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Chronic fatigue and chronic fatigue syndrome: shifting boundaries and attributions

  • Andrew R. Lloyd
    Correspondence
    Requests for reprints should be addressed to Andrew Lloyd, MD, Inflammation Research Unit, School of Pathology, University of New South Wales, 2052, Australia
    Affiliations
    The Inflammation Research Unit, School of Pathology, University of New South Wales, Sydney, New South Wales, Australia

    Department of Infectious Diseases, Prince Henry Hospital, Little Bay, New South Wales, Australia
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      Abstract

      The subjective symptom of “fatigue” is one of the most widespread in the general population and is a major source of healthcare utilization. Prolonged fatigue is often associated with neuropsychological and musculoskeletal symptoms that form the basis of several syndromal diagnoses including chronic fatigue syndrome, fibromyalgia, and neurasthenia, and is clearly not simply the result of a lack of force generation from the muscle. Current epidemiologic research in this area relies predominantly on self-report data to document the prevalence and associations of chronic fatigue. Of necessity, this subjective data source gives rise to uncertain diagnostic boundaries and consequent divergent epidemiologic, clinical, and pathophysiologic research findings. This review will highlight the impact of the case definition and ascertainment methods on the varying prevalence estimates of chronic fatigue syndrome and patterns of reported psychological comorbidty. It will also evaluate the evidence for a true postinfective fatigue syndrome.
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