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Misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome
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The '''misdiagnosis''' of [[myalgic encephalomyelitis]] and [[chronic fatigue syndrome]] are very common, this takes the form of misdiagnosis, underdiagnosis or overdiagnosis.<br> ::Many ME/CFS patients wait too long for a confirmatory diagnosis. This may be because doctors receive very little training on how to recognise and treat the illness.<ref name="Geraghty2020neg"/> —Geraghty (2020) ==Misdiagnosis== Misdiagnosing of ME or CFS involves diagnosing another illness or medical condition instead of diagnosing ME or CFS, for example erroneously diagnosing [[depression]], [[medically unexplained physical symptoms]], the symptom [[chronic fatigue]] or even a different fatiguing illness, or diagnosing ME or CFS when another illness or symptom is the cause of the symptoms, and diagnostic criteria for ME/CFS are not met. ==Underdiagnosis== Underdiagnosis means failing to diagnose ME or CFS in patients meeting diagnostic criteria, e.g. blaming lifestyle factors for symptoms, or referring to patients as [[tired all the time]].<br> Patients may even be told they are in "good health" resulting in no medical care, or be diagnosed as having another illness or [[medically unexplained physical symptoms|"medically unexplained symptoms"]]. ==Overdiagnosis== Overdiagnosis involves diagnosing ME or CFS when it is not present, meaning when the patient does not meet the diagnostic criteria for ME or CFS, especially diagnosing CFS instead of [[chronic fatigue]] or [[idiopathic chronic fatigue]] is the cause of the symptoms. While there is no [[diagnostic biomarker|diagnostic medical test for ME or CFS]], medical tests must be run to identify illness that have similar symptoms but ''can'' be identified by particular tests.<ref name="CDC-differentialdiagnosis">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/other-conditions.html | title = Other Conditions for Evaluation {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Jul 12, 2018 | website = [[Centers for Disease Control]]|language=en-us|access-date=2022-03-28}}</ref><ref name="CDC-clinicians">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/index.html | title = Presentation and Clinical Course of ME/CFS {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS | last = Centers for Disease Control and Prevention | first = | authorlink = Centers for Disease Control and Prevention | date = 2019-11-19 | website = CDC|language=en-us|archive-url=|archive-date=|url-status=|access-date=2021-12-18}}</ref> Overdiagnosis of [[chronic fatigue syndrome]] can also result when CFS is diagnosed or referred interchangably with either [[chronic fatigue]] (CF), or another illness, e.g., regarding all [[fibromyalgia]] patients as having CFS or using myalgic encephalomyelitis (ME) to refer to patients meeting CFS diagnostic criteria but not [[definitions of myalgic encephalomyelitis and chronic fatigue syndrome|ME diagnostic criteria]].<br> Sometimes an CFS diagnosis is when chronic fatigue or chronic pain (or both) are present and fully explained by another fatiguing illness. ==Evidence== ==Notable articles== *2021, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management<ref name="Essentials2021">{{Cite journal | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management | date = 2021-11-01|url=https://www.sciencedirect.com/science/article/pii/S0025619621005139|journal=Mayo Clinic Proceedings|volume=96|issue=11|pages=2861–2878 | last = Bateman | first = Lucinda | authorlink = Lucinda Bateman | last2 = Bested | first2 = Alison C. | authorlink2 = Alison Bested | last3 = Bonilla | first3 = Hector F. | authorlink3 = Hector Bonilla | last4 = Chheda | first4 = Bela V. | authorlink4 = Bela Chheda | last5 = Chu | first5 = Lily | authorlink5 = Lily Chu | last6 = Curtin | first6 = Jennifer M. | authorlink6 = | last7 = Dempsey | first7 = Tania T. | last8 = Dimmock | first8 = Mary E. | authorlink8 = Mary