Griffith James P, Zarrouf Fahd A
Internal Medicine/Psychiatry Residency Program, West Virginia University, Charleston, WV, USA.
Prim Care Companion J Clin Psychiatry. 2008;10(2):120-8. doi: 10.4088/pcc.v10n0206.
Chronic fatigue syndrome (CFS) is characterized by profound, debilitating fatigue and a combination of several other symptoms resulting in substantial reduction in occupational, personal, social, and educational status. CFS is often misdiagnosed as depression. The objective of this study was to evaluate and discuss different etiologies, approaches, and management strategies of CFS and to present ways to differentiate it from the fatigue symptom of depression.
A MEDLINE search was conducted to identify existing information about CFS and depression using the headings chronic fatigue syndrome AND depression. The alternative terms major depressive disorder and mood disorder were also searched in conjunction with the term chronic fatigue syndrome. Additionally, MEDLINE was searched using the term chronic fatigue. All searches were limited to articles published within the last 10 years, in English. A total of 302 articles were identified by these searches. Also, the term chronic fatigue syndrome was searched by itself. This search was limited to articles published within the last 5 years, in English, and resulted in an additional 460 articles. Additional publications were identified by manually searching the reference lists of the articles from both searches.
CFS definitions, etiologies, differential diagnoses (especially depression) and management strategies were extracted, reviewed, and summarized to meet the objectives of this article.
CFS is underdiagnosed in more than 80% of the people who have it; at the same time, it is often misdiagnosed as depression. Genetic, immunologic, infectious, metabolic, and neurologic etiologies were suggested to explain CFS. A biopsychosocial model was suggested for evaluating, managing, and differentiating CFS from depression.
Evaluating and managing chronic fatigue is a challenging situation for physicians, as it is a challenging and difficult condition for patients. A biopsychosocial approach in the evaluation and management is recommended. More studies about CFS manifestations, evaluation, and management are needed.
慢性疲劳综合征（CFS）的特征是严重、使人衰弱的疲劳以及其他几种症状的组合，导致职业、个人、社交和教育状况大幅下降。CFS常被误诊为抑郁症。本研究的目的是评估和讨论CFS的不同病因、治疗方法和管理策略，并提出将其与抑郁症的疲劳症状相鉴别的方法。
通过在MEDLINE中检索，使用“慢性疲劳综合征”和“抑郁症”作为关键词来识别有关CFS和抑郁症的现有信息。还结合“慢性疲劳综合征”一词检索了替代术语“重度抑郁症”和“心境障碍”。此外，使用“慢性疲劳”一词在MEDLINE中进行检索。所有检索仅限于过去10年内发表的英文文章。通过这些检索共识别出302篇文章。此外，单独检索了“慢性疲劳综合征”一词。该检索仅限于过去5年内发表的英文文章，又得到了460篇文章。通过手动检索这两次检索所得文章的参考文献列表，识别出了更多的出版物。
提取、审查和总结CFS的定义、病因、鉴别诊断（尤其是抑郁症）和管理策略，以满足本文的目的。
超过80%患有CFS的人未得到充分诊断；同时，它常被误诊为抑郁症。有人提出遗传、免疫、感染、代谢和神经病因来解释CFS。有人提出一种生物心理社会模型用于评估、管理CFS并将其与抑郁症相鉴别。
对医生来说，评估和管理慢性疲劳是一项具有挑战性的工作，因为对患者来说这是一种具有挑战性和困难的病症。建议在评估和管理中采用生物心理社会方法。需要更多关于CFS表现、评估和管理的研究。
