Mangelli L - BMJ. 2001 Jun 9;322(7299):1428 - PMID: 11397758
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11397758?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    51. Sick girl seized from mother in medical row
      Hammond P. - Courier Mail, 03-05-1999. Brisbane
      Cfr. 'Assessment and Treatment of Patients with ME/CFS - Clinical Guidelines for Psychiatrists' (Eleanor Stein MD FRCP(C), 2005) at :
      http://sacfs.asn.au/download/guidelines_psychiatrists.pdf

    52. Significant other responses are associated with fatigue and functional status among patients with chronic fatigue syndrome
      Schmaling KB, Smith WR, Buchwald DS - Psychosom Med 2000; 62: 444-450

    53. Silicone breast implants, where have we been and where are we now ?
      Gatenby PA - Aust N Z J Med 1996; 26: 341-342

    54. Single-blind, placebo phase-in trial of two escalating doses of selegiline in the chronic fatigue syndrome
      Natelson BH, Cheu J, Hill N et al. - Neuropsychobiology 1998; 37: 150-154

    55. Sleep abnormalities demonstrated by home polysomnography in teenagers with chronic fatigue syndrome
      Stores G, Wiggs L - J Psychosom Res 1998; 45: 85-91

    56. Sleep anomalies in the chronic fatigue syndrome - A comorbidity study
      Fischler B, Le Bon O, Hoffman G et al. - Neuropsychobiology 1997; 35: 115-122

    57. Small adrenal glands in chronic fatigue syndrome - A preliminary computed tomography study
      Scott LV, Teh J, Reznek R et al. - Psychoneuroendocrinology 1999; 24: 759-768

    58. Social and familial risk factors in suicide behaviour
      Maris RW - Psychiatr Clin North Am 1997; 20: 519-550

    59. Sociosomatics and illness course in chronic fatigue syndrome
      Ware NC - Psychosom Med 1998; 60: 394-401

    60. Somatization and depression in fibromyalgia syndrome
      Kirmayer LJ, Robbins JM, Kapusta MA, Institute of Community and Family Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada - Am J Psychiatry. 1988 Aug;145(8):950-4 - PMID: 3164984
      Psychiatric diagnoses, self-reports of symptoms and illness behavior of 20 fibromyalgia patients and 23 rheumatoid arthritis patients were compared.
      The fibromyalgia patients were not significantly more likely than the arthritis patients to report depressive symptoms or to receive a lifetime psychiatric diagnosis of major depression.
      These results do not support the contention that fibromyalgia is a form of somatized depression.
      Fibromyalgia patients, however, reported significantly more somatic symptoms of obscure origin and exhibited a pattern of reporting more somatic symptoms, multiple surgical procedures and help seeking that may reflect a process of somatization rather than a discrete psychiatric disorder.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/3164984

    61. Somatomedin C (insulin-like growth factor 1) levels in patients with chronic fatigue syndrome
      Bennett AL, Mayes DM, Fagioli LR et al. - J Psychiat Res 1997; 31: 91-96

    62. SPECT brain imaging in chronic fatigue syndrome
      Patterson J, Aitchison F, Wyper DJ et al. - J Immunol Immunopharmacol 1995; XV, 1-2: 53-58

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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel X

    1. SPHERE - A National Depression Project
      Nicole Phillips, Michael J Oldmeadow and Natalie Krapivensky - Med J Aust 2002; 176 (4): 193-194
      Cfr. : http://www.mja.com.au/public/issues/176_04_180202/phi_hic_letter.html

    2. SPHERE - A National Depression Project - Development of a simple screening tool for common mental disorders in general practice
      Hickie IB, Davenport TA, Hadzi-Pavlovic D et al. - Med J Aust 2001; 175 Suppl: S10-S17

    3. Strategic plan
      Penrose-Wall J, Kirsner D - Beyondblue - The national depression initiative, December 2001
      Cfr. : http://www.beyondblue.org.au/index.aspx?

    4. Stressors, personality traits and coping of Gulf War veterans with chronic fatigue
      Fiedler N, Lange G, Tiersky L et al. - J Psychosom Res 2000; 48: 525-535

    5. Study on personality and psychiatric disorder in fibromyalgia
      Rose S, Cottencin O, Chouraki V, Wattier JM, Houvenagel E, Vallet B, Goudemand M, Université Lille 2, CHRU de LILLE, Service d'Addictologie, F-59037 LILLE, France - Presse Med. 2009 May; 38(5):695-700. Epub 2009 Jan 23
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/19167861
      Also read the comment on this article :
      -
      Study on personality and psychiatric disorder in fibromyalgia (letter)
      Cathébras P - Presse Med. 2009 Sep;38(9):1368; author reply 1369. Epub 2009 Jul 8 - PMID: 19589655

      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/19589655?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    6. Studying symptoms - Sampling and measurement issues
      Kroenke K - Ann Intern Med 2001; 134 Suppl: 844-853

    7. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors
      Giesecke T, Williams DA, Harris RE, Cupps TR, Tian X, Tian TX, Gracely RH, Clauw DJ, University of Michigan, Ann Arbor, USA - Arthritis Rheum. 2003 Oct;48(10):2916-22 - PMID: 14558098
      Objective
      - Although the American College of Rheumatology (ACR) criteria for fibromyalgia are used to identify individuals with both widespread pain and tenderness, individuals who meet these criteria are not a homogeneous group.
      Patients differ in their accompanying clinical symptoms, as well as in the relative contributions of biologic, psychological and cognitive factors to their symptom expression.
      Therefore, it seems useful to identify subsets of fibromyalgia patients on the basis of which of these factors are present.
      Previous attempts at identifying subsets have been based solely on psychological and cognitive features.
      In this study, we attempt to identify patient subsets by incorporating these features as well as the degree of hyperalgesia/tenderness, which is a key neurobiologic feature of this illness.
      Methods
      - Ninety-seven individuals meeting the ACR criteria for fibromyalgia finished the same battery of self-report and evoked-pain testing.
      Analyzed variables were obtained from several domains, consisting of
      1) mood (evaluated by the Center for Epidemiologic Studies Depression Scale [for depression] and the State-Trait Personality Inventory [for symptoms of trait-related anxiety]),
      2) cognition (by the catastrophizing and control of pain subscales of the Coping Strategies Questionnaire) and
      3) hyperalgesia/tenderness (by dolorimetry and random pressure-pain applied at suprathreshold values).
      Cluster analytic procedures were used to distinguish subgroups of fibromyalgia patients based on these domains.
      Results
      - Three clusters best fit the data. Multivariate analysis of variance (ANOVA) confirmed that each variable was differentiated by the cluster solution (Wilks' lambda [degrees of freedom 6,89] = 0.123, P < 0.0001), with univariate ANOVAs also indicating significant differences (all P < 0.05).
      One subgroup of patients (n = 50) was characterized by moderate mood ratings, moderate levels of catastrophizing and perceived control over pain and low levels of tenderness.
      A second subgroup (n = 31) displayed significantly elevated values on the mood assessments, the highest values on the catastrophizing subscale, the lowest values for perceived control over pain and high levels of tenderness.
      The third group (n = 16) had normal mood ratings, very low levels of catastrophizing and the highest level of perceived control over pain, but these subjects showed extreme tenderness on evoked-pain testing.
      Conclusion
      - These data help support the clinical impression that there are distinct subgroups of patients with fibromyalgia.
      There appears to be a group of fibromyalgia patients who exhibit extreme tenderness but lack any associated psychological/cognitive factors, an intermediate group who display moderate tenderness and have normal mood and a group in whom mood and cognitive factors may be significantly influencing the symptom report.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/14558098
      Also read the comment on this article :
      No justification for publication of study on subgrouping of fibromyalgia patients - Comment on the article by Giesecke et al.
      Ehrlich GE - Arthritis Rheum. 2004 Aug;50(8):2716; author reply 2716-7 - PMID: 15334497
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/15334497?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    8. Successful intravenous immunoglobulin therapy in 3 cases of parvovirus B19-associated chronic fatigue syndrome
      Kawamura Y, Kihara M, Nishimoto K, Taki M - Clin Infect Dis ( 2003;) 36:: e100–6

    9. Successful use of a primary care practice-specialty collaboration in the care of an adolescent with chronic fatigue syndrome
      Kuo DZ, Cheng TL, Rowe PC, Maple Avenue Pediatrics, Fair Lawn, New Jersey, USA : dkuo5@jhmi.edu - Pediatrics. 2007 Dec;120(6):e1536-9 - PMID: 18055669

      We report on the successful collaborative care of an adolescent with chronic fatigue syndrome between a primary care pediatrician and an academic chronic fatigue syndrome specialist located in different cities.
      Regular telephone and e-mail communication and clearly defined patient-care roles allowed for timely management of symptoms and marked clinical improvement.
      We discuss ways to improve the collaboration of primary care and subspecialty physicians for patients with chronic fatigue syndrome and children with special health care needs.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/18055669

    10. Symptom frequency and severity in chronic fatigue syndrome
      Tiersky LA, Weisberg S, Zhang QW et al. (2000) - Unpublished manuscript
      Cfr. '
      A Comparison of the 1988 and 1994 Diagnostic Criteria for Chronic Fatigue Syndrome' at : http://www.cfids-cab.org/cfs-inform/CFS.case.def/jason.etal.01.txt

    11. Symptom occurrence in persons with chronic fatigue syndrome
      Jason LA, Torres-Harding SR, Carrico AW, Taylor RR, DePaul University, Center for Community Research, 990 West Fullerton Road, Chicago, IL 60614, USA : Ljason@depaul.edu - Biol Psychol. 2002 Feb;59(1):15-27 - PMID: 11790441
      This investigation compared differences in the occurrence of symptoms in participants with CFS, melancholic depression and no fatigue (controls).
      The following Fukuda et al. [Ann. Intern. Med. 121 (1994) 953] criteria symptoms differentiated the CFS group from controls, but did not differentiate the melancholic depression group from controls : headaches, lymph node pain, sore throat, joint pain and muscle pain.
      In addition, participants with CFS uniquely differed from controls in the occurrence of muscle weakness at multiple sites as well as in the occurrence of various cardiopulmonary, neurological and other symptoms not currently included in the current case definition.
      Implications of these findings are discussed.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11790441

    12. Symptom patterns in long-duration chronic fatigue syndrome
      Friedberg F, Dechene L, McKenzie MJI, Fontanetta R - J Psychosom Res 2000; 48: 59-68

    13. Symptom patterns of children and adolescents with chronic fatigue syndrome
      Rowe KS, Rowe KJ – In : 'International perspectives on child and adolescent mental health' - Singh NN, Ollendick T, Singh AN, editors

    14. Symptom profile of multiple chemical sensitivity in actual life
      Mariko Saito, MD, Hiroaki Kumano, MD, PhD, Kazuhiro Yoshiuchi, MD, PhD, Naomi Kokubo, Kyoko Ohashi, PhD, Yoshiharu Yamamoto, PhD, Naohide Shinohara, PhD, Yukio Yanagisawa, PhD, Kou Sakabe, MD, PhD, Mikio Miyata, MD, PhD, Satoshi Ishikawa, MD, PhD and Tomifusa Kuboki, MD, PhD, From the Department of Psychosomatic Medicine (M.S., H.K., K.Y., T.K.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; the Educational Physiology Laboratory (N.K., K.O., Y. Yamamoto), Graduate School of Education, The University of Tokyo, Tokyo, Japan; the Graduate School of Frontier Sciences (N.S., Y. Yanagisawa), Institute of Environmental Studies, The University of Tokyo, Tokyo, Japan; and the Environmental Medical Center (K.S., M.M., S.I.), The Kitasato Institute Hospital, Tokyo, Japan - Address correspondence and reprint requests to : Hiroaki Kumano, MD, PhD, Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7–3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan – E-mail : hikumano-tky@umin.ac.jp - Psychosomatic Medicine 67:318-325 (2005) - © 2005 American Psychosomatic Society

      Cfr. :
      -
      http://www.psychosomaticmedicine.org/cgi/content/abstract/67/2/318
      - http://www.psychosomaticmedicine.org/cgi/content/abstract/67/2/318?ijkey=38c0456f9f576bb901ad229f206ec7e715115c7e&keytype2=tf_ipsecsha

