Lieb K, Dammann G, Berger M, Bauer J
Universitätsklinik für Psychiatrie und Psychosomatik, Universität, Freiburg.
Nervenarzt. 1996 Sep;67(9):711-20. doi: 10.1007/s001150050045.
This article reviews the chronic fatigue syndrome (CFS), a disorder whose etiology is unknown. The diagnostic criteria proposed in 1994 by the CDC and the International Chronic Fatigue Syndrome Study Group are introduced. In contrast to widespread belief, there are no laboratory tests available to underpin the diagnosis of CFS; the diagnosis is made solely on the basis of clinical criteria. In the differential diagnosis, the exclusion of other conditions that can cause chronic fatigue, such as neuropsychiatric or sleep disorders, is of critical importance. In this context, the question as to whether CFS is a clinical entity that can be differentiated from psychiatric diagnoses, such as depression, somatoform disorder, or neurasthenia, is discussed. At the moment, there is no specific therapy for CFS. Therefore, therapeutic approaches are limited to symptomatic management of the concomitant sleep disturbances, pain, or psychiatric symptoms, such as depression. Patients may benefit from cognitive behavioral therapy, as this may help then to identify and exclude factors contributing to and maintaining chronic fatigue. An integrated medical and psychological approach should be adopted, with the aim of preventing significant secondary negative results of the illness, such as interpersonal conflicts or chronic disability.
本文综述了慢性疲劳综合征（CFS），这是一种病因不明的疾病。文中介绍了美国疾病控制与预防中心（CDC）和国际慢性疲劳综合征研究小组于1994年提出的诊断标准。与普遍看法相反，目前尚无实验室检查可作为CFS诊断的依据；诊断仅基于临床标准。在鉴别诊断中，排除其他可导致慢性疲劳的疾病，如神经精神或睡眠障碍，至关重要。在此背景下，讨论了CFS是否为一种可与诸如抑郁症、躯体形式障碍或神经衰弱等精神疾病相鉴别的临床实体这一问题。目前，CFS尚无特效疗法。因此，治疗方法仅限于对伴随的睡眠障碍、疼痛或精神症状（如抑郁）进行对症处理。患者可能从认知行为疗法中获益，因为这可能有助于他们识别并排除导致和维持慢性疲劳的因素。应采用综合的医学和心理方法，以防止该疾病产生严重的继发性负面后果，如人际冲突或慢性残疾。
