MEpedia - User contributions [en]

Help:Foreign languages/Tech notes

2026-09-28T21:31:47Z

WikiVisor:Updated help for localization

== Configuration ==
* Changes are to be made in the [https://github.com/me-pedia/docker-me-pedia.org repository] and deployed to the server.
** Language namespaces must be configured in <code>LocalSettings.php</code>
** URL re-writes must be set in <code>robots.txt</code>

== Wiki changes ==
* Language codes must be added to [[Template:Language_links]]
* Localized name inputs for new languages must be added to the [[Form:Lang]]
* New banners must be added to the <code>MediaWiki:Top-notice-ns-{NAMESPACE_NUMBER}</code>, see example at [[MediaWiki:Top-notice-ns-4002]] (Copy and adapt the markup).

Help:Foreign languages/Tech notes

2026-09-28T21:31:25Z

WikiVisor:Updated help for localization

== Configuration ==
* Changes are to be made in the [https://github.com/me-pedia/docker-me-pedia.org repository] and deployed to the server.
* Language namespaces must be configured in <code>LocalSettings.php</code>
* URL re-writes must be set in <code>robots.txt</code>

== Wiki changes ==
* Language codes must be added to [[Template:Language_links]]
* Localized name inputs for new languages must be added to the [[Form:Lang]]
* New banners must be added to the <code>MediaWiki:Top-notice-ns-{NAMESPACE_NUMBER}</code>, see example at [[MediaWiki:Top-notice-ns-4002]] (Copy and adapt the markup).

Help:Foreign languages

2026-09-28T21:29:33Z

WikiVisor:Updated help for localization

{{mbox|text=MEpedia supports foreign languages. The following instructions are a work in progress.}}
This page describes how '''foreign languages''' are supported in MEpedia.

== Language settings ==
There are two language settings in MEpedia:
*The reader's preferred language
*The page's content language

Changing the reader's preferred language changes the interface language.

== Approach to the content localization ==
* '''MEpedia's default language is English'''.
* Every original page in English may have localized versions. Categorize a page as [[:Category:Multilingual pages|Multiligual page]] to enable localization interface.
* Upon saving, the ''Edit with form'' link will appear in page tools of the original page.
* Click ''Edit with form'' and specify the name of the localized page in one of the supported languages <ref>Request the addition of [[MEpedia:Language codes|other languages]] from the established users. [[/Tech notes|See technical notes]]</ref>:
** Deutsch
** Español
** Français
** Svenska
* Upon saving, you will be given the panel with the links to the localized versions.
* The localized versions will be created in the dedicated namespaces.
* The corresponding content language will be set automatically.
* Edit localized versions in their respective languages like any other page.
* Opening the localized page will override the interface language and set it to the language of the page content.
* The listing of all localized pages for a given language is available through the namespace selector on [[Special:AllPages]].
* To link pages inline use <code><nowiki>[[{LANGCODE}:{LOCALIZED_PAGENAME}|{LINKTEXT}]]</nowiki></code> (e.g. <code><nowiki>[[sv:Kräkning|kräkning]]</nowiki></code> will result in [[sv:Kräkning|kräkning]]).
* The localized pages use the natural language names, so '''you don't need''' to set <code><nowiki>{{DISPLAYTITLE: ...}}</nowiki></code> '''just to translate''' the original title.

== Tips/caution regarding automated translation ==
These days, short messages can be translated using automated translators, such as https://translatr.varunmalhotra.xyz/ or Google Translate. However, some caution is warranted, and some human work will be needed to ensure that the translation is indeed accurate. Here are some tips to improve automated translation:
# Start with the simplest possible English phrasing. (Subject-verb-object)
# Use the simplest, clearest, but most ''precise'' English words possible.
# Don't use any English words that have multiple meanings. (e.g. don't use the word "clean-up", which has multiple meanings)
# Don't use any English idioms, slang, or metaphors.
# Avoid technical terms, such as "Myalgic Encephalomyelitis", unless you are sure of the translation.
# After translating, translate it back into English to make sure the translation actually says what you think it says! If it doesn't, there may be an error in either the translation or the back-translation.

== Translating the user interface ==
MEpedia's user interface stores its text in messages stored in the "MediaWiki:" namespace. Each message is translated into foreign languages. If you notice a specific piece of the user interface that needs to be translated into a specific foreign language, you can:
# Find the "MediaWiki:" page that stores that user interface message. In your browser's address bar, add <code>?uselang=qqx</code> to the end of the URL. This should show the names of the "MediaWiki:" pages that correspond to each part of the user interface. For example, the text for the "Main page" link at the top of the lefthand sidebar is stored in the "MediaWiki:mainpage-description" page.
# Translate the "MediaWiki:" page into the specific foreign language and store that translation in a page named after the "MediaWiki:" page, but with "/" and the [[Wikipedia:List_of_ISO_639-1_codes|language code]] at the end of the page name. For example, the French translation of "MediaWiki:mainpage-description" should be stored in "MediaWiki:mainpage-description/fr". Note that only [[MEpedia:Administrators|MEpedia administrators]] can create new "MediaWiki:" pages, so you will have to ask an administrator to create the page for you.
# Record your translation in the user interface message table at [[MEpedia:User interface translation]]. This table is designed to keep track of which user interface messages have been translated into which languages.
For more information, see [[MEpedia:User interface translation]].

== Translating "Template:" pages ==
See [[MEpedia:Template translation]].

==Priority languages ==
See [[MEpedia:Language codes#priority|Priority languages]].

==See also==
* [[MEpedia:Language codes#priority|Priority languages]]
* [[MEpedia:Language codes]]
* [[MEpedia:User interface translation]]
* [[MEpedia:Template translation]]

[[Category:MEpedia help]]

== Notes ==

Help:Foreign languages/Tech notes

2026-09-28T21:28:22Z

WikiVisor:Updated help for localization

== Configuration ==
* Language namespaces must be configured in <code>LocalSettings.php</code>
* URL re-writes must be set in <code>robots.txt</code>

== Wiki changes ==
* Language codes must be added to [[Template:Language_links]]
* Localized name inputs for new languages must be added to the [[Form:Lang]]
* New banners must be added to the <code>MediaWiki:Top-notice-ns-{NAMESPACE_NUMBER}</code>, see example at [[MediaWiki:Top-notice-ns-4002]] (Copy and adapt the markup).

Help:Foreign languages

2026-09-28T21:17:48Z

WikiVisor:Endnotes section

{{mbox|text=MEpedia supports foreign languages. The following instructions are a work in progress.}}
This page describes how '''foreign languages''' are supported in MEpedia.

== Language settings ==
There are two language settings in MEpedia:
*The reader's preferred language
*The page's content language

Changing the reader's preferred language changes the interface language.

== Approach to the content localization ==
* '''MEpedia's default language is English'''.
* Every original page in English may have localized versions. Categorize a page as [[:Category:Multilingual pages|Multiligual page]] to enable localization interface.
* Upon saving, the ''Edit with form'' link will appear in page tools of the original page.
* Click ''Edit with form'' and specify the name of the localized page in one of the supported languages <ref>Request the addition of [[MEpedia:Language codes|other languages]] from the established users.</ref>:
** Deutsch
** Español
** Français
** Svenska
* Upon saving, you will be given the panel with the links to the localized versions.
* The localized versions will be created in the dedicated namespaces.
* The corresponding content language will be set automatically.
* Edit localized versions in their respective languages like any other page.
* Opening the localized page will override the interface language and set it to the language of the page content.
* The listing of all localized pages for a given language is available through the namespace selector on [[Special:AllPages]].
* To link pages inline use <code><nowiki>[[{LANGCODE}:{LOCALIZED_PAGENAME}|{LINKTEXT}]]</nowiki></code> (e.g. <code><nowiki>[[sv:Kräkning|kräkning]]</nowiki></code> will result in [[sv:Kräkning|kräkning]]).
* The localized pages use the natural language names, so '''you don't need''' to set <code><nowiki>{{DISPLAYTITLE: ...}}</nowiki></code> '''just to translate''' the original title.

== Tips/caution regarding automated translation ==
These days, short messages can be translated using automated translators, such as https://translatr.varunmalhotra.xyz/ or Google Translate. However, some caution is warranted, and some human work will be needed to ensure that the translation is indeed accurate. Here are some tips to improve automated translation:
# Start with the simplest possible English phrasing. (Subject-verb-object)
# Use the simplest, clearest, but most ''precise'' English words possible.
# Don't use any English words that have multiple meanings. (e.g. don't use the word "clean-up", which has multiple meanings)
# Don't use any English idioms, slang, or metaphors.
# Avoid technical terms, such as "Myalgic Encephalomyelitis", unless you are sure of the translation.
# After translating, translate it back into English to make sure the translation actually says what you think it says! If it doesn't, there may be an error in either the translation or the back-translation.

== Translating the user interface ==
MEpedia's user interface stores its text in messages stored in the "MediaWiki:" namespace. Each message is translated into foreign languages. If you notice a specific piece of the user interface that needs to be translated into a specific foreign language, you can:
# Find the "MediaWiki:" page that stores that user interface message. In your browser's address bar, add <code>?uselang=qqx</code> to the end of the URL. This should show the names of the "MediaWiki:" pages that correspond to each part of the user interface. For example, the text for the "Main page" link at the top of the lefthand sidebar is stored in the "MediaWiki:mainpage-description" page.
# Translate the "MediaWiki:" page into the specific foreign language and store that translation in a page named after the "MediaWiki:" page, but with "/" and the [[Wikipedia:List_of_ISO_639-1_codes|language code]] at the end of the page name. For example, the French translation of "MediaWiki:mainpage-description" should be stored in "MediaWiki:mainpage-description/fr". Note that only [[MEpedia:Administrators|MEpedia administrators]] can create new "MediaWiki:" pages, so you will have to ask an administrator to create the page for you.
# Record your translation in the user interface message table at [[MEpedia:User interface translation]]. This table is designed to keep track of which user interface messages have been translated into which languages.
For more information, see [[MEpedia:User interface translation]].

== Translating "Template:" pages ==
See [[MEpedia:Template translation]].

==Priority languages ==
See [[MEpedia:Language codes#priority|Priority languages]].

==See also==
* [[MEpedia:Language codes#priority|Priority languages]]
* [[MEpedia:Language codes]]
* [[MEpedia:User interface translation]]
* [[MEpedia:Template translation]]

[[Category:MEpedia help]]

== Notes ==

Help:Foreign languages

2026-09-28T19:42:54Z

WikiVisor:Updated help for the content localization

{{mbox|text=MEpedia supports foreign languages. The following instructions are a work in progress.}}
This page describes how '''foreign languages''' are supported in MEpedia.

== Language settings ==
There are two language settings in MEpedia:
*The reader's preferred language
*The page's content language

Changing the reader's preferred language changes the interface language.

== Approach to the content localization ==
* '''MEpedia's default language is English'''.
* Every original page in English may have localized versions. Categorize a page as [[:Category:Multilingual pages|Multiligual page]] to enable localization interface.
* Upon saving, the ''Edit with form'' link will appear in page tools of the original page.
* Click ''Edit with form'' and specify the name of the localized page in one of the supported languages <ref>Request the addition of [[MEpedia:Language codes|other languages]] from the established users.</ref>:
** Deutsch
** Español
** Français
** Svenska
* Upon saving, you will be given the panel with the links to the localized versions.
* The localized versions will be created in the dedicated namespaces.
* The corresponding content language will be set automatically.
* Edit localized versions in their respective languages like any other page.
* Opening the localized page will override the interface language and set it to the language of the page content.
* The listing of all localized pages for a given language is available through the namespace selector on [[Special:AllPages]].
* To link pages inline use <code><nowiki>[[{LANGCODE}:{LOCALIZED_PAGENAME}|{LINKTEXT}]]</nowiki></code> (e.g. <code><nowiki>[[sv:Kräkning|kräkning]]</nowiki></code> will result in [[sv:Kräkning|kräkning]]).
* The localized pages use the natural language names, so '''you don't need''' to set <code><nowiki>{{DISPLAYTITLE: ...}}</nowiki></code> '''just to translate''' the original title.

== Tips/caution regarding automated translation ==
These days, short messages can be translated using automated translators, such as https://translatr.varunmalhotra.xyz/ or Google Translate. However, some caution is warranted, and some human work will be needed to ensure that the translation is indeed accurate. Here are some tips to improve automated translation:
# Start with the simplest possible English phrasing. (Subject-verb-object)
# Use the simplest, clearest, but most ''precise'' English words possible.
# Don't use any English words that have multiple meanings. (e.g. don't use the word "clean-up", which has multiple meanings)
# Don't use any English idioms, slang, or metaphors.
# Avoid technical terms, such as "Myalgic Encephalomyelitis", unless you are sure of the translation.
# After translating, translate it back into English to make sure the translation actually says what you think it says! If it doesn't, there may be an error in either the translation or the back-translation.

== Translating the user interface ==
MEpedia's user interface stores its text in messages stored in the "MediaWiki:" namespace. Each message is translated into foreign languages. If you notice a specific piece of the user interface that needs to be translated into a specific foreign language, you can:
# Find the "MediaWiki:" page that stores that user interface message. In your browser's address bar, add <code>?uselang=qqx</code> to the end of the URL. This should show the names of the "MediaWiki:" pages that correspond to each part of the user interface. For example, the text for the "Main page" link at the top of the lefthand sidebar is stored in the "MediaWiki:mainpage-description" page.
# Translate the "MediaWiki:" page into the specific foreign language and store that translation in a page named after the "MediaWiki:" page, but with "/" and the [[Wikipedia:List_of_ISO_639-1_codes|language code]] at the end of the page name. For example, the French translation of "MediaWiki:mainpage-description" should be stored in "MediaWiki:mainpage-description/fr". Note that only [[MEpedia:Administrators|MEpedia administrators]] can create new "MediaWiki:" pages, so you will have to ask an administrator to create the page for you.
# Record your translation in the user interface message table at [[MEpedia:User interface translation]]. This table is designed to keep track of which user interface messages have been translated into which languages.
For more information, see [[MEpedia:User interface translation]].

== Translating "Template:" pages ==
See [[MEpedia:Template translation]].

==Priority languages ==
See [[MEpedia:Language codes#priority|Priority languages]].

==See also==
* [[MEpedia:Language codes#priority|Priority languages]]
* [[MEpedia:Language codes]]
* [[MEpedia:User interface translation]]
* [[MEpedia:Template translation]]

[[Category:MEpedia help]]

Svenska:Depression

2026-09-28T19:39:14Z

WikiVisor:Removes Display title

'''Depression''' eller '''nedstämdhet''' och den svårare '''svår depression''' ('''klinisk depression''') är vanliga men potentiellt allvarliga affektiva störningar. Depression orsakar svåra symptom som påverkar hur någon känner, tänker, och agerar i dagliga aktiviteter, som att sova, äta, eller arbeta. För att bli diagnostiserad med depression måste man ha haft symptomen i minst två veckor. <ref name="nimh">{{Cite web | url = https://www.nimh.nih.gov/health/topics/depression/index.shtml | title = Depression | last = | first = | authorlink = | date = | website = National Institute of Mental Health| archive-url = | archive-date = |url-status = | access-date=2021-03-24}}</ref>

Depression som uttryckt i [[ME/CFS]] anses generellt vara sekundär depression eller reaktiv depression orsakad av de utmattande effekterna av ME/CFS.<ref name="Castro-Marrero, 2017">{{Citation | last = Castro-Marrero | first1 = Jesus | author-link1 = | last2 = Sáez-Francàs | first2 = Naia | authorlink2 = | last3 = Santillo | first3 = Dafna | authorlink3 = | last4 =Alegre | first4 = Jose | authorlink4 = | title = Treatment and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: all roads lead to Rome | journal = British Journal of Pharmacology | volume = | issue = | page = | date = 2017 | pmid = | doi = 10.1111/bph.13702}}</ref> Sekundär eller reaktiv depression är vanlig i många kroniska sjukdomar, liksom [[cancer]], vilket kan vara en akut eller kronisk sjukdom.<ref name="DeJean, 2013">{{Citation | last1 = DeJean | first1 =D. | author-link1 = | last2 = Giacomini | first2 = M. | authorlink2 = | last3 = Vanstone | first3 = M. | authorlink3 = | last4 = Brundisini | first4 = F. | authorlink4 = | title = Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis| journal = Ontario Health Technology Assessment Series | volume = 13 | issue = 16 | page = 1-33 | date = 2013 | url = http://www.hqontario.ca/Portals/0/Documents/evidence/reports/full-report-qualitative-patients-experience-depression-anxiety-cd-130906-en.pdf}}</ref>

==Feldiagnostisering av ME/CFS==
ME/CFS feldiagnostiseras ofta som depression, eftersom många symptom kan överlappa. Äldre falldefinitioner, som [[Fukuda criteria|Fukuda kritierierna]] och [[Holmes criteria|Holmes Kriterierna]] särskiljer inte tillräckligt mellan de symptomatiska kriterierna för depression och [[Chronic fatigue syndrome|kroniskt trötthetssyndrom]](CFS).