    15. Symptoms of autonomic dysfunction in chronic fatigue syndrome
      Newton JL, Okonkwo O, Sutcliffe K, Seth A, Shin J, Jones DE, Fatigue Interest group and Liver Research Group, Institute for Cellular Medicine, University of Newcastle, Newcastle, UK : julia.newton@nuth.nhs.uk - QJM. 2007 Aug;100(8):519-26. Epub 2007 Jul 7 - PMID: 17617647
      Background - Chronic fatigue syndrome (CFS) is common and its cause is unknown.
      Aim
      - To study the prevalence of autonomic dysfunction in CFS and to develop diagnostic criteria.
      Design
      - Cross-sectional study with independent derivation and validation phases.
      Methods
      - Symptoms of autonomic dysfunction were assessed using the Composite Autonomic Symptom Scale (COMPASS).
      Fatigue was assessed using the Fatigue Impact Scale (FIS).
      Subjects were studied in two groups : phase 1 (derivation phase), 40 CFS patients and 40 age- and sex-matched controls; phase 2 (validation phase), 30 CFS patients, 37 normal controls and 60 patients with primary biliary cirrhosis.
      Results - Symptoms of autonomic dysfunction were strongly and reproducibly associated with the presence of CFS or primary biliary cirrhosis (PBC) and correlated with severity of fatigue.
      Total COMPASS score >32.5 was identified in phase 1 as a diagnostic criterion for autonomic dysfunction in CFS patients and was shown in phase 2 to have a positive predictive value of 0.96 (95%CI 0.86-0.99) and a negative predictive value of 0.84 (0.70-0.93) for the diagnosis of CFS.
      Discussion
      - Autonomic dysfunction is strongly associated with fatigue in some, but not all, CFS and PBC patients.
      We postulate the existence of a 'cross-cutting' aetiological process of dysautonomia-associated fatigue (DAF).
      COMPASS >32.5 is a valid diagnostic criterion for autonomic dysfunction in CFS and PBC and can be used to identify patients for targeted intervention studies.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/17617647

    16. Tc99-HMPAO SPECT and magnetic resonance imaging in 30 patients suffering from chronic fatigue syndrome
      Osmanagaoglu K, Lambrecht L, Van de Wiele C et al. - Neurospect. SPECT in Clinical Neurology and Psychiatry. Acta Neurol Belg 1995; Suppl: 87-88

    17. The assessment of vascular abnormalities in late life chronic fatigue syndrome by brain SPECT - Comparison with late life major depressive disorder
      Goldstein JA, Mena I, Jouanne E, Lesser I - J Chronic Fatigue Syndr 1995; 1: 55-79

    18. The BEACH study of general practice
      Britt HC, Miller GC - Med J Aust 2000; 173: 63-64

    19. The biology of chronic fatigue syndrome
      Komaroff AL - Am J Med 2000; 108: 169-171

    20. The chronic fatigue syndrome - A comprehensive approach to its definition and study - International Chronic Fatigue Syndrome Study Group
      Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333 - Ann Intern Med. 1994 Dec 15;121(12):953-9 - PMID: 7978722
      The complexities of the chronic fatigue syndrome and the methodologic problems associated with its study indicate the need for a comprehensive, systematic and integrated approach to the evaluation, classification and study of persons with this condition and other fatiguing illnesses.
      We propose a conceptual framework and a set of guidelines that provide such an approach.
      Our guidelines include recommendations for the clinical evaluation of fatigued persons, a revised case definition of the chronic fatigue syndrome and a strategy for subgrouping fatigued persons in formal investigations.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/7978722
      Also read the comments on this article :
      -
      The chronic fatigue syndrome
      Lapp CW, Cheney PR - Ann Intern Med. 1995 Jul 1;123(1):74-5 - PMID: 7762921
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/7762921?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Dis
      co
      veryPanel.Pubmed_RVAbstractPlus
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      The chronic fatigue syndrome
      Rest J - Ann Intern Med. 1995 Jul 1;123(1):75; author reply 76 - PMID: 7762922
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/7762922?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Dis
      co
      veryPanel.Pubmed_RVAbstractPlus
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      The chronic fatigue syndrome
      Dodge JH, Kita MW - Ann Intern Med. 1995 Jul 1;123(1):75; author reply 76 - PMID: 7619172
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/7619172?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Dis
      coveryPanel.Pubmed_RVAbstractPlus

      -
      The chronic fatigue syndrome
      Rotheram EB Jr. - Ann Intern Med. 1995 Jul 1;123(1):75; author reply 76 - PMID: 7762923
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/7762923?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Dis
      co
      veryPanel.Pubmed_RVAbstractPlus

    21. The Chronic Fatigue Syndrome Controversy
      W. C. Reeves, P. E. Pellett and H. Gary Jr. - Ann Intern Med, August 15, 1992; 117(4): 343 – 344
      Cfr. : http://www.annals.org/content/117/4/343.extract

    22. The connection between chronic fatigue syndrome and neurally mediated hypotension
      Wilke WS, Fouad-Tarazi FM, Cash JM, Calabrese LH, Department of Rheumatic and Immunologic Disease, Cleveland Clinic Foundation, OH 44195, USA - Cleve Clin J Med. 1998 May;65(5):261-6 - PMID: 9599909
      Research from several groups of investigators indicates that some patients with chronic fatigue syndrome have abnormal vasovagal or vasodepressor responses to upright posture.
      If confirmed, these findings may explain some of the symptoms of chronic fatigue syndrome.
      There is also speculation that neurally mediated hypotension may be present in fibromyalgia.
      This article discusses the original research in this area, the results of follow-up studies and the current approach to treating patients with chronic fatigue syndrome in whom neurally mediated hypotension is suspected.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/9599909

    23. The Dubbo INfgection Outcomes Study - Post-infective Fatigue as a model for CFS
      Jones, J., Hickie, I., Wakefield, D., Davenport, T.A., Vollmer-Conna, U. & Lloyd, A. (2004a)
      Cfr. '
      Some Interesting Facets of Research Science - AACFS Seventh International Conference' (Alan Cocchetto, 2004) at : http://www.ncf-net.org/forum/InterestingFacets.htm

    24. The economic impact of chronic fatigue syndrome
      Reynolds KJ, Vernon SD, Bouchery E, Reeves WC, Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention, Atlanta, U.S.A. : wcr1@cdc.gov - Cost Eff Resour Alloc. 2004 Jun 21;2(1):4 - PMID: 15210053
      Background - Chronic fatigue syndrome (CFS) is a chronic incapacitating illness that affects between 400,000 and 800,000 Americans.
      Despite the disabling nature of this illness, scant research has addressed the economic impact of CFS either on those affected or on the national economy.
      Methods
      - We used microsimulation methods to analyze data from a surveillance study of CFS in Wichita, Kansas and derive estimates of productivity losses due to CFS.
      Results
      - We estimated a 37% decline in household productivity and a 54% reduction in labor force productivity among people with CFS.
      The annual total value of lost productivity in the United States was $9.1 billion, which represents about $20,000 per person with CFS or approximately one-half of the household and labor force productivity of the average person with this syndrome.
      Conclusion
      - Lost productivity due to CFS was substantial both on an individual basis and relative to national estimates for other major illnesses.
      CFS resulted in a national productivity loss comparable to such losses from diseases of the digestive, immune and nervous systems and from skin disorders.
      The extent of the burden indicates that continued research to determine the cause and potential therapies for CFS could provide substantial benefit both for individual patients and for the nation.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/15210053

    25. The effect of paroxetine and nefazodone on sleep - A placebo controlled trial
      Sharpley AL, Williamson DJ, Attenburrow MEJ et al. - Psychopharmacology Berl 1996; 126: 50-54

    26. The epidemiology of anxiety disorders - Prevalence and societal costs
      Lépine JP, Assistance Publique Hôpitaux de Paris, Service de Psychiatrie, Hôpital Fernand Widal, Paris, France : jean-pierre.lepine@lrb.aphop-paris.fr - J Clin Psychiatry. 2002;63 Suppl 14:4-8 -PMID: 12562112
      Anxiety disorders are the most prevalent of psychiatric disorders, yet less than 30% of individuals who suffer from anxiety disorders seek treatment.
      Prevalence of anxiety disorders is difficult to pinpoint since even small changes in diagnostic criteria, interview tools or study methodology affect results.
      Analyses of the largest prevalence studies of psychiatric illnesses in the United States find that anxiety disorders afflict 15.7 million people in the United States each year and 30 million people in the United States at some point in their lives.
      Currently, the European Study of Epidemiology of Mental Disorders and the World Health Organization World Mental Health 2000 studies are underway.
      These studies, which share a similar methodology, will facilitate future worldwide comparisons of the prevalence of anxiety disorders.
      Anxiety disorders impose high individual and social burden, tend to be chronic and can be as disabling as somatic disorders.
      Compared with those who have other psychiatric disorders, people with anxiety disorders are high care utilizers who present to general practitioners more frequently than to psychiatric professionals, placing a strain upon the health care system.
      The economic costs of anxiety disorders include psychiatric, nonpsychiatric and emergency care; hospitalization; prescription drugs; reduced productivity; absenteeism from work; and suicide.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12562112?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed

    27. The epidemiology of chronic fatigue in San Francisco
      Steele L, Dobbins JG, Fukuda K et al. - Am J Med 1998; 105: 83S-90S

    28. The epidemiology of chronic fatigue syndrome
      Wessely S - Epidemiol Rev 1995; 17: 139-151

    29. The epidemiology of fatigue and depression - A French primary-care study
      Fuhrer R, Wessely S - Psychol Med 1995; 25: 895-905

    30. The existence of a fatigue syndrome after glandular fever
      White PD, Thomas JM, Amess J et al. - Psychol Med 1995; 25: 907-916

    31. The family response questionnaire - A new scale to assess the responses of family members to people with chronic fatigue syndrome
      Cordingley L, Wearden A, Appleby L, Fisher L - J Psychosom Res 2001; 51: 417-424

    32. The fibromyalgia syndrome as a manifestation of neuroticism ?
      P. Netter & J. Hennig, Department of Psychology, University of Giessen, Germany : petra.netter@psychol-uni-giessen.de - Zeitschrift fur Rheumatologie 1998;57 Suppl 2():105-8
      After elucidating the components and theory of neuroticism (N) as well as of psychosomatic complaints and their relationships to personality dimensions and to psychosomatic diseases, comparisons are performed between patients suffering from fibromyalgia syndrome (FMS) or related pain diseases with healthy subjects scoring high on personality dimensions related to neuroticism.
      FMS and pain patients score high on depression, anxiety and experience of stress although questionnaire scores on depression are higher in subjects not exhibiting somatic features of the disease.
      High subjective pain sensitivity and low thresholds for pain perception are also common features in high N subjects and FMS patients.
      On the endocrinological level cortisol responses to challenge tests with CRH as well as prolactin responses to TRH are higher in FMS patients than in high N healthy subjects indicating an endocrinological difference.
      A common feature, however, is the lack of adaptability in the two groups, since neurotics are in particular characterized by a low capacity to shift their behavior from one state to the other (waking-sleeping, working-relaxing), to re-adapt to baseline levels after endocrinological or physiological stress responses or to adjust to conditions of shift work.
      This is reflected by chronobiological disturbances in FMS patients and could also explain their maintainance of pain perception, because they are incapable of correcting conditioned pain-producing muscle tension.
      Cfr. :
      http://www.websciences.org/cftemplate/NAPS/archives/indiv.cfm?ID=19991043

    33. The global burden of disease - A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020
      Murray CJL, Lopez AD (editors) - Cambridge, MA : Harvard University Press, 1996

