Chang-Gue Son: Differential diagnosis between “chronic fatigue” and “chronic fatigue syndrome”

Inara

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Fatigue is a common complaint experienced by most of subjects during lifetime, which affects approximately 30–50% of general population as point prevalence.1 According to the fatigue-lasting duration, it is classified as acute (<1 month), prolonged (>1 month, <6 months), and chronic fatigue (≥6 months), respectively. Acute fatigue is generally disappears after taking a rest or treating the causative diseases, while uncontrolled prolonged and chronic fatigue limit the physical and social activities.2 Especially, medically unexplained chronic fatigue is a debilitating status, such as idiopathic chronic fatigue (ICF) and chronic fatigue syndrome (CFS).

On the other hand, to distinguish CFS from chronic fatigue or ICF is very important in clinical practice. The reason is that although patients present fatigue symptom as their main complaint in subjects suffering from chronic fatigue or CFS, CFS is considered as to being in totally different pathologic illness.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522773/
 

Inara

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I am not sure if I agree with Fig. 2, although I see the point the author is making. The author states/suggests as diagnosis algorithm:
at least 6 months fatigue + PEM + unrefreshing sleep, but no cognitive impairment and no orthostatic intolerance = idiopathic chronic fatigue (what is that?)
and
at least 6 months fatigue + PEM + unrefreshing sleep + cognitive impairment + orthostatic intolerance = ME/CFS/SEID.

What do others think?