==Skillnader mellan depression och ME/CFS==
Hawk, [[Leonard Jason|Jason]], och [[Susan Torres-Harding|Torres-Harding]] definerade ett antal nyckelsymptom som var värre eller olika i ME/CFS jämfört med klinisk depression utan ME/CFS.
*Betydande [[post-exertional malaise|ansträngningsutlöst försämring]] (PEM) iakktogs i ME/CFS-patienter<ref name="Laferney, 2008" />
PEM är nu ett [[:Category:Definitions|nödvändigt diagnostiskt kriteria för ME/CFS]] i de flesta länder.<ref name="CDCsymptoms" /><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref>
*[[Fatigue|Utmattning]] varar en procentuellt längre del av tiden i ME/CFS
*Graden av [[Unrefreshing sleep|oåterställande sömn]] är högre
*Graden av [[Confusion|förvirring och desorientering]] är högre
*Graden av [[Shortness of breath|andningssvårigheter]] är högre
*ME/CFS-patienter har mindre själklander (som poängsatt i [[Beck Depression Inventory]]<ref name="Hawk, 2006" />

Genom att använda symptomlistan ovan lyckades Hawk, Jason, och Torres-Harding redogöra 100% korrekt klassificering mellan patienter med svår depression kontra ME/CFS.<ref name="Hawk, 2006" />

LaFerney, en psykiatrisk klinisk specialistsjöterska, tillägger:
*'''Anledningar till depression''': Individer med svår depression kan ofta inte ge en anledning eller identifiere en förlust som förklarar deras nedstämdhet. Det är sannolikare att ME/CFS-patienter anger att de känner sig modfällda och deprimerade på grund av oförmågan att utföra sysslor, vara anställda, eller delta i sociala funktioner p.g.a ME/CFS-symptom.<ref name="Laferney, 2008" />
*'''Inget bristande intresse för aktiviteter''': Deprimerade patienter rapporterar vanligtvis bristande intresse för aktiviteter de tidigare gillat. ME/CFS-patienter säger att de skulle delta i favoritaktiviteter mer om deras sjukdom tillät det.<ref name="Laferney, 2008" />
*'''[[Post-exertional malaise|Ansträngningsutlöst försämring]]''': Även om både deprimerade och ME/CFS-patienter rapporterar utmattning är det enbart [[ME/CFS]] som rapporterar ansträngningsutlöst försämring: med symptom som vanligtvis försämras efter 12 till 48 timmar efter en aktivitet och varar dagar till veckor.<ref name="Laferney, 2008" />
*'''[[Antidepressant|Antidepressiva läkemedel]] hjälper inte mot ME/CFS]]:''' För deprimerade patienter borde den [[Cognitive dysfunction|minskade förmågan att tänka och koncentrera sig]] förbättras av [[Antidepressant|antidepressiva läkemedel]] eller terapi. För patienter med ME/CFS hjälper antidepressiva läkemedel ofta inte koncentration eller minne.<ref name="Laferney, 2008">{{Citation | last1 = Laferney | first1 = Michael C. | author-link1 = | title = Depression or chronic fatigue syndrome?| journal = Current Psychiatry | volume = 7 | issue = 1 | page = 91-94 | date = 2008| url = https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/0701CP_Pearls1.pdf}}</ref>

Dr. [[Sarah Myhill]] lägger till ytterligare en skillnade mellan depression och [[Chronic fatigue syndrome|CFS]]:
*'''Respons på träning''': Träning kan göra CFS-patienter mycket sämre, men kan vara väldigt terapeutiskt för ren depression.<ref>{{Cite web | url = http://drmyhill.co.uk/wiki/CFS_or_depression_-_what_are_the_differences| title = CFS or Depression: What are the differences? | last = Myhill | first =Sarah | authorlink = Sarah Myhill |website =Dr Myhill|access-date=2021-03-24}}</ref><ref name="OxfordBrookesSurvey">{{Cite web | url = https://www.meassociation.org.uk/wp-content/uploads/NICE-Patient-Survey-Outcomes-CBT-and-GET-Final-Consolidated-Report-03.04.19.pdf | title =Evaluation of a survey exploring the experiences of adults and children with ME/CFS who have participated in CBT and GET interventional programmes. FINAL REPORT | last = Oxford Clinical Allied Technology and Trials Services Unit (OxCATTS)|location=Oxford Brookes University | date = Feb 27, 2019}}</ref><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref><ref name="CDCsymptoms">{{Cite web | url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref>

Kliniska prövningar och patientbevis har båda visat att:
*[[Cognitive behavioral therapy|Kognitiv beteendeterapi]] inriktat på ME/CFS-symptom är inneffektivt och oft skadligt, och kan skada mental hälsa,<ref name="OxfordBrookesSurvey" /><ref name=Smith2016>{{cite journal| vauthors = Smith ME, Nelson HD, Haney E, Pappas M, Daeges M, Wasson N, McDonagh M | title = Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome No. 219| journal = Evidence Report/Technology Assessment | pages = 1–433 | date = Dec 2014 |pmid =30313001 | doi = 10.23970/AHRQEPCERTA219 |url = https://www.ncbi.nlm.nih.gov/books/NBK379582/ | publisher = Agency for Healthcare Research and Quality (US) | doi-access = free }}</ref> men är en effektiv evidensbaserad behandling för depression
*'''De flesta ME/CFS-patienter har inte depression''', även om, likt andra kroniska sjukdomar, ett betydande antal patienter utvecklar [[Depression/sv#reactive_depression|reaktiv eller sekundär depression]]<ref name="ICC2011primer"/>

*Det finns många [[abnormal findings in ME/CFS|fysiska abnormaliteter]] som inte finns i depression, men många av dessa abnormaliteter återfinns inte i standardiserade diagnostiska test och ingen enskild abnormalitet kan än så länge användas som [[Diagnostic biomarker|diagnostisk biomarkör]] för ME/CFS. Fysiska abnormaliteter i ME/CFS indikerar immuna, neurologiska, energitransport, och andra abnormaliteter som inte kan förklaras med depression, [[Medically unexplained physical symptoms|somatisering]], [[Deconditioning|avkonditionering]], [[Health anxiety|hälsoångest]], eller andra psykologiska eller beteende faktorer.<ref name="ICC2011primer"/>

==Om jag botades imorgon==
{{Cquote|text=En fråga som kan skilja de två grupperna åt är att fråga patienten, "Om du botades imorgon, vad skulle du göra?" Deprimerade patienter kan vanligtvis inte svara på frågan utan eftertanke. ME/CFS-patienter listar vanligtvis en stor mängd aktiviteter utan föranledning. | author = Michael LaFerney}}

The [[Forgotten Plague]] Facebook-sidan hade en "If i was cured tomorrow..." kampanj där ME/CFS-patienter uppmuntrades att ladda upp sina drömmar för att belysa den skillnaden från depression.<ref>http://www.forgottenplague.com/upload-your-dream/</ref>

==Fukudakriterier==
2006 fann Hawk, [[Leonard Jason|Jason]], och [[Susan Torres-Harding|Torres Harding]] att [[CDC]]s [[Fukuda criteria|Fukuda ME/CFS kriterier, som inte längre används, bara klassificerade 84.4% av patienter korrekt när patienter med större depression jämfördes med patienter med ME/CFS.<ref name="Hawk, 2006">{{Citation | last = Hawk | first1 = C | author-link1 = | last2 = Jason | first2 = L | authorlink2 = Leonard Jason | last3 = Torres-Harding | first3 = S | authorlink3 = Susan Torres-Harding| title = Differential diagnosis of chronic fatigue syndrome and major depressive disorder | journal = International Journal of Behavioral Medicine | volume = 13 | issue = 3 | page = 244-51 | date = 2006 | pmid = 17078775 | doi = 10.1207/s15327558ijbm1303_8 | url = http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf}}</ref>

==Förekomst==
*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av depression på 65-90% i ME/CFS-patienter.<ref>{{citation | last = Berne | first = Katrina | author-link = Katrina Berne/sv |date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 |isbn= 978-0897931915}}</ref>

==Symptomigenkänning==
* I [[Holmes criteria|Holmeskriterierna]] från 1988 är depression ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria - Neuropsychologic Complaints''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref> Det är inte ett diagnostiserbart symptom i de nuvarande [[Systemic Exertion Intolerance Disease|CDCkriterierna]], [[Fukuda criteria|Fukudakriterierna]], [[Canadian Consensus Criteria|Kanadakriterierna]] eller de [[International Consensus Criteria|internationella konsensuskriterierna]], men sekundär depression erkänns som ett möjligt symptom och komorbitet av ME/CFS i de internationella konsensuskriterierna.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref>

==Nämnvärda studier==
*2006, Differential diagnosis of chronic fatigue syndrome and major depressive disorder<ref name="Hawk, 2006" /> [http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf (Full Text)]
*2008, A Systematic Review of Chronic Fatigue Syndrome: Don't Assume It's Depression<ref name="Griffith, 2008">{{Citation | last1 = Griffith | first1 = J.P. | author-link1 = | last2 = Zarrouf | first2 = F.A. | authorlink2 = | title = A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/| pmc =2292451| journal = Primary Care Companion to The Journal of Clinical Psychiatry | volume = 10 | issue = 2 | page = 120–128| date = 2008 | pmid = 18458765 | doi = 10.4088/pcc.v10n0206 }}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ (Full Text)]

==Möjliga orsaker==
Depression i ME/CFS-patienter kan orsakas av:
*Effekten av att leva med en dåligt förstådd kronisk sjukdom, känt som ''reaktiv depression''' eller '''sekundär depression'''<ref name="ICC2011primer" />
*Någon med ME/CFS kan ha depression orelaterat till deras ME/CFS-symptom, känt som '''primär depression'''<ref name="ICC2011primer" />
*Personer med ME/CFS förlorar vanligtvis de naturliga fördelarna av [[exercise|träning]], vilket betyder att en person som tidigare använt träning för att förbättra sitt humör inte längre kan göra det<ref name="ICC2011primer" />
*Depression är en potentiell bieffekt av vissa mediciner, speciellt en kategori av medicin kallad stämningsstabiliserare, som används för bipolär sjukdom(manodepressiv sjukdom) men som orsakar depression eller förvärrar depression i personer utan bipolär sjukdom.

==Möjliga behandlingar==
*[[Antidepressant|Antidepressiva läkemedel]]
*Kognitiv beteendeterapi för depression (CBT)
*[[Mindfulness and meditation|Midnfullness och meditation]]

==Se även==
*[[Mood swings|Humörsvängningar]]
*[[St. John’s Wort|Äkta Johannesört]]
*[[Anxiety|Ångest]]
*[[Fibromyalgia#depression|Depression i fibromyalgi]]

==Vidare läsning==
* 2008, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression]
* 2008, [http://www.mdedge.com/currentpsychiatry/article/62979/depression-or-chronic-fatigue-syndrome Depression or chronic fatigue syndrome? by Michael C. Laferney]
* 2014, [http://www.healthrising.org/blog/2014/04/26/prove-doctor-youve-got-chronic-fatigue-syndrome-mecfs-just-depressed/ How to Prove to Your Doctor You’ve Got Chronic Fatigue Syndrome (ME/CFS) And Are Not Just Depressed] by [[Cort Johnson]]

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Depression

2026-09-28T19:38:12Z

WikiVisor:WikiVisor moved page Depression/sv to Svenska:Depression without leaving a redirect

{{DISPLAYTITLE:Depression}}

'''Depression''' eller '''nedstämdhet''' och den svårare '''svår depression''' ('''klinisk depression''') är vanliga men potentiellt allvarliga affektiva störningar. Depression orsakar svåra symptom som påverkar hur någon känner, tänker, och agerar i dagliga aktiviteter, som att sova, äta, eller arbeta. För att bli diagnostiserad med depression måste man ha haft symptomen i minst två veckor. <ref name="nimh">{{Cite web | url = https://www.nimh.nih.gov/health/topics/depression/index.shtml | title = Depression | last = | first = | authorlink = | date = | website = National Institute of Mental Health| archive-url = | archive-date = |url-status = | access-date=2021-03-24}}</ref>

Depression som uttryckt i [[ME/CFS]] anses generellt vara sekundär depression eller reaktiv depression orsakad av de utmattande effekterna av ME/CFS.<ref name="Castro-Marrero, 2017">{{Citation | last = Castro-Marrero | first1 = Jesus | author-link1 = | last2 = Sáez-Francàs | first2 = Naia | authorlink2 = | last3 = Santillo | first3 = Dafna | authorlink3 = | last4 =Alegre | first4 = Jose | authorlink4 = | title = Treatment and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: all roads lead to Rome | journal = British Journal of Pharmacology | volume = | issue = | page = | date = 2017 | pmid = | doi = 10.1111/bph.13702}}</ref> Sekundär eller reaktiv depression är vanlig i många kroniska sjukdomar, liksom [[cancer]], vilket kan vara en akut eller kronisk sjukdom.<ref name="DeJean, 2013">{{Citation | last1 = DeJean | first1 =D. | author-link1 = | last2 = Giacomini | first2 = M. | authorlink2 = | last3 = Vanstone | first3 = M. | authorlink3 = | last4 = Brundisini | first4 = F. | authorlink4 = | title = Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis| journal = Ontario Health Technology Assessment Series | volume = 13 | issue = 16 | page = 1-33 | date = 2013 | url = http://www.hqontario.ca/Portals/0/Documents/evidence/reports/full-report-qualitative-patients-experience-depression-anxiety-cd-130906-en.pdf}}</ref>

==Feldiagnostisering av ME/CFS==
ME/CFS feldiagnostiseras ofta som depression, eftersom många symptom kan överlappa. Äldre falldefinitioner, som [[Fukuda criteria|Fukuda kritierierna]] och [[Holmes criteria|Holmes Kriterierna]] särskiljer inte tillräckligt mellan de symptomatiska kriterierna för depression och [[Chronic fatigue syndrome|kroniskt trötthetssyndrom]](CFS).

==Skillnader mellan depression och ME/CFS==
Hawk, [[Leonard Jason|Jason]], och [[Susan Torres-Harding|Torres-Harding]] definerade ett antal nyckelsymptom som var värre eller olika i ME/CFS jämfört med klinisk depression utan ME/CFS.
*Betydande [[post-exertional malaise|ansträngningsutlöst försämring]] (PEM) iakktogs i ME/CFS-patienter<ref name="Laferney, 2008" />
PEM är nu ett [[:Category:Definitions|nödvändigt diagnostiskt kriteria för ME/CFS]] i de flesta länder.<ref name="CDCsymptoms" /><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref>
*[[Fatigue|Utmattning]] varar en procentuellt längre del av tiden i ME/CFS
*Graden av [[Unrefreshing sleep|oåterställande sömn]] är högre
*Graden av [[Confusion|förvirring och desorientering]] är högre
*Graden av [[Shortness of breath|andningssvårigheter]] är högre
*ME/CFS-patienter har mindre själklander (som poängsatt i [[Beck Depression Inventory]]<ref name="Hawk, 2006" />

Genom att använda symptomlistan ovan lyckades Hawk, Jason, och Torres-Harding redogöra 100% korrekt klassificering mellan patienter med svår depression kontra ME/CFS.<ref name="Hawk, 2006" />

LaFerney, en psykiatrisk klinisk specialistsjöterska, tillägger:
*'''Anledningar till depression''': Individer med svår depression kan ofta inte ge en anledning eller identifiere en förlust som förklarar deras nedstämdhet. Det är sannolikare att ME/CFS-patienter anger att de känner sig modfällda och deprimerade på grund av oförmågan att utföra sysslor, vara anställda, eller delta i sociala funktioner p.g.a ME/CFS-symptom.<ref name="Laferney, 2008" />
*'''Inget bristande intresse för aktiviteter''': Deprimerade patienter rapporterar vanligtvis bristande intresse för aktiviteter de tidigare gillat. ME/CFS-patienter säger att de skulle delta i favoritaktiviteter mer om deras sjukdom tillät det.<ref name="Laferney, 2008" />
*'''[[Post-exertional malaise|Ansträngningsutlöst försämring]]''': Även om både deprimerade och ME/CFS-patienter rapporterar utmattning är det enbart [[ME/CFS]] som rapporterar ansträngningsutlöst försämring: med symptom som vanligtvis försämras efter 12 till 48 timmar efter en aktivitet och varar dagar till veckor.<ref name="Laferney, 2008" />
*'''[[Antidepressant|Antidepressiva läkemedel]] hjälper inte mot ME/CFS]]:''' För deprimerade patienter borde den [[Cognitive dysfunction|minskade förmågan att tänka och koncentrera sig]] förbättras av [[Antidepressant|antidepressiva läkemedel]] eller terapi. För patienter med ME/CFS hjälper antidepressiva läkemedel ofta inte koncentration eller minne.<ref name="Laferney, 2008">{{Citation | last1 = Laferney | first1 = Michael C. | author-link1 = | title = Depression or chronic fatigue syndrome?| journal = Current Psychiatry | volume = 7 | issue = 1 | page = 91-94 | date = 2008| url = https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/0701CP_Pearls1.pdf}}</ref>