Dimmock | last9 = Dowell | first9 = Theresa G. | last10 = Felsenstein | first10 = Donna | last11 = Kaufman | first11 = David L. | authorlink11 = David Kaufman|language=en|doi=10.1016/j.mayocp.2021.07.004|pmc=|pmid=|access-date=|issn=0025-6196|quote=|via=}}</ref> - [https://www.sciencedirect.com/science/article/pii/S0025619621005139 (Full text)] *2020, Ethical Psychotherapeutic Management of Medically Unexplained Symptoms<ref name="Geraghty2020Ch">{{Cite web|url=https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780198817338.001.0001/oxfordhb-9780198817338-e-72 | title = Ethical Psychotherapeutic Management of Patients with Medically Unexplained Symptoms: The Risk of Misdiagnosis and Harm | last = O'Leary | first = Diane | authorlink=Diane O'Leary | last2 = Geraghty | first2 = Keith | authorlink2 = Keith Geraghty | date = 2021-08-27 | website = Oxford Handbook of Psychotherapy Ethics|language=en|doi=10.1093/oxfordhb/9780198817338.013.72|archive-url=|archive-date=|url-status=|access-date=2022-01-13}}</ref> - [https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780198817338.001.0001/oxfordhb-9780198817338-e-72 (Abstract, Book Chapter)] *2020, The negative impact of the psychiatric model of chronic fatigue syndrome on doctors' understanding and management of the illness<ref name="Geraghty2020neg">{{Cite journal | title = The negative impact of the psychiatric model of chronic fatigue syndrome on doctors’ understanding and management of the illness | date = 2020-07-02|url=https://www.researchgate.net/profile/Keith-Geraghty/publication/344492676_The_Negative_Impact_of_the_Psychiatric_Model_of_Chronic_Fatigue_Syndrome_on_Doctors'_Understanding_and_Management_of_the_Illness/links/607964eb2fb9097c0cea032a/The-Negative-Impact-of-the-Psychiatric-Model-of-Chronic-Fatigue-Syndrome-on-Doctors-Understanding-and-Management-of-the-Illness.pdf | journal = Fatigue: Biomedicine, Health & Behavior |volume=8|issue=3|pages=167–180 | last = Geraghty | first = Keith | authorlink = Keith Geraghty|doi=10.1080/21641846.2020.1834295|pmc=|pmid=|access-date=|issn=2164-1846|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Keith-Geraghty/publication/344492676_The_Negative_Impact_of_the_Psychiatric_Model_of_Chronic_Fatigue_Syndrome_on_Doctors'_Understanding_and_Management_of_the_Illness/links/607964eb2fb9097c0cea032a/The-Negative-Impact-of-the-Psychiatric-Model-of-Chronic-Fatigue-Syndrome-on-Doctors-Understanding-and-Management-of-the-Illness.pdf (Full text)] *2020, A relational analysis of an invisible illness: A meta-ethnography of people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their support needs<ref name="Pilkington2020">{{Cite journal | last = Pilkington | first = Karen | authorlink = | last2 = Ridge | first2 = Damien T. | authorlink2 = | last3 = Igwesi-Chidobe | first3 = Chinonso N. | authorlink3 = | last4 = Chew-Graham | first4 = Carolyn A. | authorlink4 = Carolyn Chew-Graham | last5 = Little | first5 = Paul | authorlink5 = | last6 = Babatunde | first6 = Opeyemi | authorlink6 = | last7 = Corp | first7 = Nadia | last8 = McDermott | first8 = Clare | last9 = Cheshire | first9 = Anna | date = 2020-11-01 | title = A relational analysis of an invisible illness: A meta-ethnography of people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their support needs|url=https://westminsterresearch.westminster.ac.uk/item/v138x/a-relational-analysis-of-an-invisible-illness-a-meta-ethnography-of-people-with-chronic-fatigue-syndrome-myalgic-encephalomyelitis-and-their-support-needs|journal=Social Science & Medicine|language=en|volume=265|issue=|pages=113369|doi=10.1016/j.socscimed.2020.113369|issn=0277-9536|pmc=|pmid=|access-date=|quote=|via=}}</ref> [https://westminsterresearch.westminster.ac.uk/item/v138x/a-relational-analysis-of-an-invisible-illness-a-meta-ethnography-of-people-with-chronic-fatigue-syndrome-myalgic-encephalomyelitis-and-their-support-needs (Full text)] *2019, Dismissing chronic illness: A qualitative analysis of negative health care experiences<ref>{{Cite journal | last = McManimen | first = Stephanie | authorlink = Stephanie McManimen | last2 = McClellan | first2 = Damani | authorlink2 = | last3 = Stoothoff | first3 = Jamie | authorlink3 = | last4 = Gleason | first4 = Kristen | authorlink4 = | last5 = Jason | first5 = Leonard A. | authorlink5 = Leonard Jason | date = 2019-03-04 | title = Dismissing chronic illness: A qualitative analysis of negative health care experiences|url=https://www.tandfonline.com/doi/full/10.1080/07399332.2018.1521811|journal=Health Care for Women International|language=en|volume=|issue=|pages=1–18|doi=10.1080/07399332.2018.1521811|issn=0739-9332|quote=|via=}}</ref> - [[pubmed:30829147|(Abstract)]] *2017, Differentiating [[Multiple Sclerosis]] from [[Myalgic Encephalomyelitis]] and [[Chronic Fatigue Syndrome]]<ref name="Jason, Ohanian, 2017">{{Cite journal | last1 = Jason | first1 = LA | authorlink1 = Leonard Jason | last2 = Ohanian | first2 = D | authorlink2 = Diana Ohanian | last3 = Brown | first3 = A | authorlink3 = Abigail Brown | last4 = Sunnquist | first4 = M | authorlink4 = Madison Sunnquist | last5 =McManimen | first5 = S | authorlink5 = Stephanie McManimen | last6 = Klebek | first6 = L | authorlink6 = | last7 = Fox | first7 = P | authorlink7 = Pamela Fox | last8 =Sorenson | first8 = M | authorlink8 = Matthew Sorenson | title = Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome| journal = Insights in Biomedicine | volume = 2 | issue = 2 | pages = | date = 2017 | url = https://doi.org/10.21767%2F2572-5610.100011 | doi = 10.21767/2572-5610.100011 }}</ref> - [http://biomedicine.imedpub.com/differentiating-multiple-sclerosis-from-myalgic-encephalomyelitis-and-chronic-fatigue-syndrome.pdf (Full Text)] [http://biomedicine.imedpub.com/differentiating-multiple-sclerosis-from-myalgic-encephalomyelitis-and-chronic-fatigue-syndrome.pdf (Full Text)] *2017, [[Post-exertional malaise|Post-Exertional Malaise]] in Patients with [[Myalgic encephalomyelitis|ME]] and [[Chronic fatigue syndrome|CFS]] with Comorbid [[Fibromyalgia]]<ref>{{Cite journal | last = McManimen | first = Stephanie L. | authorlink = Stephanie McManimen | last2 = Jason | first2 = Leonard A. | authorlink2 = Leonard Jason | date = 2017 | title=Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/28603794|journal=SRL neurology & neurosurgery|volume=3|issue=1|pages=22–27|pmc=|pmid=28603794|via=}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464757/ (Full Text)] *2017, Differentiating [[Multiple Sclerosis]] from [[Myalgic Encephalomyelitis]] and [[Chronic Fatigue Syndrome]]<ref name="Jason, Ohanian, 2017" /> [http://biomedicine.imedpub.com/differentiating-multiple-sclerosis-from-myalgic-encephalomyelitis-and-chronic-fatigue-syndrome.pdf (Full Text)] *2017, [[Post-exertional malaise|Post-Exertional Malaise]] in Patients with [[Myalgic encephalomyelitis|ME]] and [[Chronic fatigue syndrome|CFS]] with Comorbid [[Fibromyalgia]]<ref>{{Cite journal | last = McManimen | first = Stephanie L. | authorlink = Stephanie McManimen | last2 = Jason | first2 = Leonard A. | authorlink2 = Leonard Jason | date = 2017 | title=Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia|url=https://www.ncbi.nlm.nih.gov/pubmed/28603794|journal=SRL neurology & neurosurgery|volume=3|issue=1|pages=22–27|pmc=|pmid=28603794|via=}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464757/ (Full Text)] ==See also== *[[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome]] *[[Psychologization]] *[[Ethical issues]] *[[Mental illness]] *[[Pervasive Refusal Syndrome]] ==Learn more== *[https://www.tymestrust.org/pdfs/metheillness.pdf ME - The Illness and Common Misconceptions: Abuse, Neglect, Mental Incapacity. ''A summary originally produced for the legal profession''] - The Young ME Sufferer's Trust *[https://25megroup.org/download/2527/ Knowledge in the Hope of Protecting M.E. Sufferers from Unnecessary Sectioning] - [[The Grace Charity for M.E.]] and [[25 Percent ME Group|The 25% ME Group]] ==References == {{Reflist}} [[Category:Ethics]] [[Category:Diagnoses]]
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