    34. The head-up tilt test with haemodynamic instability score in diagnosing chronic fatigue syndrome
      Naschitz JE, Rosner I, Rozenbaum M, Naschitz S, Musafia-Priselac R, Shaviv N, Fields M, Isseroff H, Zuckerman E, Yeshurun D, Sabo E, Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel : Naschitz@tx.technion.ac.il - QJM. 2003 Feb;96(2):133-42 - PMID: 12589011
      Background
      - Studying patients with chronic fatigue syndrome (CFS), we have developed a method that uses a head-up tilt test (HUTT) to estimate BP and HR instability during tilt, expressed as a 'haemodynamic instability score' (HIS).
      Aim
      - To assess HIS sensitivity and specificity in the diagnosis of CFS.
      Design
      - Prospective controlled study.
      Methods
      - Patients with CFS (n=40), non-CFS chronic fatigue (n=73), fibromyalgia (n=41), neurally mediated syncope (n=58), generalized anxiety disorder (n=28), familial Mediterranean fever (n=50), arterial hypertension (n=28) and healthy subjects (n=59) were evaluated with a standardized head-up tilt test (HUTT).
      The HIS was calculated from blood pressure (BP) and heart rate (HR) changes during the HUTT.
      Results
      - The tilt was prematurely terminated in 22% of CFS patients when postural symptoms occurred and the HIS could not be calculated.
      In the remainder, the median(IQR) HIS values were : CFS +2.14(4.67), non-CFS fatigue -3.98(5.35), fibromyalgia -2.81(2.62), syncope -3.7(4.36), generalized anxiety disorder -0.21(6.05), healthy controls -2.66(3.14), FMF -5.09(6.41), hypertensives -5.35(2.74) (p<0.0001 vs. CFS in all groups, except for anxiety disorder, p=NS).
      The sensitivity for CFS at HIS >-0.98 cut-off was 90.3% and the overall specificity was 84.5%.
      Discussion
      - There is a particular dysautonomia in CFS that differs from dysautonomia in other disorders, characterized by HIS >-0.98.
      The HIS can reinforce the clinician's diagnosis by providing objective criteria for the assessment of CFS, which until now, could only be subjectively inferred.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12589011
      Also read the comments on this article :
      -
      The head-up tilt test for diagnosing chronic fatigue syndrome
      Ghosh AK, Ghosh K - QJM. 2003 May;96(5):379-80 - PMID: 12702788
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12702788?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Assessing chronic fatigue
      Baschetti R - QJM. 2003 Jun;96(6):454 - PMID: 12788966
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12788966?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    35. The HPA axis and the genesis of chronic fatigue syndrome
      Cleare AJ, Section of Neurobiology of Mood Disorders, Division of Psychological Medicine, The Institute of Psychiatry, London, SE5 8AF, UK : a.cleare@iop.kcl.ac.uk - Trends Endocrinol Metab. 2004 Mar;15(2):55-9 - PMID: 15036250
      Many studies of patients with long-standing chronic fatigue syndrome (CFS) have found alterations to the hypothalamo-pituitary-adrenal (HPA) axis, including mild hypocortisolism, heightened negative feedback and blunted responses to challenge.
      However, recent prospective studies of high-risk cohorts suggest that there are no HPA axis changes present during the early stages of the genesis of fatiguing illnesses.
      Moreover, HPA axis changes can be reversed by modifying behavioural features of the illness, such as inactivity, deconditioning and sleep disturbance.
      Nevertheless, raising levels of cortisol pharmacologically can temporarily alleviate symptoms of fatigue.
      This article presents the case that there is no specific change to the HPA axis in CFS and that the observed changes are of multifactorial aetiology, with some factors occurring as a consequence of the illness.
      Nevertheless, the HPA axis might play a role in exacerbating or perpetuating symptoms late on in the course of the illness.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/15036250

    36. The hypothalamic-pituitary-adrenal stress axis in fibromyalgia and chronic fatigue syndrome
      Crofford LJ, Division of Rheumatology, University of Michigan, Ann Arbor 48109-0680, USA : crofford@umich.edu - Z Rheumatol. 1998;57 Suppl 2:67-71 - PMID: 10025087
      HPA axis abnormalities in FM, CFS and other stress-related disorders must be placed in a broad clinical context.
      We know that interventions providing symptomatic improvement in patients with FM and CFS can directly or indirectly affect the HPA axis.
      These interventions include exercise, tricyclic anti-depressants and serotonin reuptake inhibitors.
      There is little direct information as to how the specific HPA axis perturbations seen in FM can be related to the major symptomatic manifestations of pain, fatigue, sleep disturbance and psychological distress.
      Since many of these somatic and psychological symptoms are present in other syndromes that exhibit HPA axis disturbances, it seems reasonable to suggest that there may be some relationship between basal and dynamic function of the HPA axis and clinical manifestations of FM and CFS.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/10025087?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedreviews&logdbfrom=pubmed

    37. The hypothalamo-pituitary-adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome
      Tanriverdi F, Karaca Z, Unluhizarci K, Kelestimur F, Department of Endocrinology, Medical School, Erciyes University, Kayseri, Turkey - Stress. 2007 Mar;10(1):13-25 - PMID: 17454963
      The hypothalamo-pituitary-adrenal (HPA) axis plays a major role in the regulation of responses to stress.
      Human stress-related disorders such as chronic fatigue syndrome (CFS), fibromyalgia syndrome (FMS), chronic pelvic pain and post-traumatic stress disorder are characterized by alterations in HPA axis activity.
      However, the role of the HPA axis alterations in these stress-related disorders is not clear.
      Most studies have shown that the HPA axis is underactive in the stress-related disorders, but contradictory results have also been reported, which may be due to the patients selected for the study, the methods used for the investigation of the HPA axis, the stage of the syndrome when the tests have been done and the interpretation of the results.
      There is no structural abnormality in the endocrine organs which comprise the HPA axis, thus it seems that hypocortisolemia found in the patients with stress-related disorder is functional.
      It may be also an adaptive response of the body to chronic stress.
      In this review, tests used in the assessment of HPA axis function and the HPA axis alterations found in CFS and FMS are discussed in detail.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/17454963

    38. The impact of catastrophic beliefs on functioning in chronic fatigue syndrome
      Petrie K, Moss-Morriss R, Weinman J - J Psychosom Res 1995; 39: 31-37

    39. The low dose ACTH test in chronic fatigue syndrome and in health
      Scott LV, Medbak S, Dinan TG - Clin Endocrinol 1998; 48: 733-737

    40. The measurement of fatigue in patients with multiple sclerosis - A multidimensional comparison with patients with chronic fatigue syndrome and healthy subjects
      Vercoulen JH, Hommes OR, Swanink CM et al. - Arch Neurol 1996; 53: 642-649

    41. The mental health of patients with a chief complaint of chronic fatigue - A prospective evaluation and follow-up
      Manu P, Matthews DA, Lane TJ, Division of General Medicine, University of Connecticut Health Center, Farmington 06032 - Arch Intern Med. 1988 Oct;148(10):2213-7 - PMID: 3178379
      To determine the psychiatric morbidity of patients complaining of chronic fatigue, we undertook a prospective evaluation of 100 adults (65 women and 35 men; mean age, 41 years; and mean duration of chronic fatigue, 13 years).
      The study was conducted in an internal medicine outpatient clinic.
      In addition to a comprehensive medical evaluation, the patients were administered the 260-item Diagnostic Interview Schedule, a highly structured instrument that enabled the physician-interviewer to make accurate psychiatric diagnoses.
      A thorough follow-up examination was given an average of 8.4 months later.
      Sixty-six patients had one or more psychiatric disorders that were considered a major cause of their chronic fatigue (mood disorder, 47 patients; somatization disorder, 15 patients; and anxiety disorder, nine patients).
      Five patients had medical conditions that were considered a major cause of their fatigue.
      The complaint of chronic fatigue remained unexplained in 31 patients.
      In this prospective study, two thirds of cases of chronic fatigue appeared to be caused by psychiatric disorders.
      A thorough evaluation of the mental health of patients complaining of chronic fatigue could therefore provide pharmacologic and psychotherapeutic approaches and avoid unnecessary and costly medical investigations and therapies.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/3178379
      Also read the comment on this article :
      Chronic fatigue - Psyche or sleep ?
      [No authors listed] - Arch Intern Med. 1990 May;150(5):1116, 1118, 1121 - PMID: 2331192
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2331192?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Dis
      coveryPanel.Pubmed_RVAbstractPlus

    42. The natural history of concurrent sick building syndrome and chronic fatigue syndrome
      Chester AC, Levine PH - J Psychiat Res 1997; 31: 51-57

    43. The nature of chronic fatigue
      DH Streeten - JAMA 1998;280:1094-1095
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/9757860

    44. The neuroendocrinology of chronic fatigue syndrome
      Cleare AJ, Section of Neurobiology of Mood Disorders, Division of Psychological Medicine, The Institute of Psychiatry, London SE5 8AZ, United Kingdom : a.cleare@iop.kcl.ac.uk - Endocr Rev. 2003 Apr;24(2):236-52 - PMID: 12700181
      Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin, the nature of the pathophysiological components remains unclear.
      There has been a wealth of interest in the endocrinology of this condition, which will be reviewed in this article.
      Most studied has been the hypothalamic-pituitary-adrenal (HPA) axis; although the quality of many studies is poor, the overall balance of evidence points to reduced cortisol output in at least some patients, with some evidence that this is linked to symptom production or persistence.
      There is evidence for heightened negative feedback and glucocorticoid receptor function and for impaired ACTH and cortisol responses to a variety of challenges.
      However, there is no evidence for a specific or uniform dysfunction of the HPA axis.
      Given the many factors that may impinge on the HPA axis in CFS, such as inactivity, sleep disturbance, psychiatric comorbidity, medication and ongoing stress, it seems likely that HPA axis disturbance is heterogeneous and of multifactorial etiology in CFS.
      Studies assessing GH, dehydroepiandrostenedione and its sulfate, melatonin, leptin and neuroendocrine-monoamine interactions are also reviewed.
      There is some evidence from these studies to suggest alterations of dehydroepiandrostenedione sulfate function and abnormal serotonin function in CFS, but whether these changes are of functional importance remains unclear.
      To obtain a clearer assessment of the etiological and pathophysiological relevance of endocrine changes in CFS, it is suggested that more prospective cohort studies be undertaken in groups at high risk for CFS, that patients with CFS are followed up into recovery and that multidimensional assessments are undertaken to unravel the influence of the various confounding factors on the observed endocrine changes in CFS.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12700181

    45. The neuropsychiatry of chronic fatigue syndrome
      Wessely S - Ciba Found Symp 1993; 173: 212-229

    46. The Night Side - Chronic Fatigue Syndrome and the Illness Experience
      Michael Loudon - JAMA. 1997;278(20):1709
      Cfr. : http://jama.ama-assn.org/cgi/reprint/278/20/1709

    47. The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome - A prospective primary care study
      Wessely S, Chalder T, Hirsch S, Wallace P, Wright D - Am J Public Health 1997; 87: 1449-1455
      Cfr. : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380968/

    48. The prevalence of chronic fatiguing illnesses among adolescents in the United States
      Dobbins JG, Randall B, Reyes M et al. - J Chronic Fatigue Syndr 1997; 3: 15-27

    49. The prevalence of psychiatric morbidity - OPCS survey of psychiatric morbidity in Great Britain
      Mason P, Wilkinson G - Br J Psychiatry 1996; 168: 1-3

    50. The prognosis of chronic fatigue and chronic fatigue syndrome - A systematic review
      Joyce J, Hotopf M, Wessely S - QJM 1997; 90: 223-233

    51. The psychiatric status of patients with the chronic fatigue syndrome
      Hickie, I., Lloyd, A., Wakefield, D. & Parker, G. (1990) - British Journal of Psychiatry, 156, 534-540
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/2386862


    Lees verder : Deel XI


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    M.E. (cvs) – Richtlijnen voor psychiaters

    Deel XI

    1. The quality and accessibility of Australian depression sites on the World Wide Web
      Griffiths KM, Christensen H - Med J Aust 2002; 176 Suppl: S97-S104

    2. The relationship between fatigue, psychological and immunological variables in acute infectious illness
      Bennett BK, Hickie IB, Vollmer-Conna US et al. - Aust N Z J Psychiatry 1998; 32: 180-186

    3. The relationship between fatigue, psychological and immunological variables in acute infectious illness
      Bennett BK, Hickie IB, Vollmer-Conna US et al. - Aust N Z J Psychiatry 1998; 32: 180-186
      Cfr. : http://informahealthcare.com/doi/abs/10.3109/00048679809062727?cookieSet=1&journalCode=anp

    4. The relationship between fibromyalgia and major depressive disorder
      Hudson JI, Pope HG - Rheum Dis Clin North Am 1996; 22: 285-303

    5. The relationship between infection and fatigue
      White PD - J Psychosom Res 1997; 43: 345-350

    6. The relationship between neurally mediated hypotension and the chronic fatigue syndrome
      Bou-Holaigah I, Rowe PC, Kan J, Calkins H, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, USA - JAMA. 1995 Sep 27;274(12):961-7 - PMID: 7674527
      Cfr. :
      -
      http://jama.ama-assn.org/cgi/content/abstract/274/12/961
      - http://www.ncbi.nlm.nih.gov/pubmed/7674527

    7. The role of essential fatty acids in chronic fatigue syndrome - A case-controlled study of red-cell membrane essential fatty acids (EFA) and a placebo-controlled treatment study with high dose of EFA
      Warren G, McKendrick M, Peet M - Acta Neurol Scand 1999; 99: 112-116

    8. The role of personality in the development and perpetuating of chronic fatigue syndrome
      White C, Schweitzer R - J Psychosom Res 2000; 48: 515-524

    9. The role of physical inactivity in the chronic fatigue syndrome
      White PD - J Psychosom Res 2000; 49: 283-284

    10. The role of psychiatric disorders in fibromyalgia
      McBeth J, Silman Ajm Arthritis Research Campaign Epidemiology Unit, School of Epidemiology and Health Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK . john.mcbeth@fsl.ser.man.ac.uk - Curr Rheumatol Rep. 2001 Apr;3(2):157-64 - PMID: 11286672
      The cardinal features of fibromyalgia are chronic widespread pain in the presence of widespread tenderness as measured by multiple tender points.
      Despite extensive investigations, the etiology of this syndrome remains unclear.
      Increased rates of psychiatric disorders, particularly depressive, anxiety and somatoform disorders, are apparent in clinic populations.
      Epidemiologic evidence suggests that this is also true for community subjects.
      Depression, generalized psychological distress and other psychological factors have been shown to be associated with the onset and persistence of fibromyalgia symptoms.
      However, the bodily processes through which such factors may lead to the onset of fibromyalgia are unclear.
      Recent investigations have demonstrated altered stress system responsiveness, most notably the hypothalamic-pituitary-adrenal stress axis, in patients with fibromyalgia.
      These findings and one promising avenue for investigating the interaction between psychological and biological factors in the onset of chronic pain syndromes including fibromyalgia, are discussed.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11286672

    11. The roles of orthostatic hypotension, orthostatic tachycardia, and subnormal erythrocyte volume in the pathogenesis of the chronic fatigue syndrome
      Streeten DH, Thomas D, Bell DS, Department of Medicine, State University of New York Health Science Center, Syracuse 13210, USA - Am J Med Sci. 2000 Jul;320(1):1-8 - PMID: 10910366
      Background -
      Orthostatic hypotension during upright tilt is an important physical disorder in patients with chronic fatigue syndrome.
      We have tested its occurrence during prolonged standing, whether it is correctable and whether reduced circulating erythrocyte volume is present.
      Methods
      - Fifteen patients were randomly selected from a large population of patients with chronic fatigue syndrome, studied and observed for several years (by DSB).
      Blood pressure (BP) and heart rate (HR) measured with Dinamap every minute for 30 minutes supine and 60 minutes standing were compared with these findings in 15 healthy age- and gender-matched control subjects and later during lower body compression with military antishock trousers (MAST).
      Plasma catecholamines and circulating erythrocyte and plasma volumes were also measured by isotopic dilution methods.
      Results
      - Abnormal findings in the patients included excessive orthostatic reductions in systolic (P < 0.001) and diastolic BP (P < 0.001) and excessive orthostatic tachycardia (P < 0.01), together with presyncopal symptoms in 11 of the 15 patients and in none of the control subjects after standing for 60 min.
      Lower body compression with the MAST restored all orthostatic measurements to normal and overcame presyncopal symptoms within 10 min.
      Circulating erythrocyte but not plasma volumes were subnormal in the 12 women (P < 0.01) and plasma norepinephrine concentration rose excessively after standing for 10 min.
      Conclusion
      - Delayed orthostatic hypotension and/or tachycardia caused by excessive gravitational venous pooling, which is correctable with external lower-body compression, together with subnormal circulating erythrocyte volume, are very frequent, although not invariably demonstrable, findings in moderate to severe chronic fatigue syndrome.
      When present, they may be involved in its pathogenesis.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/10910366

    12. The Sickness of War
      Thomas M. Walshe, MD - Published in Journal Watch Neurology October 6, 2005 (covering Ann Intern Med 2005 Jun 7; 142:881-90)
      Questionnaire studies aimed at identifying causes of illness in military personnel deployed during the 1991 Gulf War have provided no clear evidence of specific causes...
      Cfr. :
      http://neurology.jwatch.org/cgi/content/citation/2005/1006/9

    13. The Structured Clinical Interview for DSM-III-R (SCID) – I. - History, rationale and description
      Spitzer RL, Williams JB, Gibbon M, First MB, Department of Psychiatry, Columbia University, New York, NY - Arch Gen Psychiatry. 1992 Aug;49(8):624-9 - PMID: 1637252
      The history, rationale and development of the Structured Clinical Interview for DSM-III-R (SCID) is described.
      The SCID is a semistructured interview for making the major Axis I DSM-III-R diagnoses.
      It is administered by a clinician and includes an introductory overview followed by nine modules, seven of which represent the major axis I diagnostic classes.
      Because of its modular construction, it can be adapted for use in studies in which particular diagnoses are not of interest.
      Using a decision tree approach, the SCID guides the clinician in testing diagnostic hypotheses as the interview is conducted.
      The output of the SCID is a record of the presence or absence of each of the disorders being considered, for current episode (past month) and for lifetime occurrence.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/1637252

    14. The Structured Clinical Interview for DSM-III-R (SCID) – II. - Multisite test-retest reliability
      Williams JB, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MJ, Kane J, Pope HG Jr, Rounsaville B et al., Department of Psychiatry, Columbia University, New York, NY. - Arch Gen Psychiatry. 1992 Aug;49(8):630-6 - PMID: 1637253
      A test-retest reliability study of the Structured Clinical Interview for DSM-III-R was conducted on 592 subjects in four patient and two nonpatient sites in this country as well as one patient site in Germany.
      For most of the major categories, kappa s for current and lifetime diagnoses in the patient samples were above .60, with an overall weighted kappa of .61 for current and .68 for lifetime diagnoses.
      For the nonpatients, however, agreement was considerably lower, with a mean kappa of .37 for current and .51 for lifetime diagnoses.
      These values for the patient and nonpatient samples are roughly comparable to those obtained with other structured diagnostic instruments.
      Sources of diagnostic disagreement, such as inadequate training of interviewers, information variance and low base rates for many disorders, are discussed.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/1637253?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

    15. The symptoms and signs of upper airway resistance syndrome - A link to the functional somatic syndromes
      Gold Avram R. (1) ; Dipalo Francis (1) ; Gold Morris S. (2) ; O'Hearn Daniel (1) - (1) Division of Pulmonary/Critical Care Medicine, SUNY-Stony Brook, School of Medicine, DVA Medical Center, Northport, NY, Etats-Unis - (2) Biostatistics and Data Management, Novartis Consumer Health, Summit, NJ, Etats-Unis - Chest 2003, vol. 123, no1, pp. 87-95 - American College of Chest Physicians, Northbrook, IL, Etats-Unis (1970)
      Study objectives - The functional somatic syndromes are associated with a variety of symptoms/ signs of uncertain etiology.
      We determined the prevalence of several of those symptoms/signs in patients with sleep-disordered breathing and examined the relationship between the prevalence of the symptoms/signs and the severity of sleep-disordered breathing.
      Design
      - A descriptive study without intervention.
      Setting
      - A university sleep-disorders center located in a suburban setting.
      Patients or participants : three groups of 25 consecutively collected patients with sleep-disordered breathing.
      Groups varied in their apnea hypopnea indexes (AHIs) as follows : upper airway resistance syndrome (UARS) [AHI < 10/h), mild-to-moderate obstructive sleep apnea/ hypopnea (OSA/H) [AHI ≥ 10 to < 40/h) and moderate-to-severe OSA/H (AHI ≥ 40/h).
      Measurements and results
      - Patients underwent comprehensive medical histories, physical examinations and full-night polysomnography.
      The diagnosis of UARS included quantitative measurement of inspiratory airflow and inspiratory effort with demonstration of inspiratory flow limitation.
      The percentage of women among the patients with sleep-disordered breathing (p = 0.001) and the prevalence of sleep-onset insomnia (p = 0.04), headaches (p = 0.01), irritable bowel syndrome (p = 0.01) and alpha-delta sleep (p = 0.01) was correlated with decreasing severity of AHI group.
      Conclusions
      - We conclude that patients with UARS, mild-to-moderate OSA/H and moderate-to-severe OSA/H differ in their presenting symptoms/signs.
      The symptoms/signs of UARS closely resemble those of the functional somatic syndromes.
      Cfr. :
      http://cat.inist.fr/?aModele=afficheN&cpsidt=14474218

    16. The symptoms of chronic fatigue syndrome are related to abnormal ion channel function
      Chaudhuri A, Watson WS, Pearn J et al. - Med Hypotheses 2000; 54: 59-63

    17. The temporal stability and co-morbidity of prolonged fatigue - A longitudinal study in primary care
      Hickie I, Koschera A, Hadzi-Pavlovic D et al. - Psychol Med 1999; 29: 855-861

    18. The use of a symptom "self-report" inventory to evaluate the acceptability and efficacy of a walking program for patients suffering with chronic fatigue syndrome
      Coutts R, Weatherby R, Davie A - J Psychosom Res 2001; 51: 425-429

    19. The validity and reliability of the fatigue syndrome that follows glandular fever
      White PD, Grover SA, Kangro HO et al. - Psychol Med 1995; 25: 917-924

    20. Thirteen-year follow-up of children and adolescents with chronic fatigue syndrome
      Bell DS, Jordan K, Robinson M, Primary Care Pediatrics, Lyndonville, New York, USA - Pediatrics. 2001 May;107(5):994-8 - PMID: 11331676
      Objective - To describe the educational, social, and symptomatic outcome of children and adolescents with chronic fatigue syndrome 13 years after illness onset.
      Methods
      - Between January 1984 and December 1987, 46 children and adolescents developed an illness suggestive of chronic fatigue syndrome.
      Follow-up questionnaires were obtained from 35 participants an average of 13 years after illness onset.
      Data were obtained concerning subsequent medical diagnoses, amount of school missed, presence and severity of current symptoms and subjective assessment of degree of illness resolution.
      Results
      - Of the 35 participants, 24 were female (68.6%) and 11 were male (31.4%).
      Average age at illness onset was 12.1 years.
      Eight participants (22.9%) had an acute onset of symptoms, 27 (77.1%) had a gradual onset.
      No participant received an alternative medical diagnosis that could have explained the symptom complex between illness onset and follow-up.
      Thirteen participants (37.1%) considered themselves resolved of illness at follow-up; 15 participants (42.9%) considered themselves well but not resolved; 4 (11.4%) considered themselves chronically ill; and 3 (8.6%) considered themselves more ill than during the early years of illness.
      Correlation with the Medical Outcomes Study Short Form Health Survey was good for current level of symptoms and degree of recovery.
      Eight participants (22.9%) missed >2 years of school and 5 of these were still ill at follow-up.
      Amount of school missed correlated with both illness severity at follow-up and perceived social impact of the illness.
      Conclusions
      - These data demonstrate the presence of an illness consistent with the current definition of chronic fatigue syndrome.
      Eighty percent of children and adolescents affected had a satisfactory outcome from their fatiguing illness, although the majority of these participants had mild to moderate persisting symptoms.
      Twenty percent of participants remain ill with significant symptoms and activity limitation 13 years after illness onset.
      Chronic fatigue syndrome in children and adolescents may result in persistent somatic symptoms and disability in a minority of those affected.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11331676

    21. Thoroughly modern worries - The relationship of worries about modernity to reported symptoms, health and medical care utlization
      Petrie KJ, Sivertsen B, Hysing M et al. - J Psychosom Res 2001; 51: 295-401

    22. Time for Healing - Relaxation for mind and body
      Catherine Regan, Ph.D. - Bull Publishing
      Catherine Regan, Ph.D., is a clinical psychologist whose work includes a broad range of psychotherapy and behavioral medicine interventions.
      She lives and works in San Francisco, CA.
      '
      Time for Healing' includes two 30-minute relaxation exercises with soft background music and the voice of Catherine Regan.
      They are meant to release tension, achieve deep muscular relaxation and guide listeners toward heightened self-awareness.
      Widely used in conjunction with our chronic conditions books.
      Now available in CD format.
      Cfr. :
      http://www.bullpub.com/healing.html

    23. To exercise or not to exercise in chronic fatigue syndrome ?
      Garry C Scroop and Richard B Burnet - Ellie Stein and Christine Hunter - Andrew R Lloyd - Med J Aust 2004; 181 (10): 578-580
      Cfr. : http://www.mja.com.au/public/issues/181_10_151104/letters_151104-6.html

    24. To exercise or not to exercise in chronic fatigue syndrome ? - No longer a question
      Andrew R Lloyd - Med J Aust 2004; 180 (9): 437-438
      Cfr. : http://www.mja.com.au/public/issues/180_09_030504/llo10096_fm.html

    25. Traditional Chinese Medicine for Chronic Fatigue Syndrome
      Rui Chen1,2, Junji Moriya2, Jun-ichi Yamakawa2, Takashi Takahashi2 and Tsugiyasu Kanda2 - 1Department of Traditional Chinese Medicine, Union Hospital Affiliated to Huazhong University of Science and Technology, Wuhan, China and 2Department of General Medicine, Kanazawa Medical University, Ishikawa, Japan - Evid Based Complement Alternat Med 2008
      More and more patients have been diagnosed as having chronic fatigue syndrome (CFS) in recent years.
      Western drug use for this syndrome is often associated with many side-effects and little clinical benefit.
      As an alternative medicine, traditional Chinese medicine (TCM) has provided some evidences based upon ancient texts and recent studies, not only to offer clinical benefit but also offer insights into their mechanisms of action.
      It has perceived advantages such as being natural, effective and safe to ameliorate symptoms of CFS such as fatigue, disordered sleep, cognitive handicaps and other complex complaints, although there are some limitations regarding the diagnostic standards and methodology in related clinical or experimental studies.
      Modern mechanisms of TCM on CFS mainly focus on adjusting immune dysfunction, regulating abnormal activity in the hypothalamic-pituitary-adrenal (HPA) axis and serving as an antioxidant.
      It is vitally important for the further development to establish standards for ‘
      zheng’ of CFS, i.e. the different types of CFS pathogenesis in TCM, to perform randomized and controlled trials of TCM on CFS and to make full use of the latest biological, biochemical, molecular and immunological approaches in the experimental design.
      Cfr. :
      http://ecam.oxfordjournals.org/cgi/content/full/nen017

    26. Treating depression - The beyondblue guidelines for treating depression in primary care - "Not so much what you do but that you keep doing it"
      Ellis PM, Smith DA, Beyond blue, the national depression initiative - Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand : ellis@wnmeds.ac.nz - Med J Aust. 2002 May 20;176 Suppl:S77-83 - PMID: 12065002

      1/ Most people with depression will be treated in general practice, either by the GP alone or (for more serious depression) in partnership with specialist mental health services.
      2/ Treatment plans should always be based on thorough assessment, including the type, severity and duration of the depressive episode and any stressors that contributed to the episode.
      3/ For mild and moderate depression, meta-analysis shows there is little difference in relative effectiveness of treatments and continuation of therapy is more important than initial treatment choice.
      4/ The best outcomes are likely when a good therapeutic alliance is formed between a healthcare professional and the patient and adequate treatment is provided over a long enough period.
      For pharmacological interventions, treatment should continue for : at least one year for a first episode of depression and at least two years for repeated episodes or where there are other risk factors for relapse.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/12065002?dopt=Abstract
      Also read the comment on this article :
      How long should drug treatment of depression last ?
      Fava GA, Ruini C, Tossani E - Med J Aust. 2003 May 19;178(10):526; author reply 526-7 - PMID: 12741948
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/12741948?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    27. Treatment for Chronic Fatigue Syndrome
      Baschetti et al. - Arch Intern Med 1998;158:2266-2267
      Cfr. : http://archinte.ama-assn.org/cgi/content/full/158/20/2266

    28. Treatment of common mental disorders in Australian general practice
      Hickie IB, Davenport TA, Naismith S et al. - Med J Aust 2001; 175 Suppl Jul 16: S25-S30

    29. Treatment options and patient perspectives in the management of fibromyalgia - Future trends
      Lawson K, Biomedical Research Centre, Sheffield Hallam University, Faculty of Health and Wellbeing, Sheffield, UK - Neuropsychiatr Dis Treat. 2008 Dec;4(6):1059-71 - PMID: 19337451
      Fibromyalgia (FM) is a common, complex and difficult to treat chronic widespread pain disorder, which usually requires a multidisciplinary approach using both pharmacological and non-pharmacological (education and exercise) interventions.
      It is a condition of heightened generalized sensitization to sensory input presenting as a complex of symptoms including pain, sleep dysfunction and fatigue, where the pathophysiology could include dysfunction of the central nervous system pain modulatory systems, dysfunction of the neuroendocrine system and dysautonomia.
      A cyclic model of the pathophysiological processes is compatible with the interrelationship of primary symptoms and the array of postulated triggers associated with FM.
      Many of the molecular targets of current and emerging drugs used to treat FM have been focused to the management of discrete symptoms rather than the condition.
      Recently, drugs (eg, pregabalin, duloxetine, milnacipran, sodium oxybate) have been identified that demonstrate a multidimensional efficacy in this condition.
      Although the complexity of FM suggests that monotherapy, non-pharmacological or pharmacological, will not adequately address the condition, the outcomes from recent clinical trials are providing important clues for treatment guidelines, improved diagnosis, and condition-focused therapies.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/19337451?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_PMC&linkpos=1&log$=citedinpmcarticles&logdbfrom=pub
      med

    30. Unexplained suffering in the aftermath of war
      Anthony L. Komaroff - Annals 2005 142: 938-939
      In 1990, military forces from Iraq invaded and occupied Kuwait and massed at the Saudi Arabia border.
      Early in 1991, an international alliance led by the United States attacked Iraqi forces and rapidly drove them back into Iraq.
      More than 500 000 U.S. personnel were involved in the Gulf War military action.
      Approximately 300 were killed and 500 were wounded—remarkably low numbers for a force of that size.
      But the end of hostilities was not the end of the story.
      By the end of 1991, many Gulf War veterans felt unwell.
      They reported various persistent and debilitating symptoms.
      Both the U.S. Department of Defense and the U.S. Department of Veterans Affairs created registries of ailing combatants from the Gulf War.
      The most commonly reported symptoms were fatigue, rashes, headache, muscle and joint pain and memory impairment (1, 2).
      Disability claims mounted. By 2001, nearly 20% of personnel deployed to the Gulf War were receiving some form of disability compensation (3).
      Was the Gulf War, in fact, associated with an unusual burden of chronic multisymptom reports ?
      Data from the registries could not answer that question, since the individuals in the registries were self-selected. Therefore, the U.S. Department of Veterans Affairs initiated several large population-based studies.
      The studies—conducted in the United States (4, 5), the United Kingdom (6, 7), Canada (8), and Denmark (9)—shared certain features .../...
      Cfr. :
      http://www.annals.org/content/142/11/938.extract

    31. Unique genetic and environmental determinants of prolonged fatigue - A twin study
      Hickie I, Kirk K, Martin N, School of Psychiatry, University of New South Wales, Sydney, Australia - Psychol Med. 1999 Mar;29(2):259-68 - PMID: 10218917
      Background - Prolonged fatigue syndromes have been proposed as prevalent and disabling forms of distress that occur independently of conventional notions of anxiety and depression.
      Methods
      - To investigate the genetic and environmental antecedents of common forms of psychological and somatic distress, we measured fatigue, anxiety, depression and psychological distress in 1004 normal adult twin pairs (533 monozygotic (MZ), 471 dizygotic (DZ)) over 50 years of age.
      Results
      - Familial aggregation of psychological distress, anxiety and fatigue appeared to be due largely to additive genetic factors (MZ:DZ ratios of 2.12-2.69).
      The phenotypic correlations between the psychological measures (distress, anxiety and depression) were moderate (0.67-0.79) and higher than that between fatigue and psychological distress (0.38).
      Multivariate genetic modelling revealed a common genetic factor contributing to the development of all the observed phenotypes (though most strongly for the psychological forms), a second independent genetic factor also influenced anxiety and depression and a third independent genetic factor made a major contribution to fatigue alone.
      In total, 44% (95% CI 25-60%) of the genetic variance for fatigue was not shared by the other forms of distress.
      Similarly, the environmental factor determining psychological distress made negligible contributions to fatigue, which was underpinned largely by its own independent environmental factor.
      Conclusion
      - This study supports the aetiological independence of prolonged fatigue and, therefore, argues strongly for its inclusion in classification systems in psychiatry.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/10218917

    32. Upregulation of the 2-5A synthetase/RNase L antiviral pathway associated with chronic fatigue syndrome
      Suhadolnik,R.J., Reichenbach,N.L., Hitzges,P., Sobol,R.W., Peterson,D.L., Henry, B, Ablashi,D.V., Muller,W.E., Schroder,H.C. & Carter,W.A. (1994) - Clinical Infectious Diseases, 18 Suppl 1, S96-104

    33. Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers
      Scott,L.V. & Dinan,T.G. (1998) - Journal of Affective Disorders, 47, 49-54

    34. US case definition of chronic fatigue syndrome - Diagnostic and theoretical issues
      Jason LA, King CP, Richman JA et al. - J Chronic Fatigue Synd 1999; 5(3/4): 3-33

    35. Use of medications by people with chronic fatigue syndrome and healthy persons - A population-based study of fatiguing illness in Georgia
      Boneva RS, Lin JM, Maloney EM, Jones JF, Reeves WC, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA : rboneva@cdc.gov - Health Qual Life Outcomes. 2009 Jul 20;7:67 - PMID: 19619330
      Background - Chronic fatigue syndrome (CFS) is a debilitating condition of unknown etiology and no definitive pharmacotherapy.
      Patients are usually prescribed symptomatic treatment or self-medicate.
      We evaluated prescription and non-prescription drug use among persons with CFS in Georgia and compared it to that in non-fatigued Well controls and also to chronically Unwell individuals not fully meeting criteria for CFS.
      Methods
      - A population-based, case-control study. To identify persons with possible CFS-like illness and controls, we conducted a random-digit dialing telephone screening of 19,807 Georgia residents, followed by a detailed telephone interview of 5,630 to identify subjects with CFS-like illness, other chronically Unwell, and Well subjects. All those with CFS-like illness (n = 469), a random sample of chronically Unwell subjects (n = 505) and Well individuals (n = 641) who were age-, sex-, race- and geographically matched to those with CFS-like illness were invited for a clinical evaluation and 783 participated (48% overall response rate).
      Clinical evaluation identified 113 persons with CFS, 264 Unwell subjects with insufficient symptoms for CFS (named ISF) and 124 Well controls; the remaining 280 subjects had exclusionary medical or psychiatric conditions and 2 subjects could not be classified.
      Subjects were asked to bring all medications taken in the past 2 weeks to the clinic where a research nurse viewed and recorded the name and the dose of each medication.
      Results
      - More than 90% of persons with CFS used at least one drug or supplement within the preceding two weeks. Among users, people with CFS used an average of 5.8 drugs or supplements, compared to 4.1 by ISF and 3.7 by Well controls. Persons with CFS were significantly more likely to use antidepressants, sedatives, muscle relaxants and anti-acids than either Well controls or the ISF group.
      In addition, persons with CFS were significantly more likely to use pain-relievers, anti-histamines and cold/sinus medications than were Well controls.
      Conclusion
      - Medical care providers of patients with chronic fatigue syndrome should be aware of polypharmacy as a problem in such patients and the related potential iatrogenic effects and drug interactions.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/19619330?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed

    36. Variability in diagnostic criteria for chronic fatigue syndrome may result in substantial differences in patterns of symptoms and disability
      Leonard A. Jason, Jena Helgerson & Susan R. Torres-Harding, DePaul University - Adam W. Carrico, University of Miami - Renee R. Taylor, University of Illinois - Evaluation & the Health Professions, Vol. 26, No. 1, 3-22 (2003)
      Chronic fatigue syndrome (CFS) is an illness that involves severe, prolonged exhaustion as well as neurologic, immunologic and endocrine system pathology.
      Because the pathogenesis of CFS has yet to be determined, case definitions have relied on clinical observation in classifying signs and symptoms for diagnosis.
      The current investigation examined differences between CFS as defined by Fukuda and colleagues and a set of criteria that has been stipulated for myalgic encephalomyelitis (ME).
      Dependent measures included psychiatric comorbidity, symptom frequency, symptom severity and functional impairment.
      The ME and Fukuda et al. (1994) CFS criteria were compared with a group having chronic fatigue due to psychiatric reasons.
      Significant differences occurred primarily with neurologic, neuropsychiatric, fatigue/weakness and rheumatological symptoms.
      These findings suggest that it might be inappropriate to synthesize results from studies of this illness that use different definitions to select study populations.
      Cfr. :
      http://ehp.sagepub.com/cgi/content/abstract/26/1/3

    37. Vascular perturbations in the chronic orthostatic intolerance of the postural orthostatic tachycardia syndrome
      Stewart and Weldon
      J. Appl. Physiol. 2000;89:1505-1512

    38. Viral serologies in patients with chronic fatigue syndrome
      Buchwald D, Ashley RL, Pearlman T et al. - J Med Virol 1996; 50: 25-30

    39. Vo2peak versus Vo2max ? - An important distinction
      Sargent C, Scroop GC - Med Sci Sports Exerc 2002; 34: 1215-1216

    40. War syndromes and their evaluation - From the U.S. Civil War to the Persian Gulf War
      Hyams KC, Wignall FS, Roswell R - Ann Intern Med 1996;125:398–405

    41. What is chronic fatigue syndrome ? - Heterogeneity within an international multicentre study
      Wilson A, Hickie I, Hadzi-Pavlovic D et al. - Aust N Z J Psych 2001; 35: 520-527

    42. What people say about their general practitioners' treatment of anxiety and depression
      Andrews G, Carter GL, School of Psychiatry, University of NSW at St Vincent's Hospital, Sydney : gavina@crufad.unsw.edu.au - Med J Aust. 2001 Jul 16;175 Suppl:S48-51 - PMID: 11556437 (erratum in : Med J Aust 2001 Nov 19;175(10):560 & Med J Aust 2002 Jan 21;176(2):69)
      Objective - To determine from self-report how often people with anxiety and depressive disorders consult GPs and what treatment they receive.
      Design
      - The study was derived from the 1997 Australian National Survey of Mental Health and Wellbeing.
      A probability sample of adults was interviewed to determine how many had which mental disorders, how disabled they were by those disorders and what treatment they had received.
      Participants
      - 10641 adults, a 78% response rate.
      Main outcome measures
      - Prevalence of anxiety and depressive disorders and related disability; frequency of consultations for a mental problem; treatment received.
      Results
      - 13.6% of the population both met criteria for an anxiety or depressive disorder in the 12 months before the survey and, when they suffered from more than one disorder, nominated this as their principal complaint.
      They reported some disability in 7 of the previous 28 days, and consulted a GP or other health professional 1.4 times in that period.
      Over half did not seek a consultation for a mental health problem at any time during the year, many because they thought they had no need.
      Conclusion
      - Many people who could benefit from treatment for anxiety and depressive disorders are not being reached.
      If people were registered with a general practice it would be possible for GPs to take a proactive stance that could result in greater benefit to patients at a lower cost to the health system.
      Cfr. :
      http://www.ncbi.nlm.nih.gov/pubmed/11556437?dopt=Abstract
      Also read the comments on this article :
      -
      Mental distress or disorder ?
      Harris MF, Penrose-Wall J, School of Community Medicine, University of New South Wales, Sydney - Med J Aust. 2001 Jul 16;175 Suppl:S6-7 - PMID: 11556439
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11556439?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract
      -
      Treating depression - Making it better
      Ellis PM, Smith DA, Bushnell JA, Wellington School of Medicine and Health Sciences, University of Otago, New Zealand - Med J Aust. 2001 Jul 16;175 Suppl:S8-9 - PMID: 11556440
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11556440?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract

    43. When do symptoms become a disease ?
      Aronowitz RA - Ann Intern Med 2001; 134 Suppl: 803-808
      When do symptoms become a disease ?
      Are there rules or norms, currently or in the past, that tell us when a particular collection of largely symptom-based criteria has enough specificity, utility or plausibility to justify the appellation disease ?
      The history of numerous symptom-based diagnoses in use today suggests partial answers to these questions.
      The 19th-century shift to understanding ill health as a result of specific diseases, increasingly defined more by signs than symptoms, led to a loss of status for illnesses that possessed little clinical or laboratory specificity.
      Nevertheless, clinicians then and now have used symptom-based diagnoses.
      Some of these diagnoses owe their existence as specific diseases to the norms and practices of an older era much different from our own.
      Others have not only thrived but have resisted plausible redefinition done by using more “objective” criteria.
      Many strategies, such as response-to-treatment arguments, quantitative methods (for example : factor analysis) and consensus conferences, have been used to find or confer specificity in symptom-based diagnoses.
      These strategies are problematic and have generally been used after symptom-based diagnoses have been recognized and defined.
      These historical observations emphasize that although biological and clinical factors have set boundaries for which symptoms might plausibly be linked in a disease concept, social influences have largely determined which symptom clusters have become diseases.

      Cfr. : http://www.annals.org/content/134/9_Part_2/803.abstract

    44. WHO calls for new pact on health care
      Eaton L - BMJ. 2002 Jan 5;324(7328):7 - PMID: 11777786
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/11777786?dopt=Abstract

    45. Working at the World Health Organization - An international perspective on mental health nursing
      Grigg M - Int J Ment Health Nurs. 2003 Dec;12(4):235-6 - PMID: 14750922
      Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/14750922?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_Single
      ItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

    46. Written emotional expression produces health benefits in fibromyalgia patients
      Joan E. Broderick, PhD, Doerte U. Junghaenel, MA and Joseph E. Schwartz, PhD, from the Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY (J.E.B., J.E.S.); and the Department of Psychology, Stony Brook University, Stony Brook, NY (D.U.J.) - Address correspondence and reprint requests to : Joan E. Broderick, PhD, Department of Psychiatry and Behavioral Science, Putnam Hall, Stony Brook University, Stony Brook, NY 11794-8790 – E-mail : Joan.Broderick@stonybrook.edu - Psychosomatic Medicine 67:326-334 (2005) - © 2005 American Psychosomatic Society

      Cfr. :
      http://www.psychosomaticmedicine.org/cgi/content/abstract/67/2/326


    ~

    08-04-2010 om 23:13 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    Tags:chronic fatigue syndrome, fbromyalgia, fibromyalgie, FM, M.E./CFS, ME/CFS, Myalgische Encefalomyelitis (M.E.), psychiater, psychiatrist, psychological, psycholoog
    >> Reageer (1)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.When do symptoms become a disease ?
    Klik op de afbeelding om de link te volgen

    In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs (observed by a physician), symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others. In recent decades, the term has been used outside medicine to refer to a combination of phenomena seen in association.

    The term 'syndrome' derives from its Greek roots (σύνδρομος) and means literally "run together", as the features do.
    It is most often used to refer to the set of detectable characteristics when the reason that they occur together (the pathophysiology of the syndrome) has not yet been discovered.
    A familiar syndrome name often continues to be used even after an underlying cause has been found or when there are a number of different primary causes that all give rise to the same combination of symptoms and signs.
    Many syndromes are named after the physicians credited with first reporting the association; these are "eponymous" syndromes (cfr. also the list of eponymous diseases, many of which are referred to as "syndromes").
    Otherwise, disease features or presumed causes, as well as references to geography, history or poetry, can lend their names to syndromes.

    "Subsyndromal" conditions (or "formes fruste") are those which do not meet full criteria for a diagnosis, for example because the symptoms are fewer or less severe, but which nevertheless can be identified and related to the "full-blown" syndrome.

    A culture-bound syndrome is a set of symptoms where there is no evidence of an underlying biological cause and which is only recognized as a "disease" in a particular culture.


    When do symptoms become a disease ?

    Aronowitz RA - Ann Intern Med 2001; 134 Suppl: 803-808

    When do symptoms become a disease ?
    Are there rules or norms, currently or in the past, that tell us when a particular collection of largely symptom-based criteria has enough specificity, utility or plausibility to justify the appellation disease ?

    The history of numerous symptom-based diagnoses in use today suggests partial answers to these questions.
    The 19th-century shift to understanding ill health as a result of specific diseases, increasingly defined more by signs than symptoms, led to a loss of status for illnesses that possessed little clinical or laboratory specificity.

    Nevertheless, clinicians then and now have used symptom-based diagnoses.
    Some of these diagnoses owe their existence as specific diseases to the norms and practices of an older era much different from our own.
    Others have not only thrived but have resisted plausible redefinition done by using more “objective” criteria.
    Many strategies, such as response-to-treatment arguments, quantitative methods (for example factor analysis) and consensus conferences, have been used to find or confer specificity in symptom-based diagnoses.
    These strategies are problematic and have generally been used after symptom-based diagnoses have been recognized and defined.

    These historical observations emphasize that although biological and clinical factors have set boundaries for which symptoms might plausibly be linked in a disease concept, social influences have largely determined which symptom clusters have become diseases.

    Cfr. : http://www.annals.org/content/134/9_Part_2/803.abstract


    08-04-2010 om 20:30 geschreven door Jules

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    Tags:biological factors, clinical factors, criteria, diagnoses, disease, health, illnesses, objective criteria, social influences, symptoms, syndrome
    >> Reageer (1)
    07-04-2010
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Burnout
    Klik op de afbeelding om de link te volgen











     



    Burnout

    Gezondheidsplein.nl

    Burnout is een specifieke stressreactie of toestand van overspannenheid die voornamelijk voorkomt bij mensen in sociale of contactuele beroepen zoals het welzijnswerk, de gezondheidszorg, het onderwijs.
    Werkende vrouwen en managers hebben er vaker last van dan anderen.

    In het algemeen worden bij burnout drie reacties onderscheiden, die niet gelijktijdig hoeven voor te komen : emotionele uitputting, depersonalisatie (het gevoel buiten je eigen lichaam of geest te staan) en verminderde persoonlijke bekwaamheid.

    Specifieke symptomen zijn :

    • Niet meer met plezier naar je werk gaan (als gevolg van vermoeidheid).

    • Slaapstoornissen.

    • Te lang en te veel over het werk piekeren.

    • Niet meer kunnen genieten van dingen.

    • Geen zin meer in seks.

    • Chaotisch denken en handelen (niet meer kunnen organiseren)

    • Hoofd- en nekpijn.

    • Verlies van eetlust.

    Neurotische klachten zoals schuldgevoelens, angsten, depressies of obsessies manifesteren zich meestal in een latere fase.

    De risicofactoren voor burnout zijn : hoge werkdruk, slechte werksfeer, beperkte controlemogelijkheden (zoals beslissen over vrije dagen en pauzes) en lage beloning.
    Uit onderzoek blijkt dat één op de tien Nederlanders zich 'opgebrand' voelt.
    Met name werknemers in het onderwijs en de horeca hebben hier last van.
    Daarnaast komt werkstress in het bijzonder voor bij mensen tussen de 35 en 55 jaar.
    Er is ook een verband tussen opleiding en werkdruk.
    Hoe hoger opgeleid, hoe groter de kans op werkstress.

    Cfr. : http://www.gezondheidsplein.nl/aandoeningen/181/


    Cfr. ook :

    1. Burn-out - Werken tot je erbij neervalt
      Cfr. dit blog dd. 17-12-2009

    2. Een workaholic getuigt : Mijn leven ging kapot
      Cfr. dit blog dd. 20-09-2009

    3. Gek op je werk
      Cfr. dit blog dd. 19-10-2009


    07-04-2010 om 15:37 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 5/5 - (1 Stemmen)
    Tags:angsten, burn-out, burnout, depersonalisatie, depressie, eetlust, emotionele uitputting, hoofdpijn, nekpijn, obsessies, opgebrand, overspannenheid, piekeren, schuldgevoelens, slaapstoornissen, stress, vermoeidheid, werkdruk, werksfeer, workaholic
    >> Reageer (1)
    06-04-2010
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Gepest ? - Zet de juiste stappen
    Klik op de afbeelding om de link te volgen










     



    Gepest ? - Zet de juiste stappen

    Hendrik Mertens - VDAB.be/magezine, april 2010

    Wie getreiterd wordt op het werk, gaat soms door een hel.
    Er is een wet die de slachtoffers beschermt, maar er zit een addertje onder het gras : van die bescherming kan je alleen genieten als je je moed bijeenraapt en je klacht op de juiste manier kenbaar maakt.

    Dat is gebleken voor het Arbeidshof (arrest van het Arbeidshof van Bergen dd. 28-11-2008 - A.R. nr. 20538).
    Na een lange voorgeschiedenis had een arbeider op de dag van zijn terugkeer uit ziekte zijn ontslag gekregen.
    Hij werd uitbetaald en mocht niet meer komen werken.

    De man liet het daar niet bij.
    Hij voerde aan dat zijn problemen het gevolg waren geweest van pesterijen op het werk en eiste voor de rechtbank een morele schadevergoeding van zijn ex-werkgever.
    Maar hij ving bot – hoewel zijn dokter schriftelijk getuigde dat de zenuwinzinking van zijn patiënt een gevolg was geweest van pesterijen op het werk.

    Doktersbriefje is geen bewijs

    Om te beginnen aanvaardden de rechters het attest niet als een bewijs.
    De arts kon wel vaststellen dat zijn patiënt depressief was, maar volgens de magistraten kon hij onmogelijk weten wat zich op de arbeidsplaats had afgespeeld aangezien hij daar nooit was geweest.

    Niet meteen naar de rechter…

    Een belangrijkere struikelsteen was echter dat de arbeider zich niet kon beroepen op de wet die de slachtoffers beschermt tegen geweld, pesterijen en ongewenst seksueel gedrag op het werk.
    De arbeider had nl. niet eerst het probleem binnen het bedrijf aangekaart, vooraleer hij naar de rechter was gestapt.
    Dat is nochtans wat de wet voorschrijft.

    Doordat hij niet kon steunen op de pestwet, kon de arbeider niet genieten van de zogenaamde “omkering van bewijslast”.
    Dit is één van de voordelen van de pestwet.
    Het betekent dat het de (ex-)werkgever is die moet bewijzen dat er géén pesterijen hebben plaatsgevonden.
    Om de morele schadevergoeding te kunnen bekomen, had de arbeider in dit geval dus zelf bewijzen op tafel moeten leggen, wat hij niet had gedaan.

    maar naar de preventieadviseur

    De les is duidelijk.
    Voel je je het mikpunt van geweld, pestgedrag of ongewenste seksueel getinte woorden of handelingen op je werk, neem dan contact op met de vertrouwenspersoon of met de preventieadviseur.
    Uitleg vind je in 'Nieuwe antipestwet is van kracht' (VDAB.be/magezine, juli 2007) (cfr. hierna).

    Cfr. : http://vdab.be/magezine/april10/gepest.shtml




    Nieuwe antipestwet is van kracht

    Hendrik Mertens - VDAB.be/magezine, juli 2007

    Geweld, pesterijen en ongewenst seksueel gedrag op het werk, we weten dat het gebeurt.
    Gelukkig bestaat sedert 1996 een wet die de slachtoffers beschermt.
    Sinds 16 juni 2007 is deze wet op heel wat punten veranderd.

    Ziehier in een notendop wat je moet weten als je geen andere uitweg meer ziet dan je te beroepen op de wet.

    1. - Waarover gaat het ?

    De nieuwe wet verstaat onder geweld :

    • geestelijke bedreigingen

    • lichamelijke bedreigingen

    • aanvallen

    tijdens de uitvoering van het werk.

    De nieuwe wet verstaat onder pesterijen :

    • herhaalde feiten, buiten of binnen de onderneming, die de werknemer vernederen of zijn job in gevaar brengen,

    • bedreigingen, handelingen of woorden die een onleefbare werkomgeving creëren (kwetsende opmerkingen over bijv. godsdienst, leeftijd, geslacht, etnische afkomst, handicap of seksuele geaardheid vallen hieronder).

    De nieuwe wet verstaat onder ongewenst seksueel gedrag :

    • ongewenste seksueel getinte woorden of handelingen.

    2. - Wat is je eerste stap ?

    De nieuwe wet raadt je sterk aan de kwestie te regelen binnen de onderneming.
    Je werkgever is verplicht twee zaken op te nemen in het arbeidsreglement :

    • de naam en de gegevens van de vertrouwenspersoon en van de preventieadviseur,

    • de stappen die je moet zetten om de feiten aan te klagen.

    De nieuwe wet geeft de vertrouwenspersoon meer macht, maar je werkgever is niet verplicht er een aan te stellen.
    In dat geval moet je op de preventieadviseur rekenen.

    3. - Wat indien de pesterijen niet stoppen ?

    Wat als je een klacht hebt ingediend bij de vertrouwenspersoon of de preventieadviseur, maar de pesterijen blijven ?
    Dan kan je tijdens de interne procedure toch naar de arbeidsrechtbank stappen en maatregelen vragen.
    De rechter kan bijv. beslissen dat de collega die jij aanklaagt, verbod krijgt om de lokalen te betreden waar jij werkt.

    4. - Wat indien de interne procedure niets oplevert ?

    Dan kan je naar de rechtbank.
    Je zal moeten aantonen dat je eerst vruchteloos geprobeerd hebt een oplossing te bereiken binnen de onderneming.
    Het kan ook zijn dat jouw werkgever nalatig is en geen interne procedures heeft voorzien.
    In zo’n geval mag je meteen naar de rechter.

    Als er wél interne regels bestaan, maar ze worden niet toegepast, dan dien je best klacht in bij de Dienst Toezicht op het Welzijn op het werk (tel. : 02 233 45 11) : www.werk.belgie.be -.

    5. - Riskeer je je job te verliezen ?

    Neen, want je geniet van ontslagbescherming vanaf het moment dat de klacht is ingediend.
    Het is de werkgever verboden de volgende personen te ontslaan of hun arbeidsvoorwaarden te veranderen (tenzij om totaal andere redenen) :

    • de werknemer die een met redenen omklede klacht heeft ingediend volgens de interne procedures van de onderneming

    • of die een klacht heeft ingediend bij de Dienst Toezicht op het Welzijn op het werk

    • of die een klacht heeft ingediend bij de politie of bij het gerecht (openbaar ministerie of onderzoeksrechter)

    • of die bij de rechtbank een proces is begonnen wegens geweld, pesterijen of ongewenst seksueel gedrag.

    De ontslagbescherming geldt ook voor wie optreedt als getuige, zowel in een interne procedure als in een externe.

    6. - Wat als je elders wil gaan werken ?

    Als de procedure is afgelopen en de feiten zijn bewezen, maar de werkgever wil het slachtoffer niet in dienst houden, dan heeft het slachtoffer recht op een schadevergoeding.

    Maar wat indien het slachtoffer zélf geen zin heeft om te blijven, iets wat vaak gebeurt ?
    De nieuwe wet bepaalt dat de schadevergoeding ook moet betaald worden wanneer het slachtoffer zelf weigert te blijven werken in de onderneming.

    7. - Waar vind je de wettekst ?

    Aangename lectuur is het beslist niet, maar als je om welke reden ook de tekst van de wet zelf wilt opsporen, dan surf je naar de website van het Belgisch Staatsblad : www.ejustice.just.fgov.be -.
    Daar zoek je naar het Staatsblad van 6 juni 2007; het datumvak vul je in op zijn Amerikaans, dus als volgt : '2007 – 06 – 06'.
    Gebruik als zoekterm het woord "geweld".
    Dat levert dan de drie teksten op die je nodig hebt : een koninklijk besluit van 17 mei 2007, een wet van 6 februari 2007 en een wet van 10 januari 2007.

    Cfr. : http://vdab.be/magezine/juli07/antipestwet.shtml

    Cfr. ook :

    1. Bescherming tegen geweld en pesten op het werk
      Cfr. :
      http://www.belgium.be/nl/werk/gezondheid_en_welzijn/pesterijen_en_ongewenst_ge
      drag/bestrijding/

    2. Bescherming tegen geweld, pesterijen en ongewenst seksueel gedrag op het werk
      Cfr. :
      http://www.meta.fgov.be/defaultTab.aspx?id=2894

    3. Brochure 'Pesten op het werk'
      Cfr. :
      http://www.aclvb.be/publicaties/brochures-en-folders/brochure-pesten-op-het-werk/

    4. Nieuwe antipestwet sinds 16 juni van kracht
      Cfr. :
      http://www.gva.be/dekrant/experts/johndewit/nieuwe-antipestwet-sinds-16-juni-van-kracht.aspx

    5. Pesten op het werk
      Cfr. :
      -
      http://www.assistantplus.be/Pesten_op_het_werk
      - http://www.mijnstudentenleven.nl/arbeidsomstandigheden/pesten-op-het-werk.html
      - http://www.mindz.com/blog?n=10704&l=52
      -
      http://www.scriptiewinkel.nl/pesten-op-het-werk.86853.lynkx?RapportPointer=9-126655-127821-129589
      - http://www.vacature.com/carriere/pesten-op-het-werk

    6. Pesten op het werk - De 13 meest gestelde vragen
      Cfr. :
      http://www.deondernemer.nl/kennisbron/artikel/112357/Pesten-op-het-werk-de-13-meest-gestelde-vragen.html

    7. e.v.a.


    06-04-2010 om 22:15 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    Tags:antipestwet, arbeidsreglement, bewijslast, etnische afkomst, geslacht, geweld, godsdienst, handicap, onderneming, ongewenst seksueel gedrag, ontslagbescherming, pesterijen, pestwet, preventieadviseur, seksuele geaardheid, vertrouwenspersoon, werkomgeving
    >> Reageer (2)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Voldoet jouw werkplek aan de ARBO-normen ?
    Klik op de afbeelding om de link te volgen










     





    Oordeel mee

    Voldoet jouw werkplek aan de ARBO-normen ?

    Automatisering heeft het Nederlandse kantoorwerk de laatste twintig jaar drastisch veranderd.
    Een groot deel van de Nederlandse beroepsbevolking brengt zijn werkdagen achter het computerbeeldscherm door.

    De intrede van de automatisering heeft naast veel lusten ook enkele lasten opgeleverd.
    Spieren bewegen monotoon gedurende langere tijd, je zit uren achtereen in dezelfde houding achter een bureau in soms niet al te comfortabele bureaustoelen en ogen staren de hele dag naar een beeldscherm.

    In 1992 nam Nederland in de ARBO-wet het 'Besluit Beeldschermwerk' op.
    Hierin staan belangrijke richtlijnen, bestemd voor iedereen die met de ARBO-wet te maken heeft.
    Dus niet alleen de werknemers zelf, maar ook de werkgevers en automatiseerders zijn eraan gebonden.
    Werkplekken moeten voldoen aan de regels die in het besluit zijn opgenomen.

    Die regels hebben onder meer te maken met de apparatuur die je gebruikt; inrichting van de werkplek en verplichte pauzes zodat je niet te lang achtereen achter de pc zit.

    Is jouw werkplek 'ARBO-proof' ?
    En wat vind je van die regels : goed dat ze er zijn of is het overdreven ?
    Lees de extra informatie om meer te lezen over de ARBO-wetgeving en geef hier een reactie.

    Help ons de informatie verbeteren !

    Om zo goed mogelijk aan de vraag van informatie te kunnen voldoen, willen we graag weten hoe u over de tekst van deze pagina denkt en of u tips heeft om deze informatie en onze website te verbeteren.
    Help ons de informatie over deze pagina te verbeteren en
    vul de enquete in op : http://www.gezondheidsplein.nl/oordeelmee/168/ - !


    06-04-2010 om 20:55 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 2/5 - (5 Stemmen)
    Tags:ARBO-normen, ARBO-wet, ARBO, automatisering, beeldscherm, bureau, bureaustoelen, computerbeeldscherm, ergonomie, kantoorwerk, ogen, spieren, werkplek
    >> Reageer (1)
    02-04-2010
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Chiropractie - Vrijspraak voor Simon Singh in smaadzaak
    Klik op de afbeelding om de link te volgen








     





     

    Chiropractie
     
    Vrijspraak voor Simon Singh in smaadzaak

    Martijn van Calmthout – de Volskrant, 02-04-2010

    AMSTERDAM - De Britse wetenschapsjournalist Simon Singh heeft met zijn felle campagne tegen chiropracters geen smaad gepleegd, maar normale kritische vragen gesteld bij de werkzaamheid van een alternatieve geneeswijze.

    Dat heeft het hoogste Britse hof donderdag geoordeeld in een al twee jaar slepende zaak van de vereniging van chiropracters tegen Singh.
    Eerder had de Hoge Raad geoordeeld dat de zaak van de beroepsvereniging tegen Singh een smaadzaak was.

    Het gevolg was dat Singh in dat geval zou moeten aantonen dat chiropractische behandelingen, waarbij het lichaam wordt gemasseerd en gewrichten gerekt, niet werken tegen darmklachten en astma, zoals hij in krantenstukken had verondersteld.
    Daarmee werd de bewijslast omgedraaid.
    Singh had in krantenartikelen in The Guardian in 2008 de beroepsgroep gevraagd te bewijzen dat behandelingen wel werken.

    De zaak werd onder Britse wetenschappers en journalisten met grote belangstelling gevolgd, omdat het de speelruimte voor kritiek op alternatieve geneeswijzen ernstig zou kunnen inperken.
    Dat lijkt nu niet het geval.

    Singh zei in een reactie op het vonnis gelukkig te zijn met het oordeel van de hogerechters, maar memoreerde dat de kwestie hem hoe dan ook 200 duizend pond aan juridische bijstand heeft gekost : ‘Geen wonder dat critici wel tweemaal nadenken over wat ze zeggen en schrijven.’

    De voorzitter van de Britse vereniging van chiropracter toonde zich teleurgesteld over de uitspraak, maar zei nog mogelijkheden te zien voor verdere acties tegen Singh.

    Cfr. : http://www.volkskrant.nl/wetenschap/article1365634.ece/Vrijspraak_voor_Simon_Singh_in_smaa
    dzaak



    02-04-2010 om 19:31 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    Tags:alternatieve geneeswijze, astma, chiropracters, chiropractor, darmklachten, gewrichten, massage
    >> Reageer (1)
    29-03-2010
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.ME/CVS ? - Werk mee aan onderzoek naar tegemoetkoming chronisch zieken !
    Klik op de afbeelding om de link te volgen














     



    ME/CVS ?

    - Werk mee aan onderzoek naar tegemoetkoming chronisch zieken ! -

    Steungroep ME en Arbeidsongeschiktheid (steungroepnieuws@STEUNGROEP.NL -), 25-03-2010

    De Steungroep ME en Arbeidsongeschiktheid roept ME/CVS patiënten op om mee te werken aan onderzoek van TNO naar de Wet tegemoetkoming chronisch zieken en gehandicapten (WTCG).

    Op grond van de WTCG kunnen ouderen, arbeidsongeschikten en mensen die veel zorg gebruiken tegemoetkomingen krijgen die variëren van 150 tot 500 euro per jaar.
    Dit als compensatie voor hoge meerkosten. 

    Het onderzoek is bedoeld om na te gaan hoe op een betere manier kan worden bepaald of iemand voor zo'n tegemoetkoming in aanmerking komt en tot welk bedrag.

    Door de criteria die hiervoor nu gelden vallen bepaalde groepen buiten de boot.
    Enkele van die criteria zijn gekoppeld aan medicijngebruik of ziekenhuisbehandeling voor bepaalde aandoeningen.
    Hierbij vallen ME/CVS-patiënten buiten de boot.
    Alleen voor kinderen met ME/CVS die in een ziekenhuis behandeld worden ligt er nu een plan om dit aan te passen.
    Maar ook volwassenen met ME/CVS hebben door hun ziekte vaak forse meerkosten en niet alleen wanneer zij in een ziekehuis behandeld worden.

    Op grond van criteria die niets met de behandeling van ME/CVS te maken hebben kunnen ME/CVS-patiënten soms wel in aanmerking komen voor een (gedeeltelijke) tegemoetkoming.
    Dit is bijvoorbeeld het geval bij het krijgen van een bepaalde hoeveelheid huishoudelijke hulp via de Wet Maatschappelijke Ondersteuning (WMO) of bij een arbeidsongeschiktheid van minstens 35%.
    Het TNO-onderzoek zou kunnen bijdragen aan voorstellen die meer recht doen aan de positie van ME/CVS-patiënten.

    Het invullen van de vragenlijst gaat via internet en duurt volgens de onderzoekers ongeveer een half uur.
    Het is een algemene vragenlijst, waardoor iemand met ME/CVS zich niet in alle vragen zal herkennen (ergens 'zin' in hebben is bijvoorbeeld heel iets anders dan ergens 'energie' voor hebben).
    Maar als je je daar overheen zet is er redelijk ruimte om je beperkingen en meerkosten door te geven.

    Cfr. voor informatie over het onderzoek en vragenlijst 'TNO-onderzoek naar afbakening Wtcg' op : www.tno.nl/wtcg -.

    Meer informatie over de WTCG vind je op : http://www.wtcg.info/ en op : http://www.meerkosten.nl -.

    Over het plan om de WTCG aan te passen en over en me/cvs bij kinderen : http://www.steungroep.nl/wtcg -.

    Cfr. : http://www.steungroep.nl/index.php/nieuwsenagenda/307-26-maart-2010-mecvs-werk-mee-aan-onderzoek-naar-tegemoetkoming-chronisch-zieken


    29-03-2010 om 22:25 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 1/5 - (5 Stemmen)
    Tags:arbeidsongeschiktheid, chronisch zieken, ME, ME/CVS, medicijngebruik, TNO, WMO, WTCG, ziekenhuisbehandeling
    >> Reageer (1)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Magical Medicine - How to make a disease disappear
    Klik op de afbeelding om de link te volgen







     

    Magical Medicine : How to make a disease disappear

    Press Relaese - Medical Research Council, 12th February 2010
    Contact : Professor Malcolm Hooper (tel. : +44 191 528 5536)

    A formal complaint has been lodged by Professor Malcolm Hooper with the Rt. Hon The Lord Drayson, Minister of State with responsibility for the Medical Research Council (Science and Innovation) about the “PACE” Clinical Trial of behavioural modification interventions for people with Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS).

    PACE is the acronym for 'Pacing, Activity and Cognitive behavioural therapy', a randomised Evaluation, interventions that, according to one of the Principal Investigators, are without theoretical foundation.

    The MRC’s PACE Trial seemingly inhabits a unique and unenviable position in the history of medicine.
    It is believed to be the first and only clinical trial that patients and the charities that support them have tried to stop before a single patient could be recruited and is the only clinical trial that the Department for Work and Pensions (DWP) has ever funded.

    Since 1993, the giant US permanent health insurance company UNUMProvident has been advising the UK DWP about the most effective ways of curtailing sickness benefit payments.
    The PACE Trial is run by psychiatrists of the Wessely School, most of whom work for the medical and permanent health insurance industry, including UNUMProvident.

    These psychiatrists insist – in defiance of both the World Health Organisation and the significant biomedical evidence about the nature of it -- that CFS/ME” is a behavioural disorder, into which they have subsumed ME, a classified neurological disorder whose separate existence they deny.
    Their beliefs have been repudiated in writing by the World Health Organisation.

    In 1992, the Wessely School gave directions that in cases of ME/CFS, the first duty of the doctor is to avoid legitimisation of symptoms; in 1994, ME was described by Professor Simon Wessely as merely “a belief”; in 1996 recommendations were made that no investigations should be performed to confirm the diagnosis and in 1999 patients with ME/CFS were referred to as “the undeserving sick”.

    The complaint is supported by a 442 page Report which addresses areas of major concern about the PACE Trial.

    These include apparent coercion and exploitation of patients, flawed methodology, apparent lack of scientific rigour, apparent failure to adhere to the Declaration of Helsinki, the unusual personal financial interest of the Chief Investigator, the vested financial interests of the Principal Investigators and others involved with the trial and the underlying non-clinical purpose of the trial.

    The psychiatrists’ unproven beliefs and assumptions are presented as fact and trial therapists have been trained to provide participants with misinformation; therapists have also been trained to advise participants to ignore symptoms, a situation that may in some cases result in death.

    There are some extremely disquieting issues surrounding the MRC PACE Trial and documents obtained under the Freedom of Information Act allow the full story to be told for the first time.

    People with ME/CFS do not seek any special consideration; they simply wish to be treated equally to those who suffer from other classified neurological disorders.

    As shown in the Report that accompanies the complaint, the MRC PACE Trial clearly demonstrates that people with ME/CFS are not treated equally to those with other chronic neurological disorders.

    The Report can be accessed at : http://www.meactionuk.org.uk/magical-medicine.pdf -.

    Read more at : http://www.meactionuk.org.uk/magical-medicine.htm

    Cfr. also :

    DSM-5 may include CFS as a psychiatric diagnosis
    Cfr. : http://www.facebook.com/topic.php?uid=154801179671&topic=12654




    29-03-2010 om 21:50 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 3/5 - (2 Stemmen)
    Tags:CFS, CFS/ME, Chronic Fatigue Syndrome (CFS), chronic neurological disorders, health insurance industry, ME, Myalgic Encephalomyelitis (ME), psychiatrists, Wessely School
    >> Reageer (1)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.A new hypothesis of chronic fatigue syndrome - Co-conditioning theory
    Klik op de afbeelding om de link te volgen













     



    A new hypothesis of chronic fatigue syndrome - Co-conditioning theory

    Tanaka M, Watanabe Y, Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan - Med Hypotheses. 2010 Mar 23 - © 2010 Elsevier Ltd. - PMID: 20338693

    Chronic fatigue syndrome is an illness characterized by a profound, disabling and unexplained sensation of fatigue lasting at least 6months, which severely impairs daily functioning and is accompanied by a combination of non-specific symptoms.
    Many potential causes of chronic fatigue syndrome have been investigated, including viral infections, immune dysfunctions, abnormal neuroendocrine responses, central nervous system abnormalities, autonomic dysfunctions, impaired exercise capacities, sleep disruptions, genetic backgrounds, psychiatric abnormalities, personality and abnormal psychological processes.
    However, no etiology, specific physical signs or laboratory test abnormalities have been found.
    It is essential to establish a conceptual theory of chronic fatigue syndrome that can explain its pathophysiology in order to identify the clinical entity and to develop effective treatment methods.
    In this article, a new conceptual hypothesis about the pathophysiology of chronic fatigue syndrome, the co-conditioning theory, is presented : after repetitive overwork and/or stress, alarm signal to rest and fatigue sensation may cause in response to an unconditioned stimulus (impaired homeostasis and function) that has been paired with a conditioned stimulus (overwork and/or stress).
    In the future, a new treatment strategy for patients with chronic fatigue syndrome, re-co-conditioning therapy, may be developed on the basis of the co-conditioning theory.
    In addition, this theory will likely contribute to a better understanding of the pathophysiology of chronic fatigue syndrome.

    Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/20338693?dopt=Abstract


    29-03-2010 om 20:45 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    Tags:autonomic dysfunctions, central nervous system, chronic fatigue syndrome, fatigue, genetic backgrounds, immune dysfunctions, exercise capacities, neuroendocrine responses, overwork, psychiatric abnormalities, sleep disruptions, stress, viral infection
    >> Reageer (1)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.A light in the darkness - Good news ahead for XMRV ?
    Klik op de afbeelding om de link te volgen

    Dr. Lucinda Bateman, M.D.













    A light in the darkness

    - Good news ahead for XMRV ? -

    Phoenix Rising, March 26th, 2010

    A month ago the head Dutch researcher, Kuppeveld, stated that he considered XMRV story over.
    After what he described as an intense effort to find the virus failed he was folding up shop on it; there would be no more XMRV studies coming out of his lab.

    No papers have been published since then but it appears that a decidedly different story is brewing in Utah.
    We had heard that the three dozen or so people who participated in the Light’s fascinating exercise study were brought back to get tested for XMRV.
    What we didn’t know is that that study has recently been expanded - greatly.
    Since one thing researchers do not do is repeat negative studies, the only logical conclusion we can draw is that enough CFS patients tested positive for XMRV to make a greatly expanded and obviously much more expensive study worthwhile.
    These patients and we don't know how many were positive, appear to be the first patients who’ve tested positive at an independent laboratory.
    The XMRV story may be over in Holland but it appears to be gathering steam in Utah.

    Luckily, CBS, a member of the Phoenix Rising Forums is participating in the new study and was willing to give us some insights into what's happening.
    First the new study consists of about 100 CFS patients, hand-picked by Dr. Lucinda Bateman -
    http://www.fcclinic.com/about_dr.html - and about 200 healthy controls.
    Dr. Light appears to a major fundraiser for the study - plucking money out of every corner he can.
    Dr. Singh, a noted retrovirologist already steadying XMRV in prostate cancer, will supervise the analysis of the samples. ARUP - the research laboratory associated with the University of Utah - is providing facilities and manpower.

    When CBS showed up for his blood draws he stepped into a highly professional environment.
    He signed in and rounded the corner to find a hallway full of techs with stopwatches.
    As each of approximately 6 vials of blood were drawn, the gloved phlebotomist immediately handed it to a gloved tech who set his/her stopwatch and hustled out of the room to the next location.
    The collecting receptacles were swabbed with alcohol after each patient.

    Dr. Bateman’s role in this is interesting.
    Her video presentation about XMRV several months ago was notable for her sober approach to it is and she appeared quite concerned about how well her patients matched up with the apparently immune dysfunctional patients in the Science study.
    Although we can't know for sure it appears that something has changed in her outlook on XMRV.
    She stated that all parties were working around the clock on this.
    These researchers moved fast - it took them about a week or two to process get several hundred samples.
    They’re doing PCR, antibody and culture tests.
    CBS expects to get his results in about eight weeks and the researchers are banking blood as well - so expect more studies to follow this second study if it works out well.

    ARUP is by no means an ordinary lab.
    Employing 2,400 people it is a ‘national reference laboratory’ that specializes in ‘innovative laboratory research and development. The website states that ARUP chooses to provide "highly complex and unique lab tests".
    The Light/Bateman/Singh/ARUP team will not be looking at one sample multiple times or testing multiple samples from one patient to get one positive result.
    Nor will they accept ‘dim bands’ on the PCR as positives (a critique given to the Science paper).
    This will be a one sample one patient, clearly defined PCR result study and logically this is what we should expect over time as larger, more sophisticated labs further refine XMRV testing procedures.
    This is surely what Dr. Peterson meant at the CFSAC meeting when he said the WPI needed other researchers to pick up the ball and run with it.

    Dr. Bateman is well known for her well characterized patients and her fine-tuned sense of the different subsets present in CFS and FM.
    She stated that she believed this study will provide definitive evidence of how prevalent XMRV is in a broad swath of CFS patients.

    The Dr’s Light (there are two of them) role in this is intriguing as well.
    Dr. Alan Light came up with the scintillating study that found greatly increased receptor levels to substances like lactic acid in CFS patients.
    He is a pain researcher, not a retrovirologist - but it appears that both he and his wife are giving this study every kind of support that they can.
    We should be thankful for researchers that are able to leap over professional boundaries when needed.

    The Montoya-Goff Study - CBS is also the patient of Dr. Montoya’s.
    He noted that Dr. Goff, another celebrated retrovirologist, is working with the Montoya team in Stanford on his XMRV study - another sign that XMRV is still alive and well in the research community, at least on this side of the Atlantic.

    ARUP and Blood Testing - Please do not try to get your blood tested at ARUP.
    Dr. Bateman emphasized that ARUP is not open for commercial testing of XMRV and does not want to be flooded with requests for that.

    Conclusion - While we don’t have any published papers we do appear to have the next best thing; signs that several researchers associated with a reputable independent lab are having success finding this virus in ME/CFS patients and, in fact, are redoubling their efforts to look further.

    Cfr. : http://www.forums.aboutmecfs.org/entry.php?303-A-Light-in-the-Darkness-Good-News-Ahead-for-XMRV


    29-03-2010 om 17:04 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 4/5 - (1 Stemmen)
    Tags:antibody, CFS, FM, ME/CFS, PCR, prostate cancer, XMRV
    >> Reageer (1)


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