Dr. [[Sarah Myhill]] lägger till ytterligare en skillnade mellan depression och [[Chronic fatigue syndrome|CFS]]:
*'''Respons på träning''': Träning kan göra CFS-patienter mycket sämre, men kan vara väldigt terapeutiskt för ren depression.<ref>{{Cite web | url = http://drmyhill.co.uk/wiki/CFS_or_depression_-_what_are_the_differences| title = CFS or Depression: What are the differences? | last = Myhill | first =Sarah | authorlink = Sarah Myhill |website =Dr Myhill|access-date=2021-03-24}}</ref><ref name="OxfordBrookesSurvey">{{Cite web | url = https://www.meassociation.org.uk/wp-content/uploads/NICE-Patient-Survey-Outcomes-CBT-and-GET-Final-Consolidated-Report-03.04.19.pdf | title =Evaluation of a survey exploring the experiences of adults and children with ME/CFS who have participated in CBT and GET interventional programmes. FINAL REPORT | last = Oxford Clinical Allied Technology and Trials Services Unit (OxCATTS)|location=Oxford Brookes University | date = Feb 27, 2019}}</ref><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref><ref name="CDCsymptoms">{{Cite web | url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref>

Kliniska prövningar och patientbevis har båda visat att:
*[[Cognitive behavioral therapy|Kognitiv beteendeterapi]] inriktat på ME/CFS-symptom är inneffektivt och oft skadligt, och kan skada mental hälsa,<ref name="OxfordBrookesSurvey" /><ref name=Smith2016>{{cite journal| vauthors = Smith ME, Nelson HD, Haney E, Pappas M, Daeges M, Wasson N, McDonagh M | title = Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome No. 219| journal = Evidence Report/Technology Assessment | pages = 1–433 | date = Dec 2014 |pmid =30313001 | doi = 10.23970/AHRQEPCERTA219 |url = https://www.ncbi.nlm.nih.gov/books/NBK379582/ | publisher = Agency for Healthcare Research and Quality (US) | doi-access = free }}</ref> men är en effektiv evidensbaserad behandling för depression
*'''De flesta ME/CFS-patienter har inte depression''', även om, likt andra kroniska sjukdomar, ett betydande antal patienter utvecklar [[Depression/sv#reactive_depression|reaktiv eller sekundär depression]]<ref name="ICC2011primer"/>

*Det finns många [[abnormal findings in ME/CFS|fysiska abnormaliteter]] som inte finns i depression, men många av dessa abnormaliteter återfinns inte i standardiserade diagnostiska test och ingen enskild abnormalitet kan än så länge användas som [[Diagnostic biomarker|diagnostisk biomarkör]] för ME/CFS. Fysiska abnormaliteter i ME/CFS indikerar immuna, neurologiska, energitransport, och andra abnormaliteter som inte kan förklaras med depression, [[Medically unexplained physical symptoms|somatisering]], [[Deconditioning|avkonditionering]], [[Health anxiety|hälsoångest]], eller andra psykologiska eller beteende faktorer.<ref name="ICC2011primer"/>

==Om jag botades imorgon==
{{Cquote|text=En fråga som kan skilja de två grupperna åt är att fråga patienten, "Om du botades imorgon, vad skulle du göra?" Deprimerade patienter kan vanligtvis inte svara på frågan utan eftertanke. ME/CFS-patienter listar vanligtvis en stor mängd aktiviteter utan föranledning. | author = Michael LaFerney}}

The [[Forgotten Plague]] Facebook-sidan hade en "If i was cured tomorrow..." kampanj där ME/CFS-patienter uppmuntrades att ladda upp sina drömmar för att belysa den skillnaden från depression.<ref>http://www.forgottenplague.com/upload-your-dream/</ref>

==Fukudakriterier==
2006 fann Hawk, [[Leonard Jason|Jason]], och [[Susan Torres-Harding|Torres Harding]] att [[CDC]]s [[Fukuda criteria|Fukuda ME/CFS kriterier, som inte längre används, bara klassificerade 84.4% av patienter korrekt när patienter med större depression jämfördes med patienter med ME/CFS.<ref name="Hawk, 2006">{{Citation | last = Hawk | first1 = C | author-link1 = | last2 = Jason | first2 = L | authorlink2 = Leonard Jason | last3 = Torres-Harding | first3 = S | authorlink3 = Susan Torres-Harding| title = Differential diagnosis of chronic fatigue syndrome and major depressive disorder | journal = International Journal of Behavioral Medicine | volume = 13 | issue = 3 | page = 244-51 | date = 2006 | pmid = 17078775 | doi = 10.1207/s15327558ijbm1303_8 | url = http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf}}</ref>

==Förekomst==
*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av depression på 65-90% i ME/CFS-patienter.<ref>{{citation | last = Berne | first = Katrina | author-link = Katrina Berne/sv |date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 |isbn= 978-0897931915}}</ref>

==Symptomigenkänning==
* I [[Holmes criteria|Holmeskriterierna]] från 1988 är depression ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria - Neuropsychologic Complaints''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref> Det är inte ett diagnostiserbart symptom i de nuvarande [[Systemic Exertion Intolerance Disease|CDCkriterierna]], [[Fukuda criteria|Fukudakriterierna]], [[Canadian Consensus Criteria|Kanadakriterierna]] eller de [[International Consensus Criteria|internationella konsensuskriterierna]], men sekundär depression erkänns som ett möjligt symptom och komorbitet av ME/CFS i de internationella konsensuskriterierna.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref>

==Nämnvärda studier==
*2006, Differential diagnosis of chronic fatigue syndrome and major depressive disorder<ref name="Hawk, 2006" /> [http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf (Full Text)]
*2008, A Systematic Review of Chronic Fatigue Syndrome: Don't Assume It's Depression<ref name="Griffith, 2008">{{Citation | last1 = Griffith | first1 = J.P. | author-link1 = | last2 = Zarrouf | first2 = F.A. | authorlink2 = | title = A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/| pmc =2292451| journal = Primary Care Companion to The Journal of Clinical Psychiatry | volume = 10 | issue = 2 | page = 120–128| date = 2008 | pmid = 18458765 | doi = 10.4088/pcc.v10n0206 }}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ (Full Text)]

==Möjliga orsaker==
Depression i ME/CFS-patienter kan orsakas av:
*Effekten av att leva med en dåligt förstådd kronisk sjukdom, känt som ''reaktiv depression''' eller '''sekundär depression'''<ref name="ICC2011primer" />
*Någon med ME/CFS kan ha depression orelaterat till deras ME/CFS-symptom, känt som '''primär depression'''<ref name="ICC2011primer" />
*Personer med ME/CFS förlorar vanligtvis de naturliga fördelarna av [[exercise|träning]], vilket betyder att en person som tidigare använt träning för att förbättra sitt humör inte längre kan göra det<ref name="ICC2011primer" />
*Depression är en potentiell bieffekt av vissa mediciner, speciellt en kategori av medicin kallad stämningsstabiliserare, som används för bipolär sjukdom(manodepressiv sjukdom) men som orsakar depression eller förvärrar depression i personer utan bipolär sjukdom.

==Möjliga behandlingar==
*[[Antidepressant|Antidepressiva läkemedel]]
*Kognitiv beteendeterapi för depression (CBT)
*[[Mindfulness and meditation|Midnfullness och meditation]]

==Se även==
*[[Mood swings|Humörsvängningar]]
*[[St. John’s Wort|Äkta Johannesört]]
*[[Anxiety|Ångest]]
*[[Fibromyalgia#depression|Depression i fibromyalgi]]

==Vidare läsning==
* 2008, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression]
* 2008, [http://www.mdedge.com/currentpsychiatry/article/62979/depression-or-chronic-fatigue-syndrome Depression or chronic fatigue syndrome? by Michael C. Laferney]
* 2014, [http://www.healthrising.org/blog/2014/04/26/prove-doctor-youve-got-chronic-fatigue-syndrome-mecfs-just-depressed/ How to Prove to Your Doctor You’ve Got Chronic Fatigue Syndrome (ME/CFS) And Are Not Just Depressed] by [[Cort Johnson]]

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Insomni

2026-09-28T19:37:57Z

WikiVisor:Relocate lang link

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[sv:Depression|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[Sv:Stress|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Sv:Hypersomni|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Depression

2026-09-28T19:37:07Z

WikiVisor:

{{Language links
|page_sv=Depression
}}
'''Depression''' or '''low mood''' and the more severe '''major depressive disorder''' ('''clinical depression''') are common but potentially serious mood disorders. Depression causes severe symptoms that affect how someone feels, thinks, and handles daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.<ref name="nimh">{{Cite web | url = https://www.nimh.nih.gov/health/topics/depression/index.shtml | title = Depression | last = | first = | authorlink = | date = | website = National Institute of Mental Health| archive-url = | archive-date = |url-status = | access-date=2021-03-24}}</ref>

Depression as expressed in patients with [[ME/CFS]] is generally considered as secondary depression or reactive depression due to the debilitating effects of ME/CFS.<ref name="Castro-Marrero, 2017">{{Citation | last = Castro-Marrero | first1 = Jesus | author-link1 = | last2 = Sáez-Francàs | first2 = Naia | authorlink2 = | last3 = Santillo | first3 = Dafna | authorlink3 = | last4 =Alegre | first4 = Jose | authorlink4 = | title = Treatment and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: all roads lead to Rome | journal = British Journal of Pharmacology | volume = | issue = | page = | date = 2017 | pmid = | doi = 10.1111/bph.13702}}</ref> Secondary or reactive depression is common in many chronic illnesses as well as [[cancer]], which may be an acute or chronic illness.<ref name="DeJean, 2013">{{Citation | last1 = DeJean | first1 =D. | author-link1 = | last2 = Giacomini | first2 = M. | authorlink2 = | last3 = Vanstone | first3 = M. | authorlink3 = | last4 = Brundisini | first4 = F. | authorlink4 = | title = Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis| journal = Ontario Health Technology Assessment Series | volume = 13 | issue = 16 | page = 1-33 | date = 2013 | url = http://www.hqontario.ca/Portals/0/Documents/evidence/reports/full-report-qualitative-patients-experience-depression-anxiety-cd-130906-en.pdf}}</ref>

==Misdiagnosis of ME/CFS==
ME/CFS is often misdiagnosed as depression, as many symptoms can overlap. Older case definitions, such as the [[Fukuda criteria]] and the [[Holmes criteria]] do not differentiate enough between the symptomatic criteria of depression and [[chronic fatigue syndrome]] (CFS).

==Differences between depression and ME/CFS==
Hawk, [[Leonard Jason |Jason]], and [[Susan Torres-Harding|Torres-Harding]] defined a number of key symptoms that were worse or different in ME/CFS compared to clinical depression without ME/CFS:
*Significant [[post-exertional malaise]] (PEM) was found in ME/CFS patients<ref name="Laferney, 2008" />
::PEM is now a required [[:Category:Definitions|diagnostic criteria for ME/CFS]] in most countries<ref name="CDCsymptoms" /><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref>
*[[Fatigue]] lasts for a greater the percentage of the time in ME/CFS
*[[Unrefreshing sleep]] severity is higher
*[[Confusion|Confusion–disorientation]] severity is higher
*[[Shortness of breath]] severity is higher
*ME/CFS patients have less self-reproach (as scored on the [[Beck Depression Inventory]])<ref name="Hawk, 2006" />
Using the symptoms list above, Hawk, Jason, and Torres-Harding were able to report 100% correct classification between patients with major depressive disorder versus ME/CFS.<ref name="Hawk, 2006" />

LaFerney, a psychiatric clinical nurse specialist, adds:
*'''Reason for depression''': Individuals with major depressive disorder often cannot provide a reason or identify a loss to explain their depressed mood. ME/CFS patients are more likely to report feeling discouraged and depressed because of the inability to perform tasks, be employed, or engage in social functions due to ME/CFS symptoms.<ref name="Laferney, 2008" />
*'''No lack of interest in activities''': Depressed patients typically report a lack of interest in activities they previously enjoyed. ME/CFS patients say they would engage in favorite activities more if their illness would allow it.<ref name="Laferney, 2008" />
*'''[[Post-exertional malaise]]''': Although both depressed and ME/CFS patients report fatigue, only [[ME/CFS]] report post-exertional malaise: with physical symptoms typically worsening 12 to 48 hours after an activity and lasting for days to weeks.<ref name="Laferney, 2008" />
*'''[[Antidepressant]]s don't help in ME/CFS''': In depressed patients, the [[Cognitive dysfunction|diminished ability to think or concentrate]] should improve with [[antidepressant]] drugs or therapies. In patients with ME/CFS, antidepressants often do not improve concentration or memory.<ref name="Laferney, 2008">{{Citation | last1 = Laferney | first1 = Michael C. | author-link1 = | title = Depression or chronic fatigue syndrome?| journal = Current Psychiatry | volume = 7 | issue = 1 | page = 91-94 | date = 2008| url = https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/0701CP_Pearls1.pdf}}</ref>
Dr. [[Sarah Myhill]] adds an additional difference between depression and [[Chronic fatigue syndrome|CFS]]:
*'''Response to [[exercise]]''': Exercise makes CFS patients much worse, but can be positively therapeutic in pure depression<ref>{{Cite web | url = http://drmyhill.co.uk/wiki/CFS_or_depression_-_what_are_the_differences| title = CFS or Depression: What are the differences? | last = Myhill | first =Sarah | authorlink = Sarah Myhill |website =Dr Myhill|access-date=2021-03-24}}</ref><ref name="OxfordBrookesSurvey">{{Cite web | url = https://www.meassociation.org.uk/wp-content/uploads/NICE-Patient-Survey-Outcomes-CBT-and-GET-Final-Consolidated-Report-03.04.19.pdf | title =Evaluation of a survey exploring the experiences of adults and children with ME/CFS who have participated in CBT and GET interventional programmes. FINAL REPORT | last = Oxford Clinical Allied Technology and Trials Services Unit (OxCATTS)|location=Oxford Brookes University | date = Feb 27, 2019}}</ref><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref><ref name="CDCsymptoms">{{Cite web | url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref>
Clinical trials and patient evidence have both shown that:
*[[Cognitive behavioral therapy]] aimed at ME/CFS symptoms is ineffective and often harmful, and can harm mental health,<ref name="OxfordBrookesSurvey" /><ref name=Smith2016>{{cite journal| vauthors = Smith ME, Nelson HD, Haney E, Pappas M, Daeges M, Wasson N, McDonagh M | title = Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome No. 219| journal = Evidence Report/Technology Assessment | pages = 1–433 | date = Dec 2014 |pmid =30313001 | doi = 10.23970/AHRQEPCERTA219 |url = https://www.ncbi.nlm.nih.gov/books/NBK379582/ | publisher = Agency for Healthcare Research and Quality (US) | doi-access = free }}</ref> but is an effective evidence-based treatment for depression
*'''Most ME/CFS patients do not have depression''', although in common with other chronic illness a significant number of patients develop [[depression#reactive_depression|reactive or secondary depression]]<ref name="ICC2011primer"/>
* There are many [[abnormal findings in ME/CFS|physically abnormal findings]] that are not present in depression, but many of these findings are not from the standard diagnostic tests and no single finding can yet act as a [[diagnostic biomarker]] for ME/CFS. Physical abnormalities in ME/CFS indicate immune, neurological, energy transportation, and other findings that cannot be explained by depression, [[medically unexplained physical symptoms|somatization]], [[deconditioning]], [[health anxiety]], or other psychological or behavioral factors<ref name="ICC2011primer"/>

===If I was cured tomorrow...===
{{Cquote|text=One question that can differentiate the two groups is to ask the patient, "If you were cured tomorrow, what would you do?" Depressed patients typically can not answer the question without forethought. ME/CFS patients typically can list an abundance of activities without prompt. | author = Michael LaFerney}}

The [[Forgotten Plague]] Facebook page had a "If I was cured tomorrow..." campaign encouraging ME/CFS patients to upload their dreams to highlight this difference from depression.<ref>http://www.forgottenplague.com/upload-your-dream/</ref>

===Fukuda criteria ===
In 2006, Hawk, [[Leonard Jason |Jason]], and [[Susan Torres-Harding|Torres-Harding]] found that the [[CDC]]'s [[Fukuda criteria|Fukuda ME/CFS criteria]], which is now retired from use, only correctly classified 84.4% of patients when comparing patients with major depressive disorder and to patients with ME/CFS.<ref name="Hawk, 2006">{{Citation | last = Hawk | first1 = C | author-link1 = | last2 = Jason | first2 = L | authorlink2 = Leonard Jason | last3 = Torres-Harding | first3 = S | authorlink3 = Susan Torres-Harding| title = Differential diagnosis of chronic fatigue syndrome and major depressive disorder | journal = International Journal of Behavioral Medicine | volume = 13 | issue = 3 | page = 244-51 | date = 2006 | pmid = 17078775 | doi = 10.1207/s15327558ijbm1303_8 | url = http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf}}</ref>

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 65-90% for depression in ME/CFS patients.<ref>{{citation | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 |isbn= 978-0897931915}}</ref>

==Symptom recognition==
*In the 1988 [[Holmes criteria]], depression is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria - Neuropsychologic Complaints''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref> It is not a diagnosable symptom in the current [[Systemic Exertion Intolerance Disease|CDC criteria]], the [[Fukuda criteria]], the [[Canadian Consensus Criteria]] or the [[International Consensus Criteria]] although secondary depression is recognized as a possible symptom and comorbidity of ME/CFS in the International Consensus Criteria.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref>

Depression is also a potential symptom of [[Long COVID]] in the [[World Health Organization Long COVID diagnostic criteria|World Health Organization]]'s definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | authorlink4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Notable studies==
*2006, Differential diagnosis of chronic fatigue syndrome and major depressive disorder<ref name="Hawk, 2006" /> [http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf (Full Text)]
*2008, A Systematic Review of Chronic Fatigue Syndrome: Don't Assume It's Depression<ref name="Griffith, 2008">{{Citation | last1 = Griffith | first1 = J.P. | author-link1 = | last2 = Zarrouf | first2 = F.A. | authorlink2 = | title = A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/| pmc =2292451| journal = Primary Care Companion to The Journal of Clinical Psychiatry | volume = 10 | issue = 2 | page = 120–128| date = 2008 | pmid = 18458765 | doi = 10.4088/pcc.v10n0206 }}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ (Full Text)]

==Possible causes==
Depression in ME/CFS patients may be caused by:
* The impact of living with a poorly understood chronic illness, known as '''reactive depression''' or '''secondary depression'''<ref name="ICC2011primer" />
* Someone with ME/CFS may have depression unrelated to their ME/CFS symptoms, known as '''primary depression'''<ref name="ICC2011primer" />
* People with ME/CFS typicallly lose the natural benefit of [[exercise]], which means a person who previously used exercise to improve their mood is no longer able to do this<ref name="ICC2011primer" />
* Depression is a potential side effect of some drugs, particularly a class of drugs known as mood stabilizers, which are used for bipolar depression (manic depression) but cause depression or worsen depression in people without bipolar disorder.

==Potential treatments==
* [[Antidepressant]]s
* Cognitive behavioral therapy for depression (CBT)
* [[Mindfulness and meditation|Mindfulness and Meditation]]

==See also==
*[[Mood swings]]
*[[St. John’s Wort]]
*[[Anxiety]]
*[[Fibromyalgia#depression|Depression in fibromyalgia]]

==Learn more==
* 2008, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression]
* 2008, [http://www.mdedge.com/currentpsychiatry/article/62979/depression-or-chronic-fatigue-syndrome Depression or chronic fatigue syndrome? by Michael C. Laferney]
* 2014, [http://www.healthrising.org/blog/2014/04/26/prove-doctor-youve-got-chronic-fatigue-syndrome-mecfs-just-depressed/ How to Prove to Your Doctor You’ve Got Chronic Fatigue Syndrome (ME/CFS) And Are Not Just Depressed] by [[Cort Johnson]]

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Multilingual pages]]

Depression

2026-09-28T19:36:53Z

WikiVisor:Categorize as multiligual

'''Depression''' or '''low mood''' and the more severe '''major depressive disorder''' ('''clinical depression''') are common but potentially serious mood disorders. Depression causes severe symptoms that affect how someone feels, thinks, and handles daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.<ref name="nimh">{{Cite web | url = https://www.nimh.nih.gov/health/topics/depression/index.shtml | title = Depression | last = | first = | authorlink = | date = | website = National Institute of Mental Health| archive-url = | archive-date = |url-status = | access-date=2021-03-24}}</ref>

Depression as expressed in patients with [[ME/CFS]] is generally considered as secondary depression or reactive depression due to the debilitating effects of ME/CFS.<ref name="Castro-Marrero, 2017">{{Citation | last = Castro-Marrero | first1 = Jesus | author-link1 = | last2 = Sáez-Francàs | first2 = Naia | authorlink2 = | last3 = Santillo | first3 = Dafna | authorlink3 = | last4 =Alegre | first4 = Jose | authorlink4 = | title = Treatment and management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: all roads lead to Rome | journal = British Journal of Pharmacology | volume = | issue = | page = | date = 2017 | pmid = | doi = 10.1111/bph.13702}}</ref> Secondary or reactive depression is common in many chronic illnesses as well as [[cancer]], which may be an acute or chronic illness.<ref name="DeJean, 2013">{{Citation | last1 = DeJean | first1 =D. | author-link1 = | last2 = Giacomini | first2 = M. | authorlink2 = | last3 = Vanstone | first3 = M. | authorlink3 = | last4 = Brundisini | first4 = F. | authorlink4 = | title = Patient experiences of depression and anxiety with chronic disease: a systematic review and qualitative meta-synthesis| journal = Ontario Health Technology Assessment Series | volume = 13 | issue = 16 | page = 1-33 | date = 2013 | url = http://www.hqontario.ca/Portals/0/Documents/evidence/reports/full-report-qualitative-patients-experience-depression-anxiety-cd-130906-en.pdf}}</ref>

==Misdiagnosis of ME/CFS==
ME/CFS is often misdiagnosed as depression, as many symptoms can overlap. Older case definitions, such as the [[Fukuda criteria]] and the [[Holmes criteria]] do not differentiate enough between the symptomatic criteria of depression and [[chronic fatigue syndrome]] (CFS).

==Differences between depression and ME/CFS==
Hawk, [[Leonard Jason |Jason]], and [[Susan Torres-Harding|Torres-Harding]] defined a number of key symptoms that were worse or different in ME/CFS compared to clinical depression without ME/CFS:
*Significant [[post-exertional malaise]] (PEM) was found in ME/CFS patients<ref name="Laferney, 2008" />
::PEM is now a required [[:Category:Definitions|diagnostic criteria for ME/CFS]] in most countries<ref name="CDCsymptoms" /><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref>
*[[Fatigue]] lasts for a greater the percentage of the time in ME/CFS
*[[Unrefreshing sleep]] severity is higher
*[[Confusion|Confusion–disorientation]] severity is higher
*[[Shortness of breath]] severity is higher
*ME/CFS patients have less self-reproach (as scored on the [[Beck Depression Inventory]])<ref name="Hawk, 2006" />
Using the symptoms list above, Hawk, Jason, and Torres-Harding were able to report 100% correct classification between patients with major depressive disorder versus ME/CFS.<ref name="Hawk, 2006" />

LaFerney, a psychiatric clinical nurse specialist, adds:
*'''Reason for depression''': Individuals with major depressive disorder often cannot provide a reason or identify a loss to explain their depressed mood. ME/CFS patients are more likely to report feeling discouraged and depressed because of the inability to perform tasks, be employed, or engage in social functions due to ME/CFS symptoms.<ref name="Laferney, 2008" />
*'''No lack of interest in activities''': Depressed patients typically report a lack of interest in activities they previously enjoyed. ME/CFS patients say they would engage in favorite activities more if their illness would allow it.<ref name="Laferney, 2008" />
*'''[[Post-exertional malaise]]''': Although both depressed and ME/CFS patients report fatigue, only [[ME/CFS]] report post-exertional malaise: with physical symptoms typically worsening 12 to 48 hours after an activity and lasting for days to weeks.<ref name="Laferney, 2008" />
*'''[[Antidepressant]]s don't help in ME/CFS''': In depressed patients, the [[Cognitive dysfunction|diminished ability to think or concentrate]] should improve with [[antidepressant]] drugs or therapies. In patients with ME/CFS, antidepressants often do not improve concentration or memory.<ref name="Laferney, 2008">{{Citation | last1 = Laferney | first1 = Michael C. | author-link1 = | title = Depression or chronic fatigue syndrome?| journal = Current Psychiatry | volume = 7 | issue = 1 | page = 91-94 | date = 2008| url = https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/0701CP_Pearls1.pdf}}</ref>
Dr. [[Sarah Myhill]] adds an additional difference between depression and [[Chronic fatigue syndrome|CFS]]:
*'''Response to [[exercise]]''': Exercise makes CFS patients much worse, but can be positively therapeutic in pure depression<ref>{{Cite web | url = http://drmyhill.co.uk/wiki/CFS_or_depression_-_what_are_the_differences| title = CFS or Depression: What are the differences? | last = Myhill | first =Sarah | authorlink = Sarah Myhill |website =Dr Myhill|access-date=2021-03-24}}</ref><ref name="OxfordBrookesSurvey">{{Cite web | url = https://www.meassociation.org.uk/wp-content/uploads/NICE-Patient-Survey-Outcomes-CBT-and-GET-Final-Consolidated-Report-03.04.19.pdf | title =Evaluation of a survey exploring the experiences of adults and children with ME/CFS who have participated in CBT and GET interventional programmes. FINAL REPORT | last = Oxford Clinical Allied Technology and Trials Services Unit (OxCATTS)|location=Oxford Brookes University | date = Feb 27, 2019}}</ref><ref name="ng206">{{Cite web | url = https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last = NICE Guideline Development Group|first = | authorlink = | publisher = [[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref><ref name="CDCsymptoms">{{Cite web | url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref>
Clinical trials and patient evidence have both shown that:
*[[Cognitive behavioral therapy]] aimed at ME/CFS symptoms is ineffective and often harmful, and can harm mental health,<ref name="OxfordBrookesSurvey" /><ref name=Smith2016>{{cite journal| vauthors = Smith ME, Nelson HD, Haney E, Pappas M, Daeges M, Wasson N, McDonagh M | title = Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome No. 219| journal = Evidence Report/Technology Assessment | pages = 1–433 | date = Dec 2014 |pmid =30313001 | doi = 10.23970/AHRQEPCERTA219 |url = https://www.ncbi.nlm.nih.gov/books/NBK379582/ | publisher = Agency for Healthcare Research and Quality (US) | doi-access = free }}</ref> but is an effective evidence-based treatment for depression
*'''Most ME/CFS patients do not have depression''', although in common with other chronic illness a significant number of patients develop [[depression#reactive_depression|reactive or secondary depression]]<ref name="ICC2011primer"/>
* There are many [[abnormal findings in ME/CFS|physically abnormal findings]] that are not present in depression, but many of these findings are not from the standard diagnostic tests and no single finding can yet act as a [[diagnostic biomarker]] for ME/CFS. Physical abnormalities in ME/CFS indicate immune, neurological, energy transportation, and other findings that cannot be explained by depression, [[medically unexplained physical symptoms|somatization]], [[deconditioning]], [[health anxiety]], or other psychological or behavioral factors<ref name="ICC2011primer"/>

===If I was cured tomorrow...===
{{Cquote|text=One question that can differentiate the two groups is to ask the patient, "If you were cured tomorrow, what would you do?" Depressed patients typically can not answer the question without forethought. ME/CFS patients typically can list an abundance of activities without prompt. | author = Michael LaFerney}}

The [[Forgotten Plague]] Facebook page had a "If I was cured tomorrow..." campaign encouraging ME/CFS patients to upload their dreams to highlight this difference from depression.<ref>http://www.forgottenplague.com/upload-your-dream/</ref>

===Fukuda criteria ===
In 2006, Hawk, [[Leonard Jason |Jason]], and [[Susan Torres-Harding|Torres-Harding]] found that the [[CDC]]'s [[Fukuda criteria|Fukuda ME/CFS criteria]], which is now retired from use, only correctly classified 84.4% of patients when comparing patients with major depressive disorder and to patients with ME/CFS.<ref name="Hawk, 2006">{{Citation | last = Hawk | first1 = C | author-link1 = | last2 = Jason | first2 = L | authorlink2 = Leonard Jason | last3 = Torres-Harding | first3 = S | authorlink3 = Susan Torres-Harding| title = Differential diagnosis of chronic fatigue syndrome and major depressive disorder | journal = International Journal of Behavioral Medicine | volume = 13 | issue = 3 | page = 244-51 | date = 2006 | pmid = 17078775 | doi = 10.1207/s15327558ijbm1303_8 | url = http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf}}</ref>

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 65-90% for depression in ME/CFS patients.<ref>{{citation | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 |isbn= 978-0897931915}}</ref>

==Symptom recognition==
*In the 1988 [[Holmes criteria]], depression is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria - Neuropsychologic Complaints''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref> It is not a diagnosable symptom in the current [[Systemic Exertion Intolerance Disease|CDC criteria]], the [[Fukuda criteria]], the [[Canadian Consensus Criteria]] or the [[International Consensus Criteria]] although secondary depression is recognized as a possible symptom and comorbidity of ME/CFS in the International Consensus Criteria.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last = Carruthers | first1 = Bruce M. | author-link1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 =Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | author-link5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | author-link6 = Martin Lerner | last7 = Bested | first7 = Alison C. | author-link8 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | author-link8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | author-link9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | author-link10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | author-link11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | author-link12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref>

Depression is also a potential symptom of [[Long COVID]] in the [[World Health Organization Long COVID diagnostic criteria|World Health Organization]]'s definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | authorlink4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Notable studies==
*2006, Differential diagnosis of chronic fatigue syndrome and major depressive disorder<ref name="Hawk, 2006" /> [http://www.healthrising.org/wp-content/uploads/2014/04/Hawk.-Jason.-Differential-Diagnosis-of-Chronic-Fatigue-Syndrome-and-Major-Depressive-Disorder.pdf (Full Text)]
*2008, A Systematic Review of Chronic Fatigue Syndrome: Don't Assume It's Depression<ref name="Griffith, 2008">{{Citation | last1 = Griffith | first1 = J.P. | author-link1 = | last2 = Zarrouf | first2 = F.A. | authorlink2 = | title = A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression| url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/| pmc =2292451| journal = Primary Care Companion to The Journal of Clinical Psychiatry | volume = 10 | issue = 2 | page = 120–128| date = 2008 | pmid = 18458765 | doi = 10.4088/pcc.v10n0206 }}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ (Full Text)]

==Possible causes==
Depression in ME/CFS patients may be caused by:
* The impact of living with a poorly understood chronic illness, known as '''reactive depression''' or '''secondary depression'''<ref name="ICC2011primer" />
* Someone with ME/CFS may have depression unrelated to their ME/CFS symptoms, known as '''primary depression'''<ref name="ICC2011primer" />
* People with ME/CFS typicallly lose the natural benefit of [[exercise]], which means a person who previously used exercise to improve their mood is no longer able to do this<ref name="ICC2011primer" />
* Depression is a potential side effect of some drugs, particularly a class of drugs known as mood stabilizers, which are used for bipolar depression (manic depression) but cause depression or worsen depression in people without bipolar disorder.

==Potential treatments==
* [[Antidepressant]]s
* Cognitive behavioral therapy for depression (CBT)
* [[Mindfulness and meditation|Mindfulness and Meditation]]

==See also==
*[[Mood swings]]
*[[St. John’s Wort]]
*[[Anxiety]]
*[[Fibromyalgia#depression|Depression in fibromyalgia]]

==Learn more==
* 2008, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292451/ A Systematic Review of Chronic Fatigue Syndrome: Don’t Assume It’s Depression]
* 2008, [http://www.mdedge.com/currentpsychiatry/article/62979/depression-or-chronic-fatigue-syndrome Depression or chronic fatigue syndrome? by Michael C. Laferney]
* 2014, [http://www.healthrising.org/blog/2014/04/26/prove-doctor-youve-got-chronic-fatigue-syndrome-mecfs-just-depressed/ How to Prove to Your Doctor You’ve Got Chronic Fatigue Syndrome (ME/CFS) And Are Not Just Depressed] by [[Cort Johnson]]

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Multilingual pages]]

Svenska:Stress

2026-09-28T19:29:26Z

WikiVisor:Removes Display title

{{stub}}

'''Stress''' kan vara antingen fysisk eller psykisk, eller både och.<ref name="physiologicalstress" /> Stress defineras som antingen ett tillstånd av emotionell eller [[mental health|psykologisk påfrestning]] eller spänning orsakad av en situation eller händelse, ''eller'' den fysiska stress(tryck eller spänning) som utövas på ett fysiskt objekt, såsom en kroppsdel, t.ex. ett '''stresstest''' är ett medicinskt test som övervakar det [[cardiovascular system|kardiovaskulära systemet]] under ansträngande [[exercise|träning]].<ref name="oxdict">{{Cite book | title=New Oxford American Dictionary | date = 2015 | publisher =Oxford University Press | editor-first = Angus | editor-last = Stevenson|editor-first2 = Christine A.|editor-last2=Lindberg}}</ref><ref name="stresstest">{{Cite web|url=https://www.webmd.com/heart-disease/guide/stress-test | title = Heart Disease and Stress Tests|website=WebMD|language=en|access-date=2021-03-11}}</ref>

==Bra stress ==
"Bra" stress syftar på upplevelser som är fysiskt eller emotionellt utmanande, men som inte varar och som är inom personens förmåga att bemästra, vilket resulterar i känslan av upprymdhet och prestation.<ref name="goodstress">{{Cite journal | last = McEwen | first = Bruce S. | date = 2007-07-01 | title = Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain|url=https://journals.physiology.org/doi/full/10.1152/physrev.00041.2006|journal=Physiological Reviews|volume=87|issue=3 | pages = 873–904|doi=10.1152/physrev.00041.2006|issn=0031-9333}}</ref> T.ex. att springa längre än normalt för att bli bättre tränad utan att bli sjuk eller utmattad, eller att framgångsrikt hantera en hektisk dag på jobbet.

==Fysiologisk stress ==
Fysiologisk stress är stress utövad på levande organismer, som celler eller personer.<ref name="physiologicalstress">{{Cite book | url =https://openstax.org/books/anatomy-and-physiology/pages/17-6-the-adrenal-glands | first=J. Gordon | last = Betts | first2 = Kelly A. | last2 =Young | first3 = James A. | last3 = Wise | first4 = Eddie | last4 = Johnson | first5 = Brandon | last5 = Poe | first6 = Dean H. | last6 = Kruse | first7 = Oksana | last7 = Korol | first8 = Jody E. | last8 = Johnson | first9 = Mark | last9 = Womble | first10 = Peter | last10 = DeSaix | website = OpenStax | title = Anatomy and Physiology|chapter=17.6 The Adrenal Glands | date = Apr 25, 2013|location= Houston, Texas}}</ref> Fysiologisk stress inkluderar fysisk skada på kroppen, kirurgi, att gå utomhus i kalla och våta förhållanden utan jacka, och undernäring.<ref name="physiologicalstress" />

==ME/CFS==
Emotionell eller psykologisk stress, i synnerhet kronisk, anses vara en potentiell utlösare av [[ME/CFS]]. Det är även känt att emotionell stress förvärrar symptomen av ME/CFS. ME-patienter rådges vanligtvis att undvika stress närhelst möjligt.

==Autonoma nervsystemet ==
Stress orsakar kroppsliga förändringar via det [[autonomic nervous system|autonoma nervsystemet]].

==Nämnvärda studier==
Flera studier har funnit att det inte är ovanligt att uppleva stor psykologisk kronisk stress(från händelser som skillsmässa, sorg eller betydande ekonomiska problem) under året innan man utvecklar ME/CFS.<ref>{{Cite journal | last = Hatcher | first = Simon | last2 = House | first2 = Allan | date = Oct 2003 | title = Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study|url=https://www.ncbi.nlm.nih.gov/pubmed/14580073|journal=Psychological Medicine|volume=33|issue=7|pages=1185–1192|doi=10.1017/s0033291703008274|issn=0033-2917|pmid=14580073|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Theorell | first = T. | last2 = Blomkvist | first2 = V. | last3 = Lindh | first3 = G. | last4 = Evengård | first4 = B. | date = May 1999 | title = Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis|url=https://www.ncbi.nlm.nih.gov/pubmed/10367610|journal=Psychosomatic Medicine|volume=61|issue=3|pages=304–310|issn=0033-3174|pmid=10367610|doi=|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Salit | first=Irving E. | date = 1997-01-01 | title = Precipitating factors for the chronic fatigue syndrome|url=http://www.sciencedirect.com/science/article/pii/S0022395696000507|journal=Journal of Psychiatric Research|volume=31|issue=1|pages=59–65|doi=10.1016/S0022-3956(96)00050-7|issn=0022-3956}}</ref>

Kronisk psykologisk stress ökar kortisolet, vilket hämmar den antivirala/intracellulära immunresponsen från Th1 och T-cell responsen.<ref>{{Cite journal | last = Dhabhar | first=Firdaus S | date = 2008-03-15 | title = Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection versus Immunopathology|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869337/|journal=Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology|volume=4|issue=1|pages=2–11|doi=10.1186/1710-1492-4-1-2|issn=1710-1484|pmc=2869337|pmid=20525121}}</ref> Det har också visats att kronisk stress ökar risken för virusinfektion betydligt.<ref>{{Cite journal | last = Murphy | first = Michael L. M. | last2 = Cohen | first2 = Sheldon | last3 = Janicki-Deverts | first3=Denise | last4 = Doyle | first4 = William J. | date = 2017-06-20 | title = Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults|url=https://www.ncbi.nlm.nih.gov/pubmed/28584098|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=114|issue=25 | pages = 6515–6520|doi=10.1073/pnas.1700610114|issn=1091-6490|pmc=5488935|pmid=28584098|quote=|access-date=|via=}}</ref>

Denna ökade mottaglighet observeras inte efter kortsiktig intensiv stress(stressperioder som varar mindre än 1 månad).<ref>{{Cite journal | last = Cohen | first = S. | last2 = Frank | first2 = E. | last3 = Doyle | first3 = W.J. | last4 = Skoner | first4 = D.P. | last5 = Rabin | first5 = B.S. | last6 = Gwaltney | first6 = J.M. | date=May 1998 | title = Types of stressors that increase susceptibility to the common cold in healthy adults|url=https://www.ncbi.nlm.nih.gov/pubmed/9619470|journal=Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association|volume=17|issue=3|pages=214–223|doi=10.1037//0278-6133.17.3.214|issn=0278-6133|pmid=9619470|pmc=|quote=|access-date=|via=}}</ref>

Eftersom ME/CFS vanligtvis framkommer efter intensiv virusinfektion, kanske förekomsten av kronisk stress försvagar immunsystemet och tillåter att ett normalt milt virus triggar den allvarliga sjukdomen ME/CFS.

==Se även ==
*[[Oxidative stress|Oxidativ stress]]
*[[Sv:Ångest|Ångest]]
*[[Trauma]]
*[[Exercise|Träning]]
*[[Cardiopulmonary exercise test|Kardiopulmonärt arbetsprov]] (CPET)
*[[Corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis|Kartikosteroider givna under allvarlig virusinfektion kanske kan trigga myalgisk encefalomyelit]]

==Vidare Läsning==
*[https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response Understanding the stress response] - Harvard Health
*[https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23112806/ Neuronal Responses to Physiological Stress]

==Referenser==
{{Reflist}}

[[Category:Triggers and risk factors]]
[[Category:Psychological signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Kräkning

2026-09-28T19:29:08Z

WikiVisor:Removes Display title

==Presentation==

==Förekomst==

*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av 20% för kräkningar i [[Chronic Fatigue Syndrome|Kroniskt trötthetssyndrom]].<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne/sv | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ |publisher= Hunter House | page = 59 |isbn= 978-0897931915}}</ref>

==Symptomigenkänning==

==Nämnvärda studier==

==Möjliga orsaker==
*Kräkning orsakas möjligen av en [[Comorbidities of Myalgic Encephalomyelitis|komorbitet]] som [[celiac disease|celiaki]] eller [[non-celiac gluten sensitivity|glutenkänslighet utan celiaki]].

==Möjliga behandlingar==
*Undvika [[Gluten]]
*[[Metoclopramide|Metoklopramid]]
*[[Mirtazapine|Mirtazapin]]

== Se även ==

== Vidare läsning ==

== Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Digestive signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Hypersomni

2026-09-28T19:28:43Z

WikiVisor:Removes Display title

{{stub}}
==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmes Kriteria]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==

==Möjliga Orsaker==

==Möjliga Behandlingar==

==Se Även==
* [[Sleep dysfunction|Sömnstörning]]
* [[Sv:Insomni|Insomni]]
==Vidare läsning==
==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Svenska:Insomni

2026-09-28T19:27:09Z

WikiVisor:Removes Display title

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[Depression/sv|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[Sv:Stress|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Sv:Hypersomni|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Hypersomnia

2026-09-28T19:13:42Z

WikiVisor:

{{Language links
|page_sv=Hypersomni
}}
{{stub}}
==Prevalence==

==Symptom recognition==
*In the [[Holmes criteria]], [[sleep disturbance]] ('''hypersomnia''' or [[insomnia]]) is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Notable studies==

==Possible causes==

==Potential treatments==

==See also==
* [[Sleep dysfunction]]
* [[Insomnia]]
==Learn more==

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Multilingual pages]]

Hypersomnia

2026-09-28T19:13:27Z

WikiVisor:Categorize as multiligual

{{stub}}
==Prevalence==

==Symptom recognition==
*In the [[Holmes criteria]], [[sleep disturbance]] ('''hypersomnia''' or [[insomnia]]) is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Notable studies==

==Possible causes==

==Potential treatments==

==See also==
* [[Sleep dysfunction]]
* [[Insomnia]]
==Learn more==

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Multilingual pages]]

Svenska:Hypersomni

2026-09-28T19:12:48Z

WikiVisor:WikiVisor moved page Hypersomnia/sv to Svenska:Hypersomni without leaving a redirect

{{DISPLAYTITLE:Hypersomni}}
{{stub}}
==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmes Kriteria]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==

==Möjliga Orsaker==

==Möjliga Behandlingar==

==Se Även==
* [[Sleep dysfunction|Sömnstörning]]
* [[Sv:Insomni|Insomni]]
==Vidare läsning==
==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Svenska:Insomni

2026-09-28T19:12:04Z

WikiVisor:Relocate lang link

{{DISPLAYTITLE:Insomni}}

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[Depression/sv|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[Sv:Stress|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Sv:Hypersomni|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Svenska:Insomni

2026-09-28T19:10:15Z

WikiVisor:WikiVisor moved page Insomnia/sv to Svenska:Insomni without leaving a redirect:MEpedia localization approach

{{DISPLAYTITLE:Insomni}}

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[Depression/sv|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[Sv:Stress|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Hypersomnia/sv|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Svenska:Hypersomni

2026-09-28T19:09:54Z

WikiVisor:Relocate lang link

Insomnia

2026-09-28T19:09:12Z

WikiVisor:

{{Language links
|page_sv=Insomni
}}
'''Insomnia''', also known as '''sleeplessness''', is a sleep disorder where people have trouble falling asleep or staying asleep as long as desired. It can occur independently or as a result of another problem. It is a common symptom of [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomnia is present when a patient finds it unusually difficult to fall asleep, maintain sleep, or wakes up early in the morning with an inability to return to sleep.

Insomnia can cause many secondary symptoms and problems, including [[fatigue]], daytime sleepiness, feeling unrefreshed after sleep, irritability, [[anxiety]], low energy, and [[Depression|depressed mood]]. Long-term insomnia can result in muscle weariness, hallucinations, [[brain fog|mental fatigue]] and [[double vision]].

==Prevalence==

==Symptom recognition==
*In the [[Holmes criteria]], [[sleep disturbance]] ([[hypersomnia]] or '''insomnia''') is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Notable studies==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Possible causes==
*High levels of [[stress]]
*Changes in levels of [[cytokines]]
*As a [[sleep dysfunction]] symptom of [[ME/CFS]] or another illness

==Potential treatments==
Behavioral changes, including:
*[[Sleep hygiene]] advice
*[[Cognitive behavioral therapy for insomnia]]
Supplements and natural remedies, including:
<DynamicPageList>
category = Hypnotics
category = Supplements
ordermethod=sortkey
order=ascending
mode=inline-list
</DynamicPageList>
Medications, including:
*[[:Category:Benzodiazepines|Benzodiazepines]], e.g. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic]]s, commonly known as z-drugs, e.g. [[zopiclone]]
*Sedating [[antidepressant]]s, particularly [[amitriptyline]]
*Sedating [[:Category:Antihistamines|anti-histamines]] including [[diphenhydramine]]
*[[Melatonin]], either on prescription or as a supplement<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label drugs, e.g.:
* Low dose [[quetiapine]], but this should not be used in overweight people with CFS

==See also==
* [[Hypersomnia]]
* [[Sleep dysfunction]]
* [[Unrefreshing sleep]]

==Learn more==
*[https://www.drugs.com/condition/insomnia.html Medications for insomnia] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Multilingual pages]]

Insomnia

2026-09-28T19:09:04Z

WikiVisor:Categorize as multiligual

'''Insomnia''', also known as '''sleeplessness''', is a sleep disorder where people have trouble falling asleep or staying asleep as long as desired. It can occur independently or as a result of another problem. It is a common symptom of [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomnia is present when a patient finds it unusually difficult to fall asleep, maintain sleep, or wakes up early in the morning with an inability to return to sleep.

Insomnia can cause many secondary symptoms and problems, including [[fatigue]], daytime sleepiness, feeling unrefreshed after sleep, irritability, [[anxiety]], low energy, and [[Depression|depressed mood]]. Long-term insomnia can result in muscle weariness, hallucinations, [[brain fog|mental fatigue]] and [[double vision]].

==Prevalence==

==Symptom recognition==
*In the [[Holmes criteria]], [[sleep disturbance]] ([[hypersomnia]] or '''insomnia''') is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Notable studies==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Possible causes==
*High levels of [[stress]]
*Changes in levels of [[cytokines]]
*As a [[sleep dysfunction]] symptom of [[ME/CFS]] or another illness

==Potential treatments==
Behavioral changes, including:
*[[Sleep hygiene]] advice
*[[Cognitive behavioral therapy for insomnia]]
Supplements and natural remedies, including:
<DynamicPageList>
category = Hypnotics
category = Supplements
ordermethod=sortkey
order=ascending
mode=inline-list
</DynamicPageList>
Medications, including:
*[[:Category:Benzodiazepines|Benzodiazepines]], e.g. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic]]s, commonly known as z-drugs, e.g. [[zopiclone]]
*Sedating [[antidepressant]]s, particularly [[amitriptyline]]
*Sedating [[:Category:Antihistamines|anti-histamines]] including [[diphenhydramine]]
*[[Melatonin]], either on prescription or as a supplement<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label drugs, e.g.:
* Low dose [[quetiapine]], but this should not be used in overweight people with CFS

==See also==
* [[Hypersomnia]]
* [[Sleep dysfunction]]
* [[Unrefreshing sleep]]

==Learn more==
*[https://www.drugs.com/condition/insomnia.html Medications for insomnia] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==References==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Multilingual pages]]

Svenska:Stress

2026-09-28T19:06:46Z

WikiVisor:WikiVisor moved page Stress/sv to Svenska:Stress without leaving a redirect:MEpedia localization approach

{{DISPLAYTITLE:Stress}}
{{stub}}

'''Stress''' kan vara antingen fysisk eller psykisk, eller både och.<ref name="physiologicalstress" /> Stress defineras som antingen ett tillstånd av emotionell eller [[mental health|psykologisk påfrestning]] eller spänning orsakad av en situation eller händelse, ''eller'' den fysiska stress(tryck eller spänning) som utövas på ett fysiskt objekt, såsom en kroppsdel, t.ex. ett '''stresstest''' är ett medicinskt test som övervakar det [[cardiovascular system|kardiovaskulära systemet]] under ansträngande [[exercise|träning]].<ref name="oxdict">{{Cite book | title=New Oxford American Dictionary | date = 2015 | publisher =Oxford University Press | editor-first = Angus | editor-last = Stevenson|editor-first2 = Christine A.|editor-last2=Lindberg}}</ref><ref name="stresstest">{{Cite web|url=https://www.webmd.com/heart-disease/guide/stress-test | title = Heart Disease and Stress Tests|website=WebMD|language=en|access-date=2021-03-11}}</ref>

==Bra stress ==
"Bra" stress syftar på upplevelser som är fysiskt eller emotionellt utmanande, men som inte varar och som är inom personens förmåga att bemästra, vilket resulterar i känslan av upprymdhet och prestation.<ref name="goodstress">{{Cite journal | last = McEwen | first = Bruce S. | date = 2007-07-01 | title = Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain|url=https://journals.physiology.org/doi/full/10.1152/physrev.00041.2006|journal=Physiological Reviews|volume=87|issue=3 | pages = 873–904|doi=10.1152/physrev.00041.2006|issn=0031-9333}}</ref> T.ex. att springa längre än normalt för att bli bättre tränad utan att bli sjuk eller utmattad, eller att framgångsrikt hantera en hektisk dag på jobbet.

==Fysiologisk stress ==
Fysiologisk stress är stress utövad på levande organismer, som celler eller personer.<ref name="physiologicalstress">{{Cite book | url =https://openstax.org/books/anatomy-and-physiology/pages/17-6-the-adrenal-glands | first=J. Gordon | last = Betts | first2 = Kelly A. | last2 =Young | first3 = James A. | last3 = Wise | first4 = Eddie | last4 = Johnson | first5 = Brandon | last5 = Poe | first6 = Dean H. | last6 = Kruse | first7 = Oksana | last7 = Korol | first8 = Jody E. | last8 = Johnson | first9 = Mark | last9 = Womble | first10 = Peter | last10 = DeSaix | website = OpenStax | title = Anatomy and Physiology|chapter=17.6 The Adrenal Glands | date = Apr 25, 2013|location= Houston, Texas}}</ref> Fysiologisk stress inkluderar fysisk skada på kroppen, kirurgi, att gå utomhus i kalla och våta förhållanden utan jacka, och undernäring.<ref name="physiologicalstress" />

==ME/CFS==
Emotionell eller psykologisk stress, i synnerhet kronisk, anses vara en potentiell utlösare av [[ME/CFS]]. Det är även känt att emotionell stress förvärrar symptomen av ME/CFS. ME-patienter rådges vanligtvis att undvika stress närhelst möjligt.

==Autonoma nervsystemet ==
Stress orsakar kroppsliga förändringar via det [[autonomic nervous system|autonoma nervsystemet]].

==Nämnvärda studier==
Flera studier har funnit att det inte är ovanligt att uppleva stor psykologisk kronisk stress(från händelser som skillsmässa, sorg eller betydande ekonomiska problem) under året innan man utvecklar ME/CFS.<ref>{{Cite journal | last = Hatcher | first = Simon | last2 = House | first2 = Allan | date = Oct 2003 | title = Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study|url=https://www.ncbi.nlm.nih.gov/pubmed/14580073|journal=Psychological Medicine|volume=33|issue=7|pages=1185–1192|doi=10.1017/s0033291703008274|issn=0033-2917|pmid=14580073|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Theorell | first = T. | last2 = Blomkvist | first2 = V. | last3 = Lindh | first3 = G. | last4 = Evengård | first4 = B. | date = May 1999 | title = Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis|url=https://www.ncbi.nlm.nih.gov/pubmed/10367610|journal=Psychosomatic Medicine|volume=61|issue=3|pages=304–310|issn=0033-3174|pmid=10367610|doi=|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Salit | first=Irving E. | date = 1997-01-01 | title = Precipitating factors for the chronic fatigue syndrome|url=http://www.sciencedirect.com/science/article/pii/S0022395696000507|journal=Journal of Psychiatric Research|volume=31|issue=1|pages=59–65|doi=10.1016/S0022-3956(96)00050-7|issn=0022-3956}}</ref>

Kronisk psykologisk stress ökar kortisolet, vilket hämmar den antivirala/intracellulära immunresponsen från Th1 och T-cell responsen.<ref>{{Cite journal | last = Dhabhar | first=Firdaus S | date = 2008-03-15 | title = Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection versus Immunopathology|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869337/|journal=Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology|volume=4|issue=1|pages=2–11|doi=10.1186/1710-1492-4-1-2|issn=1710-1484|pmc=2869337|pmid=20525121}}</ref> Det har också visats att kronisk stress ökar risken för virusinfektion betydligt.<ref>{{Cite journal | last = Murphy | first = Michael L. M. | last2 = Cohen | first2 = Sheldon | last3 = Janicki-Deverts | first3=Denise | last4 = Doyle | first4 = William J. | date = 2017-06-20 | title = Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults|url=https://www.ncbi.nlm.nih.gov/pubmed/28584098|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=114|issue=25 | pages = 6515–6520|doi=10.1073/pnas.1700610114|issn=1091-6490|pmc=5488935|pmid=28584098|quote=|access-date=|via=}}</ref>

Denna ökade mottaglighet observeras inte efter kortsiktig intensiv stress(stressperioder som varar mindre än 1 månad).<ref>{{Cite journal | last = Cohen | first = S. | last2 = Frank | first2 = E. | last3 = Doyle | first3 = W.J. | last4 = Skoner | first4 = D.P. | last5 = Rabin | first5 = B.S. | last6 = Gwaltney | first6 = J.M. | date=May 1998 | title = Types of stressors that increase susceptibility to the common cold in healthy adults|url=https://www.ncbi.nlm.nih.gov/pubmed/9619470|journal=Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association|volume=17|issue=3|pages=214–223|doi=10.1037//0278-6133.17.3.214|issn=0278-6133|pmid=9619470|pmc=|quote=|access-date=|via=}}</ref>

Eftersom ME/CFS vanligtvis framkommer efter intensiv virusinfektion, kanske förekomsten av kronisk stress försvagar immunsystemet och tillåter att ett normalt milt virus triggar den allvarliga sjukdomen ME/CFS.

==Se även ==
*[[Oxidative stress|Oxidativ stress]]
*[[Sv:Ångest|Ångest]]
*[[Trauma]]
*[[Exercise|Träning]]
*[[Cardiopulmonary exercise test|Kardiopulmonärt arbetsprov]] (CPET)
*[[Corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis|Kartikosteroider givna under allvarlig virusinfektion kanske kan trigga myalgisk encefalomyelit]]

==Vidare Läsning==
*[https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response Understanding the stress response] - Harvard Health
*[https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23112806/ Neuronal Responses to Physiological Stress]

==Referenser==
{{Reflist}}

[[Category:Triggers and risk factors]]
[[Category:Psychological signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Insomni

2026-09-28T19:06:09Z

WikiVisor:Relocate lang link

{{DISPLAYTITLE:Insomni}}

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[Depression/sv|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[Sv:Stress|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Hypersomnia/sv|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Stress

2026-09-28T19:05:25Z

WikiVisor:

{{Language links
|page_sv=Stress
}}
{{stub}}
'''Stress''' can be either physical or psychological, or both.<ref name="physiologicalstress" /> Stress is defined as either a state of emotional or [[mental health|psychological strain]] or tension resulting from a situation or event, ''or'' the physical stress (pressure or tension) exerted on a physical object such as a part of the body, e.g., a '''stress test''' is a medical test that monitors the [[cardiovascular system]] during strenuous [[exercise]].<ref name="oxdict">{{Cite book | title=New Oxford American Dictionary | date = 2015 | publisher =Oxford University Press | editor-first = Angus | editor-last = Stevenson|editor-first2 = Christine A.|editor-last2=Lindberg}}</ref><ref name="stresstest">{{Cite web|url=https://www.webmd.com/heart-disease/guide/stress-test | title = Heart Disease and Stress Tests|website=WebMD|language=en|access-date=2021-03-11}}</ref>

==Good stress ==
"Good" stress refers to experiences that are physically or emotionally challenging but don't last, and are within the person's ability to master, resulting in feelings of exhilaration and accomplishment.<ref name="goodstress">{{Cite journal | last = McEwen | first = Bruce S. | date = 2007-07-01 | title = Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain|url=https://journals.physiology.org/doi/full/10.1152/physrev.00041.2006|journal=Physiological Reviews|volume=87|issue=3 | pages = 873–904|doi=10.1152/physrev.00041.2006|issn=0031-9333}}</ref> For example, running for longer than normal in order to get fitter without becoming ill or exhausted, or handling a very busy day at work successfully.

==Physiological stress ==
Physiological stress is stress placed on living organisms, such as cells or people.<ref name="physiologicalstress">{{Cite book | url =https://openstax.org/books/anatomy-and-physiology/pages/17-6-the-adrenal-glands | first=J. Gordon | last = Betts | first2 = Kelly A. | last2 =Young | first3 = James A. | last3 = Wise | first4 = Eddie | last4 = Johnson | first5 = Brandon | last5 = Poe | first6 = Dean H. | last6 = Kruse | first7 = Oksana | last7 = Korol | first8 = Jody E. | last8 = Johnson | first9 = Mark | last9 = Womble | first10 = Peter | last10 = DeSaix | website = OpenStax | title = Anatomy and Physiology|chapter=17.6 The Adrenal Glands | date = Apr 25, 2013|location= Houston, Texas}}</ref> Physiological stresses include physical injury to the body, surgery, walking outside in cold and wet conditions without a coat on, and malnutrition.<ref name="physiologicalstress" />

==ME/CFS==
Emotional or psychological stress, particularly when chronic, is considered a potential trigger for [[ME/CFS]]. Emotional stress is also known to worsen ME/CFS symptoms. ME patients are usually advised to avoid stress wherever possible.

==Autonomic nervous system ==
Stress causes bodily changes via the [[autonomic nervous system]].

==Notable studies==
Several studies found it is not uncommon to experience major psychological chronic stress (from events such as divorce, bereavement or serious financial worries) in the year prior to developing ME/CFS.<ref>{{Cite journal | last = Hatcher | first = Simon | last2 = House | first2 = Allan | date = Oct 2003 | title = Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study|url=https://www.ncbi.nlm.nih.gov/pubmed/14580073|journal=Psychological Medicine|volume=33|issue=7|pages=1185–1192|doi=10.1017/s0033291703008274|issn=0033-2917|pmid=14580073|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Theorell | first = T. | last2 = Blomkvist | first2 = V. | last3 = Lindh | first3 = G. | last4 = Evengård | first4 = B. | date = May 1999 | title = Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis|url=https://www.ncbi.nlm.nih.gov/pubmed/10367610|journal=Psychosomatic Medicine|volume=61|issue=3|pages=304–310|issn=0033-3174|pmid=10367610|doi=|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Salit | first=Irving E. | date = 1997-01-01 | title = Precipitating factors for the chronic fatigue syndrome|url=http://www.sciencedirect.com/science/article/pii/S0022395696000507|journal=Journal of Psychiatric Research|volume=31|issue=1|pages=59–65|doi=10.1016/S0022-3956(96)00050-7|issn=0022-3956}}</ref>

Chronic psychological stress elevates cortisol which suppresses the Th1 antiviral/intracellular immune response and the T-cell response.<ref>{{Cite journal | last = Dhabhar | first=Firdaus S | date = 2008-03-15 | title = Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection versus Immunopathology|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869337/|journal=Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology|volume=4|issue=1|pages=2–11|doi=10.1186/1710-1492-4-1-2|issn=1710-1484|pmc=2869337|pmid=20525121}}</ref> Chronic stress has also been shown to greatly increase susceptibility to viral infection.<ref>{{Cite journal | last = Murphy | first = Michael L. M. | last2 = Cohen | first2 = Sheldon | last3 = Janicki-Deverts | first3=Denise | last4 = Doyle | first4 = William J. | date = 2017-06-20 | title = Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults|url=https://www.ncbi.nlm.nih.gov/pubmed/28584098|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=114|issue=25 | pages = 6515–6520|doi=10.1073/pnas.1700610114|issn=1091-6490|pmc=5488935|pmid=28584098|quote=|access-date=|via=}}</ref> This increased susceptibility is not observed after short-term acute stress (periods of stress of less than 1 month duration).<ref>{{Cite journal | last = Cohen | first = S. | last2 = Frank | first2 = E. | last3 = Doyle | first3 = W.J. | last4 = Skoner | first4 = D.P. | last5 = Rabin | first5 = B.S. | last6 = Gwaltney | first6 = J.M. | date=May 1998 | title = Types of stressors that increase susceptibility to the common cold in healthy adults|url=https://www.ncbi.nlm.nih.gov/pubmed/9619470|journal=Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association|volume=17|issue=3|pages=214–223|doi=10.1037//0278-6133.17.3.214|issn=0278-6133|pmid=9619470|pmc=|quote=|access-date=|via=}}</ref>

As ME/CFS normally appears after acute viral infection, the presence of chronic stress may weaken immunity and allow a normally mild virus to trigger the serious disease of ME/CFS.

==See also ==
*[[Oxidative stress]]
*[[Anxiety]]
*[[Trauma]]
*[[Exercise]]
*[[Cardiopulmonary exercise test]] (CPET)
*[[Corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis]]

==Learn more ==
*[https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response Understanding the stress response] - Harvard Health
*[https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23112806/ Neuronal Responses to Physiological Stress]

==References==
{{Reflist}}

[[Category:Triggers and risk factors]]
[[Category:Psychological signs and symptoms]]
[[Category:Multilingual pages]]

Stress

2026-09-28T19:05:12Z

WikiVisor:Categorize as multiligual

{{stub}}
'''Stress''' can be either physical or psychological, or both.<ref name="physiologicalstress" /> Stress is defined as either a state of emotional or [[mental health|psychological strain]] or tension resulting from a situation or event, ''or'' the physical stress (pressure or tension) exerted on a physical object such as a part of the body, e.g., a '''stress test''' is a medical test that monitors the [[cardiovascular system]] during strenuous [[exercise]].<ref name="oxdict">{{Cite book | title=New Oxford American Dictionary | date = 2015 | publisher =Oxford University Press | editor-first = Angus | editor-last = Stevenson|editor-first2 = Christine A.|editor-last2=Lindberg}}</ref><ref name="stresstest">{{Cite web|url=https://www.webmd.com/heart-disease/guide/stress-test | title = Heart Disease and Stress Tests|website=WebMD|language=en|access-date=2021-03-11}}</ref>

==Good stress ==
"Good" stress refers to experiences that are physically or emotionally challenging but don't last, and are within the person's ability to master, resulting in feelings of exhilaration and accomplishment.<ref name="goodstress">{{Cite journal | last = McEwen | first = Bruce S. | date = 2007-07-01 | title = Physiology and Neurobiology of Stress and Adaptation: Central Role of the Brain|url=https://journals.physiology.org/doi/full/10.1152/physrev.00041.2006|journal=Physiological Reviews|volume=87|issue=3 | pages = 873–904|doi=10.1152/physrev.00041.2006|issn=0031-9333}}</ref> For example, running for longer than normal in order to get fitter without becoming ill or exhausted, or handling a very busy day at work successfully.

==Physiological stress ==
Physiological stress is stress placed on living organisms, such as cells or people.<ref name="physiologicalstress">{{Cite book | url =https://openstax.org/books/anatomy-and-physiology/pages/17-6-the-adrenal-glands | first=J. Gordon | last = Betts | first2 = Kelly A. | last2 =Young | first3 = James A. | last3 = Wise | first4 = Eddie | last4 = Johnson | first5 = Brandon | last5 = Poe | first6 = Dean H. | last6 = Kruse | first7 = Oksana | last7 = Korol | first8 = Jody E. | last8 = Johnson | first9 = Mark | last9 = Womble | first10 = Peter | last10 = DeSaix | website = OpenStax | title = Anatomy and Physiology|chapter=17.6 The Adrenal Glands | date = Apr 25, 2013|location= Houston, Texas}}</ref> Physiological stresses include physical injury to the body, surgery, walking outside in cold and wet conditions without a coat on, and malnutrition.<ref name="physiologicalstress" />

==ME/CFS==
Emotional or psychological stress, particularly when chronic, is considered a potential trigger for [[ME/CFS]]. Emotional stress is also known to worsen ME/CFS symptoms. ME patients are usually advised to avoid stress wherever possible.

==Autonomic nervous system ==
Stress causes bodily changes via the [[autonomic nervous system]].

==Notable studies==
Several studies found it is not uncommon to experience major psychological chronic stress (from events such as divorce, bereavement or serious financial worries) in the year prior to developing ME/CFS.<ref>{{Cite journal | last = Hatcher | first = Simon | last2 = House | first2 = Allan | date = Oct 2003 | title = Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study|url=https://www.ncbi.nlm.nih.gov/pubmed/14580073|journal=Psychological Medicine|volume=33|issue=7|pages=1185–1192|doi=10.1017/s0033291703008274|issn=0033-2917|pmid=14580073|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Theorell | first = T. | last2 = Blomkvist | first2 = V. | last3 = Lindh | first3 = G. | last4 = Evengård | first4 = B. | date = May 1999 | title = Critical life events, infections, and symptoms during the year preceding chronic fatigue syndrome (CFS): an examination of CFS patients and subjects with a nonspecific life crisis|url=https://www.ncbi.nlm.nih.gov/pubmed/10367610|journal=Psychosomatic Medicine|volume=61|issue=3|pages=304–310|issn=0033-3174|pmid=10367610|doi=|pmc=|quote=|access-date=|via=}}</ref><ref>{{Cite journal | last = Salit | first=Irving E. | date = 1997-01-01 | title = Precipitating factors for the chronic fatigue syndrome|url=http://www.sciencedirect.com/science/article/pii/S0022395696000507|journal=Journal of Psychiatric Research|volume=31|issue=1|pages=59–65|doi=10.1016/S0022-3956(96)00050-7|issn=0022-3956}}</ref>

Chronic psychological stress elevates cortisol which suppresses the Th1 antiviral/intracellular immune response and the T-cell response.<ref>{{Cite journal | last = Dhabhar | first=Firdaus S | date = 2008-03-15 | title = Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection versus Immunopathology|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869337/|journal=Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology|volume=4|issue=1|pages=2–11|doi=10.1186/1710-1492-4-1-2|issn=1710-1484|pmc=2869337|pmid=20525121}}</ref> Chronic stress has also been shown to greatly increase susceptibility to viral infection.<ref>{{Cite journal | last = Murphy | first = Michael L. M. | last2 = Cohen | first2 = Sheldon | last3 = Janicki-Deverts | first3=Denise | last4 = Doyle | first4 = William J. | date = 2017-06-20 | title = Offspring of parents who were separated and not speaking to one another have reduced resistance to the common cold as adults|url=https://www.ncbi.nlm.nih.gov/pubmed/28584098|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=114|issue=25 | pages = 6515–6520|doi=10.1073/pnas.1700610114|issn=1091-6490|pmc=5488935|pmid=28584098|quote=|access-date=|via=}}</ref> This increased susceptibility is not observed after short-term acute stress (periods of stress of less than 1 month duration).<ref>{{Cite journal | last = Cohen | first = S. | last2 = Frank | first2 = E. | last3 = Doyle | first3 = W.J. | last4 = Skoner | first4 = D.P. | last5 = Rabin | first5 = B.S. | last6 = Gwaltney | first6 = J.M. | date=May 1998 | title = Types of stressors that increase susceptibility to the common cold in healthy adults|url=https://www.ncbi.nlm.nih.gov/pubmed/9619470|journal=Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association|volume=17|issue=3|pages=214–223|doi=10.1037//0278-6133.17.3.214|issn=0278-6133|pmid=9619470|pmc=|quote=|access-date=|via=}}</ref>

As ME/CFS normally appears after acute viral infection, the presence of chronic stress may weaken immunity and allow a normally mild virus to trigger the serious disease of ME/CFS.

==See also ==
*[[Oxidative stress]]
*[[Anxiety]]
*[[Trauma]]
*[[Exercise]]
*[[Cardiopulmonary exercise test]] (CPET)
*[[Corticosteroids given during acute viral infection may trigger myalgic encephalomyelitis]]

==Learn more ==
*[https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response Understanding the stress response] - Harvard Health
*[https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23112806/ Neuronal Responses to Physiological Stress]

==References==
{{Reflist}}

[[Category:Triggers and risk factors]]
[[Category:Psychological signs and symptoms]]
[[Category:Multilingual pages]]

Meclizine/sv

2026-09-28T18:31:41Z

WikiVisor:Relocate lang link

{{DISPLAYTITLE:Meklozin}}
{{stub}}
'''Meklozin''' är ett antihistamin som används mot [[nausea|illamående]]/[[Sv:Kräkning|kräkning]], [[vertigo|svindel]], och
åksjuka. Meklozin är en första generationens H1-blockerare, men används generellt inte som sömnmedel, och är även känd under märkesnamnen Antivert, Bonine, Dramamine, Less Drovsy, och Melicot.<ref name="Houston2021">https://www.ncbi.nlm.nih.gov/books/NBK560645/</ref><ref name="drugscom">https://www.drugs.com/ingredient/meclizine.html</ref><ref name=":7things">https://www.drugs.com/tips/meclizine-patient-tips</ref>

==Se även==
==Vidare Läsning==
*[https://www.drugs.com/ingredient/meclizine.html Meclizine] - drugs.com

==Referenser==
{{Reflist}}

[[Category:Potential treatments]]
[[Category:Antihistamines]]
[[Category:H1 antihistamines]]
[[Category:Antiemetics]]
[[Category:Swedish-language articles]]

Vomiting

2026-09-28T18:30:12Z

WikiVisor:

{{Language links
|page_sv=Kräkning
}}
==Presentation==

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 20% for vomiting in [[Chronic Fatigue Syndrome]].<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ |publisher= Hunter House | page = 59 |isbn= 978-0897931915}}</ref>

==Symptom recognition==

==Notable studies==

==Possible causes==
*Vomiting may be caused by a [[Comorbidities of Myalgic Encephalomyelitis|comorbidity]] such as [[celiac disease]] or [[non-celiac gluten sensitivity]] (gluten intolerance).

==Potential treatments==
*[[Gluten]] avoidance
*[[Metoclopramide]]
*[[Mirtazapine]]

== See also ==

== Learn more ==

== References ==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Digestive signs and symptoms]]
[[Category:Multilingual pages]]

Vomiting

2026-09-28T18:30:00Z

WikiVisor:Categorize as multiligual

==Presentation==

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 20% for vomiting in [[Chronic Fatigue Syndrome]].<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ |publisher= Hunter House | page = 59 |isbn= 978-0897931915}}</ref>

==Symptom recognition==

==Notable studies==

==Possible causes==
*Vomiting may be caused by a [[Comorbidities of Myalgic Encephalomyelitis|comorbidity]] such as [[celiac disease]] or [[non-celiac gluten sensitivity]] (gluten intolerance).

==Potential treatments==
*[[Gluten]] avoidance
*[[Metoclopramide]]
*[[Mirtazapine]]

== See also ==

== Learn more ==

== References ==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Digestive signs and symptoms]]
[[Category:Multilingual pages]]

Svenska:Kräkning

2026-09-28T18:29:25Z

WikiVisor:WikiVisor moved page Vomiting/sv to Svenska:Kräkning without leaving a redirect:MEpedia localization approach

{{DISPLAYTITLE:Kräkning}}

==Presentation==

==Förekomst==

*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av 20% för kräkningar i [[Chronic Fatigue Syndrome|Kroniskt trötthetssyndrom]].<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne/sv | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ |publisher= Hunter House | page = 59 |isbn= 978-0897931915}}</ref>

==Symptomigenkänning==

==Nämnvärda studier==

==Möjliga orsaker==
*Kräkning orsakas möjligen av en [[Comorbidities of Myalgic Encephalomyelitis|komorbitet]] som [[celiac disease|celiaki]] eller [[non-celiac gluten sensitivity|glutenkänslighet utan celiaki]].

==Möjliga behandlingar==
*Undvika [[Gluten]]
*[[Metoclopramide|Metoklopramid]]
*[[Mirtazapine|Mirtazapin]]

== Se även ==

== Vidare läsning ==

== Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Digestive signs and symptoms]]
[[Category:Swedish-language articles]]

Myalgic encephalomyelitis

2026-09-28T18:26:35Z

WikiVisor:

{{Language links
|page_de=Myalgische-Enzephalomyelitis
|page_es=Encefalomielitis miálgica
}}
'''Myalgic encephalomyelitis''' (ME) is a chronic, [[Inflammation|inflammatory]], physical and [[nervous system|neurological]] and immune-mediated disease that presents with symptoms involving multiple bodily systems. It is frequently triggered by a [[viral infection]] or a [[flu-like illness]].<ref name="ICC2011primer" /><ref name="CDC-causes" /> ME presents with symptoms in the [[central nervous system]] (CNS), [[autonomic nervous system]] (ANS), [[immune system]], [[cardiovascular system]], [[endocrine system]], [[digestive system]], and [[musculoskeletal system]].<ref name="ICC2011primer" /><ref name="CDC-symptoms" />

Myalgic encephalomyelitis was first classified as a [[nervous system|neurological]] disease by the [[World Health Organization]] (WHO) in 1969, with the publication of the [[World Health Organization#icd8|World Health Organization's ICD-8]] manual.<ref name="ICD-8">{{Cite book |url=https://apps.who.int/iris/bitstream/handle/10665/70934/ICD_10_1969_eng_v2a.pdf | title=Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death Based on the Recommendations of the Eighth Revision Conference | last = World Health Organization | first = | authorlink = World Health Organization|publisher=WHO| year = 1969|isbn=|editor-link=|edition=8th|volume=2|location=Geneva | page = 173|chapter=|quote=Encephalomyelitis (chronic),<br>(myalgic, benign) 323}}</ref>

ME has occurred in both [[Epidemic myalgic encephalomyelitis|epidemic]] and [[List of myalgic encephalomyelitis and chronic fatigue syndrome outbreaks|sporadic]] forms.

According to the [[Centers for Disease Control|CDC]] the hallmark symptom of myalglc encephalomyelitis is [[post-exertional malaise]] (PEM), which is the worsening of ME/CFS symptoms after minimal physical, mental, or emotional [[exertion|effort]].<ref name="CDC-doctors">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html | title = Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Dec 27, 2021 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2022-03-28}}</ref><ref name="Friedman2021">{{Cite journal | title = Our Evolving Understanding of ME/CFS | date = Mar 2021|url=https://www.mdpi.com/1648-9144/57/3/200/htm|journal=Medicina|volume=57|issue=3|pages=200 | last = Friedman | first = Kenneth J. | authorlink = Kenneth Friedman | last2 = Murovska | first2 = Modra | authorlink2 = Modra Murovska | last3 = Pheby | first3 = Derek F.H. | authorlink3 = Derek Pheby | last4 = Zalewski | first4 = Paweł | authorlink4 = Paweł Zalewski|language=en|doi=10.3390/medicina57030200|pmc=|pmid=33652622|access-date=|issn=1648-9144|quote=|via=}}</ref><ref name="Carruthers, 2003" /><ref name="Speight2013">{{Cite journal|url=https://www.sjmms.net/article.asp?issn=1658-631X;year=2013;volume=1;issue=1;spage=11;epage=13;aulast=Speight | title = Myalgic encephalomyelitis/chronic fatigue syndrome: Review of history, clinical features, and controversies | last = Speight | first = Nigel | authorlink=Nigel Speight | date = 2013|pages=11-13|doi=10.4103/1658-631x.112905|archive-url=|archive-date=|url-status=|access-date=|volume=1|issue=1|journal=Saudi J Med Med Sci}}</ref><ref name="CDC-symptoms" /> Other key symptoms include [[muscle weakness]] and easy [[muscle fatigability]], [[sleep dysfunction|sleep disturbance]], plus either [[orthostatic intolerance]] or [[cognitive dysfunction]]. Orthostic intolerance is [[autonomic nervous system]] dysfunction causing the worsening of symptoms when standing or sitting upright, and may include feeling [[syncope|faint]], [[dizziness]], feeling weak, [[blurred vision]], [[postural orthostatic tachycardia]] (POTS), reduced [[heart rate variability]] at night, and both [[Body temperature|cold and heat intolerance]]. Other ME/CFS common symptoms include [[myalgia|muscle pain]], [[neuralgia|nerve pain]], neck and spine stiffness, and sensory symptoms including [[sensitivity to light]], [[Hyperacusis|sound]], [[touch]], [[Paresthesia|skin tingling or numbness]] and hyperaesthesia (skin sensitivity and pain, and [[allodynia]]). There is a progressive form of ME, but it is rarer than the relapsing-remitting type.<ref name="Howes2015">{{Cite journal|url=http://www.meassociation.org.uk/wp-content/uploads/fulltext_pmr-v2-id10521.pdf | title=Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report | last = Howes | first = S | authorlink = Sandra Howes | last2 = Goudsmit | first2 = EM | authorlink2 = Ellen Goudsmit | date = Jul 7, 2015 |journal=Physical Medicine and Rehabilitation - International|volume=2|issue=6|pages=1052|doi=}}</ref>

Among adults, ME is [[Female predominant diseases|more common in women]] than men.<ref name="CDC-causes">{{Cite web|url=https://www.cdc.gov/me-cfs/about/possible-causes.html | title = Possible Causes {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> [[Onset of ME/CFS|New onset]] has been [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|observed in children]]<ref name="CDC-children">{{Cite web|url=https://www.cdc.gov/me-cfs/me-cfs-children/index.html | title = ME/CFS in Children {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> and in adults usually between the ages of 40-60.<ref name="what-is">{{Cite web|url=https://www.cdc.gov/me-cfs/about/index.html | title = What is ME/CFS? {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> [[Inger Johanne Bakken|Bakken]] et. al notes two age peaks for [[CFS/ME]]; age group 10 to 19 years and a second peak in the age group 30 to 39 years.<ref name="Bakken2014">{{Cite journal | last1 = Bakken | first1 = Inger Johanne | authorlink=Inger Johanne Bakken | last2 = Tveito | first2 = Kari | last3 = Gunnes | first3 = Nina | last4 = Ghaderi | first4 = Sara | last5 = Stoltenberg | first5 = Camilla | last6 = Trogstad | first6 = Lill | last7 = Håberg | first7 = Siri Eldevik | last8 = Magnus | first8 = Per | date = 2014-10-01 | title = Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=https://doi.org/10.1186/s12916-014-0167-5|journal=BMC Medicine|volume=12|issue=1|pages=167|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmc=4189623|pmid=25274261}}</ref>

There are no approved pharmacological treatments for ME anywhere in the world except in [[Argentina]], which has approved the immunomodulator [[Ampligen]] (rintatolimod) for [[Severe and very severe ME|severe ME/CFS]] as of August 23, 2016.<ref name="Hemispherx">{{Cite news | title = Hemispherx Biopharma Announces Major Breakthrough: Approval for Commercial Sale of Rintatolimod (U.S. Tradename: Ampligen®) to Treat Severe Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the Argentine Republic|url=http://www.globenewswire.com/news-release/2016/08/23/866212/0/en/Hemispherx-Biopharma-Announces-Major-Breakthrough-Approval-for-Commercial-Sale-of-Rintatolimod-U-S-Tradename-Ampligen-to-Treat-Severe-Cases-of-Myalgic-Encephalomyelitis-Chronic-Fat.html|work=GlobeNewswire News Room|access-date=2018-08-12|language=en-US | first = | last = Hemispherx Biopharma, Inc | date = Aug 23, 2016|archive-url=|archive-date=|url-status=}}</ref>[[File:Linda Crowhurst.JPG|thumb|[[Linda Crowhurst]] is married to [[Greg Crowhurst]]; they reside in Belfast, [[Northern Ireland]]. Greg is Linda's full-time carer as she is [[Severe and very severe ME|very severely ill with ME]]. As of June 2018, Linda has been ill for 25 years. Image source: [https://www.youtube.com/watch?v=Z1z5O_cgQ7I Wasteland (video)] which visually documents Linda's very severe ME. Greg posted a [https://www.youtube.com/watch?v=rVsOeZjhMFY YouTube video in 2006 (reposted in 2007)] of Linda speaking of her condition and showing her [[Nervous system|neurological]] symptoms which are the first known public visual document of very severe ME. She is now bedbound barely able to move and unable to feed herself.]]

[[File:Jenny Spotlia.jpg|300px|thumb|right|[[Jennie Spotila]] is an American ME patient who fell ill on October 6, 1994. Jennie is [[Severe and very severe ME|disabled, mostly housebound, and uses a wheelchair]] but has been an [[ME/CFS]] advocate for many years. She writes the blog [[Occupy M.E.]] She served on the Board of Directors of [[Solve ME/CFS Initiative|The CFIDS Association of America]] and testified before the [[Chronic Fatigue Syndrome Advisory Committee|CFSAC]]]]

== History ==
Myalgic encephalomyelitis was first classified as a [[nervous system|neurological]] disease by the [[World Health Organization]] in 1969, with the publication of the [[World_Health_Organization#icd8|ICD-8]] manual.<ref name="ICD-8" />
[[File:Hillary Johnson.jpg|200px|thumb|[[Hillary Johnson]] is an [[United States|American]] journalist and while ill herself, wrote the book [[Osler's Web]] which is the historical account of the early years of a "new" illness that had an outbreak at [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] which she shared the same symptoms. The illness came to be known as [[chronic fatigue syndrome]] (CFS). Johnson spent nine years investigating the outbreak and the [[Centers for Disease Control and Prevention|CDC]]'s refusal to acknowledge a devastating disease (deeming sufferers of Incline Village as having [[mass hysteria|"mass hysteria"]]) that can be spread through casual contact and she appears in the documentary [[Forgotten Plague]].]]

The World Health Organization's [[World Health Organization#icd8|ICD-8]] manual did not include any alternative names for myalgic encephalomyelitis although postinfectious encephalomyelitis and all other encephalomyelitis diseases were classified under the same code; fatigue-related alternative names were not added in any later revisions.<ref name="ICD-8" /><ref name="icd10-2016">{{Cite web|url=https://icd.who.int/browse10/2016/en#/G93 | title = G93 Other diseases of the nervous system - ICD-10 Version:2016 | last = World Health Organization | first = | authorlink = World Health Organization | date = 2016 | website = World Health Organization|archive-url=|archive-date=|url-status=|access-date=2019-04-13}}</ref> The alternative name [[chronic fatigue syndrome]] (CFS) was not in use at this time; it was proposed in 1987 by the [[Centers for Disease Control]], which adopted [[Holmes criteria|new diagnostic criteria]] the following year.<ref name="IOM-full" />{{Rp|29}}

In the ICD-9, which was published in 1989, the entry for myalglc encephalomyelitis is uses code 323.9:<ref name="ICD-9">{{Cite book |url=https://apps.who.int/iris/bitstream/handle/10665/40492/9241540052_eng_v2_p1.pdf?sequence=3&isAllowed=y| title = Manual of the international statistical classification of diseases, injuries, and causes of death : based on the recommendations of the ninth revision conference, 1975, and adopted by the Twenty-ninth World Health Assembly, 1975 revision: alphabetic index | first = | last = World Health Organization & International Conference for the Ninth Revision of the International Classification of Diseases|publisher=World Health Organization | year = 1978|isbn=9241540044|editor-link=|edition=9th|volume=2|location=Geneva | page = 182|chapter=|quote=}}</ref>
{{Main article | page_name =History of myalgic encephalomyelitis and chronic fatigue syndrome}}

ME has occurred in both epidemic and sporadic form since at least the 1930s, although it has likely been occurring much longer but was not formally named. The first recorded outbreak of [[epidemic myalgic encephalomyelitis]] was in [[1934 Los Angeles atypical polio outbreak|1934 in Los Angeles]] and was thought to be an outbreak of atypical [[polio]]. After the outbreak in [[Akureyri]], Iceland in 1946, the disease came to be called [[1948-49 Akureyri outbreak|''Akureyri Disease'']] or ''Icelandic disease'' through much of the 1940s and 1950s. It was named ME after London's [[Royal Free Hospital outbreak]] in 1955. Other names included benign myalgic encephalomyelitis and [[Epidemic myalgic encephalomyelitis|epidemic neuromyasthenia]].

After the [[1984 Incline Village chronic fatigue syndrome outbreak|Incline Village]] outbreak in Nevada in 1984, the disease came to be called and redefined as [[chronic fatigue syndrome]] (CFS). The most recent myalgic encephalomyelitis outbreak was caused by the [[2019-2022 Coronavirus pandemic outbreak]].{{clear|both}}

==Disease name==
{{Main article |page_name = Names of myalgic encephalomyelitis and chronic fatigue syndrome}}
[[File:Myalgic Encephalomyelitis awareness.png|thumb|right|alt=Poster of breakdown of parts of the name myalgic encephalomyelitis]]
* '''Myalgic''' - of or relating to [[myalgia]] (muscle pain).<ref name="Terminology" />

* '''Encephalo''': Refers to the [[brain]].<ref name="Terminology" />

* '''-myel''': relating to the [[spinal cord]].<ref name="Terminology" />

* '''-itis''': [[Inflammation]].<ref name="Terminology" />
The name '''myalgic encephalomyelitis''' was first used in 1956 in an article in the ''Lancet'' medical journal to describ findings from the [[1955 Royal Free Hospital outbreak]] in London, UK.<ref name="MyalgicEncephalomyelitis-first-coines">{{Cite journal | journal = Lancet|volume=1|issue= | pages = 789–790 | date = 1956 | title = A new clinical entity?|url=https://mecfsj.files.wordpress.com/2019/05/lancet_e383a9e383b3e382bbe38383e383881956_me.pdf}}</ref><ref name="Terminology" /><ref name="Ramsay1965">{{Cite journal | last = Ramsay | first = A. Melvin | authorlink = Melvin Ramsay | date = 1965-10-30 | title = Hysteria and “Royal Free Disease.”|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847119/|journal=British Medical Journal|volume=2|issue=5469|pages=1062|doi=|issn=0007-1447|pmc=1847119|pmid=|access-date=|quote=|via=}}</ref> The term myalgic encephalomyelitis is a portmanteau of several of the key signs and symptoms of the disease: myalgic (muscle pain), encephalo (brain), myel (spinal cord), itis (inflammation).<ref name="Terminology">{{Cite web|url=https://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = The Terminology of ME & CFS | first = Malcolm | last = Hooper | authorlink = Malcolm Hooper}}</ref><ref name="Smith1989">{{Cite book | title = Understanding M.E.: The Phenomenon of Myalgic Encephalomyelitis and Acute Onset Post Viral Fatigue Syndrome | page = 20 | last = Smith | first = David G | date = 1989}}</ref> The [[central nervous system]] (brain and spinal cord) are inflamed.<ref name="Terminology"/>
===Benign myalgic encephalomyelitis ===
''Benign'' myalgic encephalomyelitis was the term used by the [[World Health Organization]] from 1969,<ref name="ICD-8" /> with the prefix "benign" used to denote that M.E. was not fatal, the prefix benign was later dropped since M.E. can [[causes of death|cause death]], for example the deaths of [[Merryn Crofts]] and [[Sophia Mirza]].<ref name="Terminology" /><ref name="Vindication" /><ref name="ICD-11">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/569175314 | title = 8E49 Postviral fatigue syndrome {{!}} ICD-11 - Mortality and Morbidity Statistics | last = World Health Organization | first = | authorlink = World Health Organization | date = |website=World Health Organization|language=en|archive-url=|archive-date=|access-date=2022-03-19|quote='''8E49 Postviral fatigue syndrome'''<br />Other disorders of the nervous system<br />Inclusions<br/>chronic fatigue syndrome<br/>myalgic encephalomyelitis<br />Exclusions<br/>Fatigue (MG22)}}</ref>
[[Merryn Crofts]] had [[Severe and very severe ME#verysevere|very severe ME]], was bedbound and unable to eat. Merryn weighed under six stone (84 lbs) at her death, and was just 21 years-old. Merryn's death certificate was the second in the [[United Kingdom|UK]] to attribute a death to ME.<ref name="Vindication">{{Cite web |url=https://www.bbc.co.uk/news/health-44969741 | title = 'Vindication' for woman who wanted ME on death certificate | first = Jim | last = Taylor|publisher=BBC Radio 5 Live | date = Jul 27, 2018}}</ref>
===Disease of a thousand names ===
Myalgic Encephalomyelitis has been referred to as the ''"disease of a thousand names"''.<ref name="Bell1991">{{Cite book | last = Bell | first = David S. | authorlink = David Bell | title = Chronic Fatigue/Immune Dysfunction Syndrome. CFIDS: The disease of a thousand names|location = Lyndonville, NY|publisher=Pollard Publications | date = 1991 | url=https://books.google.com/books/about/Chronic_Fatigue_immune_Dysfunction_Syndr.html?id=QYvkugAACAAJ|archive-url=https://archive.org/details/cfidsdiseaseofth00bell|archive-date=2010-02-16}}</ref> Other names used or proposed in the history of the myalgic encephalomyelitis include [[atypical polio]], [[Icelandic disease]], benign ME, [[epidemic neuromyasthenia]], [[chronic fatigue syndrome]], [[Chronic Fatigue Immune Dysfunction Syndrome]] (CFIDS), and [[systemic exertion intolerance disease]] (SEID).<ref name="Bell1991" /><ref name="IOM-full" /> This has lead to much confusion as a variety of names have been used at different times to describe discrete outbreaks as well as a larger and potentially more heterogenous population of sporadic cases, defined by a wide variety of [[Definitions of myalgic encephalomyelitis and chronic fatigue syndrome|diagnostic criteria]]. Some names have emphasized particular symptoms or pathology, including chronic fatigue syndrome and myalgic encephalomyelitis.<ref name="Terminology" />

A survey by [[The MEAction Network]] in 2016 found that the majority of patients prefer the name ME to other names including chronic fatigue syndrome.<ref>{{Cite news | url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) - #MEAction | date = 2016-08-07|work=#MEAction|access-date=2018-09-08|language=en-US}}</ref>

Myalgic encephalomyelitis (ME) was the original name for [[chronic fatigue syndrome]] (CFS); the names are sometimes used interchangeably or with the acronym [[ME/CFS]].<ref name="Smith1989" />

== Onset ==
{{Main article |page_name =Onset of ME/CFS}}
According to Dr [[Byron Hyde]], after an incubation period of 4 to 7 days, the prodromal phase generally involve a [[flu-like illness]] with [[low-grade fever]].<ref name="Evans2018" /> In the majority but not all cases, an [[infection]] or infectious process is evident.<ref name="Evans2018">{{Cite journal | last = Evans | first = Meredyth | authorlink = Meredyth Evans | last2 = Jason | first2 =Leonard | authorlink2 = Leonard Jason | date = 2018 | title = Onset patterns of chronic fatigue syndrome and myalgic encephalomyelitis|url=https://www.openaccessjournals.com/articles/Onset%20patterns%20of%20chronic%20fatigue%20syndrome%20and%20myalgic%20encephalomyelitis.pdf | journal=Research on Chronic diseases|volume=2|issue=1|pages=2-3|quote=|via=}}</ref> Two to seven days later, a chronic phase commences, characterized by a measurable diffuse change in the function of the CNS. It is this second phase, persistent phase that most characterizes ME.<ref name="Nightingale">{{Citation | title = The Nightingale Research Foundation Definition of Myalgic Encephalomyelitis (M.E.)|pages=|language=en|title-link=Nightingale Research Foundation definition | date = 2016 | publisher=IACFS/ME | last = Hyde | first = Byron | authorlink = Byron Hyde|others=|oclc=|quote=|location=}}</ref><ref name="Evans2018" />

==Signs and symptoms==
Myalgic encephalomyelitis is a [[neurological disorder|neurological disease]] that affects multiple bodily systems, causing a widespread combination of symptoms.<ref name="ICC" /> Symptoms can range from mild to very severe and can include:

<div style="column-count:2;">
* [[ataxia|ataxia (coordination difficulties)]]
* [[cognitive dysfunction]]
* [[Chronic fatigue|fatigability]]
* [[gastrointestinal]] symptoms
* [[headache]]
*[[low-grade fever]], [[Temperature dysregulation|temperature instability]]
*[[muscle]] [[Muscle weakness|weakness]] and [[Muscle fatigability|fatiguability]]
*[[myalgia|myalgia (muscle pain)]]
*neck and back or [[spinal cord]] stiffness
*[[neuralgia|neuralgia (nerve pain)]]
*[[Orthostatic intolerance|othostatic intolerance]]
*[[post-exertional malaise]]
*sensitivity to [[Temperature sensitivity|heat or cold]]
*sensitivity to [[Light sensitivity|light]], [[Hyperacusis|sound]] and/or [[Allodynia|touch]]
*[[sleep dysfunction]]<ref name="ICC">{{Cite journal | last = Carruthers | first = Bruce M. | authorlink = Bruce Carruthers | last2 = van de Sande | first2 = Marjorie I. | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Klimas | first4 = Nancy G. | author-link4 = Nancy Klimas | last5 = Broderick | first5 = Gordon | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = Terry | authorlink6 = Terry Mitchell | last7 = Staines | first7 = Donald | author-link7 = Donald Staines | last8 = Powles | first8 = A.C. Peter | authorlink8 = A C Peter Powles | last9 = Speight | first9 = Nigel | authorlink9 = Nigel Speight | last10 = Vallings | first10 = Rosamund | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = Lucinda | authorlink11 = Lucinda Bateman | last12 = Baumgarten-Austrheim | first12 = Barbara | authorlink12 = Barbara Baumgarten-Austrheim | last13 = Bell | first13 = David | author-link13 = David Bell | last14 = Carlo-Stella | first14 = Nicoletta | author-link14 = Nicoletta Carlo-Stella | last15 = Chia | first15 = John | author-link15 = John Chia | last16 = Darragh | first16 = Austin | author-link16 = Austin Darragh | last17 = Jo | first17 = Daehyun | author-link17 = Daehyun Jo | last18 = Lewis | first18 = Donald | author-link18 = Donald Lewis | last19 = Light | first19 = Alan | author-link19 = Alan Light | last20 = Marshall-Gradisnik | first20 = Sonya | author-link20 = Sonya Marshall-Gradisnik | last21 = Mena | first21 = Ismael | author-link21 = Ismael Mena | last22 = Mikovits | first22 = Judy | author-link22 = Judy Mikovits | last23 = Miwa | first23 = Kunihisa | author-link23 = Kunihisa Miwa | last24 = Murovska | first24 = Modra | author-link24 = Modra Murovska | last25 = Pall | first25 = Martin | author-link25 = Martin Pall | last26 = Stevens | first26 = Staci | author-link26 = Staci Stevens | date = 2011-08-22 | title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365q-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}</ref>
</div>
[[File:ME CFS.png|alt=Myalgic encephalomyelitis is an acquired neurological disease with complex global dysfunctions. Pathological dysregulation of the nervous, immune and endocrine systems, with impaired cellular energy metabolism and ion transport are prominent features. - International Consensus Criteria|thumb|upright=1.6|left]]

Symptom presentation and [[:Category:Severity definitions|severity]] can vary considerably day to day and even hour to hour.<ref name="CDC-symptoms" /><ref name="Primer2014">{{Citation | date = 2014 |url=https://www.massmecfs.org/images/pdf/Primer_2014.pdf | title=Chronic Fatigue Syndrome Myalgic Encephalomyelitis Primer for Clinical Practitioners | last1 = ((International Association for Chronic Fatigue Syndrome / Myalgic Encephalomyelitis)) | author-link = International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis | last2 = Friedberg | first2 = Fred | authorlink2 = Fred Friedberg | last3 = Bateman | first3 = Lucinda | authorlink3 = Lucinda Bateman | last4 = Bested | first4 = Alison C | authorlink4 = Alison Bested | last5 = Davenport | first5 = Todd | authorlink5 = Todd Davenport | last6 = Friedman | first6 = Kenneth J | authorlink6 = Kenneth Friedman | last7 = Gurwitt | first7 = Alan R | authorlink7 = Alan Gurwitt | last8 = Jason | first8 = Leonard A | authorlink8 = Leonard Jason | last9 = Lapp | first9 = Charles W | authorlink9 = Charles Lapp | last10 = Stevens | first10 = Staci R | authorlink10 = Staci Stevens | last11 = Underhill | first11 = Rosemary A | authorlink11 = Rosemary Underhill | last12 = Vallings | first12 = Rosamund | authorlink12 = Rosamund Vallings|location=Chicago, USA|publisher= International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis |quote=The illness can vary from mild to severe, with symptoms that may fluctuate significantly from hour to hour and day to day.}}</ref> Overexertion can exacerbate all symptoms, and [[post-exertional malaise]] is often [[Delayed onset of post-exertional symptoms|delayed by 24 hours or more]].<ref name="CDC-symptoms" /> The US [[National Institutes of Health]] (NIH) notes that sensitivity to noise, light and [[multiple chemical sensitivity|chemical]]s may force patients to withdraw from society.<ref name="P2P2016">{{Cite web|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs | title = ME/CFS - Pathways to Prevention - Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | last = | first = | date = Dec 8, 2016 | website = [[National Institutes of Health]]|access-date=2022-03-28|quote=Effects of the illness can range from moderate to debilitating, and can substantially impact everyday functioning. Routine daily activities such as cooking meals, brushing teeth, and caring for children become difficult. Additionally, sensitivity to environmental factors (e.g., noise, light, chemicals) may force many individuals with ME/CFS into seclusion or withdrawal from society.|archive-url=|archive-date=|url-status=|language=en}}</ref>

=== Post-exertional malaise ===
{{Main article | page_name =Post-exertional malaise}}
A core symptom, [[post-exertional malaise]] (PEM), is intolerance to previously trivial mental or physical effort such as attending a child's school event, running an errand or grocery shopping, taking a shower or brushing teeth; this causes a worsening of symptoms, and deterioration of health from persistent or repeated exertion.<ref name="ICC2011primer" /><ref name="CDC-symptoms" />
[[File:J Brea TED.JPG|200px|thumb|right|[[Jen Brea|Jennifer Brea]] is an American who was studying at Harvard; while on a trip to [[Kenya]] she became very ill with what would eventually be diagnosed as [[ME/CFS]]. Brea began experiencing [[Nervous system|neurological]] problems. Her neurologist diagnosed her with "conversion disorder" ([[hysteria]]). When walking home from his office, she collapsed. [[Severe and very severe ME|Jen needed to use a wheelchair]] to keep her legs up due to [[Postural orthostatic tachycardia syndrome|POTS]] as her blood pools into her legs. View her TED Talk ''[https://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose What happens when you have a disease doctors can't diagnose]'']]
Some studies show that patients who have been ill for longer are more likely to uave [[severe and very severe ME|severe ME/CFS]]. ME/CFS oftens becomes more severe when patients try to [[pushing through symptoms|push through]] their symptoms and continue to repeatedly exceed their personal ''physical'' or ''cognitive'' [[energy limit|limits]], for instance by attempting to keep working, which typically entails [[anaerobic]] activity.<ref name="Vink2015LA"/><ref name="Vink2019">{{Cite journal | last = Vink | last2 = Vink-Niese | date = 2019-09-20 | title = Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies|url=https://www.mdpi.com/2075-4418/9/4/124|journal=Diagnostics|language=en|volume=9|issue=4|pages=124|doi=10.3390/diagnostics9040124|issn=2075-4418 | first = Mark | first2 = Alexandra|pmc=|pmid= | author-link = Mark Vink | authorlink2 = Alexandra Vink-Niese|access-date=|quote=People with ME/CFS often feel under pressure to continue working when they first become ill or when their symptoms worsen. Unfortunately, trying to push through this illness is counterproductive, potentially causing longer sickness absences and slower recovery.}}</ref>

== Clinical findings ==
{{Main article|1=List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis|label1=List of abnormal findings}}
[[File:Alem Matthee.png|200px|thumb|right|[[Alem Matthees]] is an [[Australia|Australian]] ME patient that filed an FOI request for data from the [[PACE trial]]. At a [[Severe and very severe ME|great cost to his health]], Alem appealed the denial of the data and won. This data proved the results published in [[The Lancet|''The Lancet'']] were untrue. Alem's health suffered significantly in part from the efforts required for the FOI request and tribunal]]
Although there is no definitive [[biomarker]], several signs and findings have been frequently observed in clinical settings:<div style="column-count:2;">
*high [[:Category:Antibodies|antibody]] titers to specific infections (including [[Epstein-Barr virus|EBV]],<ref>{{Cite journal | last = Schmaling | first = K.B. | last2 = Jones | first2 = J.F. | date = Jan 1996 | title = MMPI profiles of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/8730646|journal=Journal of Psychosomatic Research|volume=40|issue=1 | pages = 67–74|issn=0022-3999|pmid=8730646}}</ref> [[Human herpesvirus 6|HHV-6]],<ref name="Cuende1997">{{cite journal| vauthors=Cuende JI, Civeira P, Diez N, Prieto J| title=[High prevalence without reactivation of herpes virus 6 in subjects with chronic fatigue syndrome]. | journal=An Med Interna | year= 1997 | volume= 14 | issue= 9 | pages = 441-4 | pmid=9453750 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/pubmed/9453750}}</ref><ref name="Komaroff2006">{{cite journal | last=Komaroff | first = AL | authorlink = Anthony Komaroff | title=Is human herpesvirus-6 a trigger for chronic fatigue syndrome? | journal=J Clin Virol | year= 2006 | volume= 37 | issue= Suppl 1 | pages = S39-46 | pmid=17276367 | doi=10.1016/S1386-6532(06)70010-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/pubmed/17276367}}</ref> and [[Coxsackie B virus|Coxsackie B]]<ref>{{Cite journal | last = Landay | first = AL | date = September 1991 | title = Chronic fatigue syndrome: clinical condition associated with immune activation | url =https://www.ncbi.nlm.nih.gov/pubmed/1679864|journal=Lancet|volume=|pages=|via=}}</ref><ref name="Chia2005">{{Cite journal | last = Chia | first = John | date = November 2005 | title = The role of enterovirus in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770761/|journal=Journal of Clinical Pathology|volume=|pages=|via=}}</ref> among others)
*[[Hormone]] imbalance<ref name="Ruiz-Núñez, 2018">{{Cite journal | last1 = Ruiz-Núñez | first1 = Begoña | authorlink1 = | last2 = Tarasse | first2 = Rabab | authorlink2 = | last3 = Vogelaar | first3 = Emar F. | authorlink3 = | last4 = Janneke Dijck-Brouwer | first4 = D.A. | authorlink4 = | last5 =Muskiet | first5 = Frits A. J. | authorlink5 = | title = Higher Prevalence of “Low T3 Syndrome” in Patients With Chronic Fatigue Syndrome: A Case–Control Study | url = https://doi.org/10.3389%2Ffendo.2018.00097 | journal = Frontiers in Endocrinology | volume = 9 | issue = | page = 97 | date = 2018 | pmid = 29615976 | doi = 10.3389/fendo.2018.00097}}</ref>
*[[Immune system|immunological abnormalities]]<ref name="ICC" /><ref name="Brenu2014">{{Cite journal | last = Brenu | first = Ekua Weba | last2 = Huth | first2 = Teilah K. | last3 = