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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A New Name & Diagnostic Criteria

Ecoclimber

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A New Name & Diagnostic Criteria
World Neurology, The Official Newsletter of the World Federation of Neurology by Maggie L. McNulty is an assistant professor at Rush University Medical Center, Department of Neurological Sciences.

In March 2015, a report from the Institute of Medicine (IOM) was published in the Journal of the American Medical Association to redefine the illness known as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).

Over the years, clinicians and researchers have developed different diagnostic criteria for ME and CFS; however, the two terms describe conditions with similar symptoms. In the World Health Organization’s “International Classification of Diseases,” 10th Revision, both ME and CFS are coded the same and classified as disorders of the nervous system (ICD G93.3). The term “benign myalgic encephalomyelitis” was first used in the 1950s in London when describing an outbreak in patients who experienced a variety of symptoms, including “malaise, tender lymph nodes, sore throat, pain and signs of encephalomyelitis.”

The cause was never found, but it appeared infectious in etiology, and the term “benign myalgic encephalomyelitis” was used to reflect “the absent mortality, the severe muscular pains, the evidence of parenchymal damage to the nervous system and the presumed inflammatory nature of the disorder.” Then in 1970, two psychiatrists reviewed reports of 15 of these outbreaks and concluded that the outbreaks “were psychosocial phenomena” caused by mass hysteria or altered medical perception of the community.
http://www.worldneurologyonline.com/article/myalgic-encephalomyelitischronic-fatigue-syndrome-a-new-name-diagnostic-criteria/
MORE:

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sarah darwins

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Hmmm, a month later and still no comments.
That's really disappointing, isn't it. Any ideas what's going on? It's almost as though the medical community isn't hearing what the IOM report has to say.

I wonder if it's something to do with this bit: " .... less than one-third of medical school curricula and only 40 percent of medical textbooks include information regarding this syndrome."
 

sarah darwins

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Q. That article (which I think is a really nice summary) mentions something that we see a lot: "The syndrome affects women more than men ..."

Does anyone know how reliable that assertion is? Or the source?
 

Scarecrow

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Does anyone know how reliable that assertion is? Or the source?
AFAIK, many studies have reported a higher rate in women.

One source on prevalence rates, that I gave recently on another thread here, provided a M/F breakdown. Look for the columns at the right of the table - 'Prevalence rates adjusted by response rates'

The prevalence rate for all definitions of ME/CFS in this study was 0.20% of the adult population under 65. Prevalence in men was 0.09% and in women 0.30%.
 

Sasha

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@Scarecrow - perfect. Thank you. That looks pretty clear. Sadly I can't help thinking the BPS theories would get less traction if it were a 50/50 split, but it is what it is.
I'm just watching Peter Rowe's excellent presentation on managing OI, and he says that NMH was regarded as psychosomatic before tilt table testing came in. Affects more women than men, obv.

Same story with MS, of course.

It would be interesting to study this psychosomatic-to-real route for diseases and see if it's more common in diseases that are more prevalent in women.
 

Scarecrow

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@Scarecrow - perfect. Thank you. That looks pretty clear. Sadly I can't help thinking the BPS theories would get less traction if it were a 50/50 split, but it is what it is.
I've no doubt of that.

Not saying that ME is autoimmune (fence-sitter) but here's an amusing comment about autoimmune diseases and sex, reported in wiki [my bold]:

A person's sex also seems to have some role in the development of autoimmunity; that is, most autoimmune diseases are sex-related. Nearly 75%[11] of the more than 23.5 million Americans who suffer from autoimmune disease are women, although it is less-frequently acknowledged that millions of men also suffer from these diseases. According to the American Autoimmune Related Diseases Association (AARDA), autoimmune diseases that develop in men tend to be more severe. A few autoimmune diseases that men are just as or more likely to develop as women include: ankylosing spondylitis, type 1 diabetes mellitus, granulomatosis with polyangiitis, Crohn's disease, Primary sclerosing cholangitis and psoriasis.
Of course they are. ;)

To be fair, there is no citation so I googled and found the source from WebMD.com
Q. Do men get autoimmune disease?
A.
Millions of men suffer from these diseases, too. Sometimes, autoimmune diseases that develop in men tend to be more severe. There are a few autoimmune diseases that men are just as or more likely to develop as women, including: ankylosing spondylitis, type 1 diabetes and psoriasis.
I notice that AARDA didn't elaborate. They only one I can think of off-hand where it's more severe is Behçet's, which is very rare. I'm sure that there are more examples but it's such a strange comment.
 

sarah darwins

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"... autoimmune diseases that develop in men tend to be more severe."

Well, that's fair enough. Obviously men are more rational than women and not prone to hysteria. If a man gets an autoimmune disease he's going to get a proper one.

It seems about 68% of consultants (in the UK) are male, although among the more senior ones (the over 50s) it's a lot higher. Things are changing in the younger age bands:

Screen Shot 2015-07-13 at 13.14.27.png

Source: https://www.rcplondon.ac.uk/sites/d...sultant_physicians_and_medical_registrars.pdf
 

Sean

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"... autoimmune diseases that develop in men tend to be more severe."

Well, that's fair enough. Obviously men are more rational than women and not prone to hysteria. If a man gets an autoimmune disease he's going to get a proper one.
Damn right. We all know men only get real diseases. None of this vapours or wandering wombs malarky for us.

Aren't you ladies lucky some of us chaps kindly helped you out by getting this disease, so that you will taken so much more seriously by doctors.
 

osisposis

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"... autoimmune diseases that develop in men tend to be more severe."

Well, that's fair enough. Obviously men are more rational than women and not prone to hysteria. If a man gets an autoimmune disease he's going to get a proper one.

It seems about 68% of consultants (in the UK) are male, although among the more senior ones (the over 50s) it's a lot higher. Things are changing in the younger age bands:

View attachment 11830

Source: https://www.rcplondon.ac.uk/sites/default/files/2012_full_text_census_of_consultant_physicians_and_medical_registrars.pdf
HA! sorry to disappoint ya but not all woman are prone to hysteria and I've seen men that are and they can be the biggest babies of all :)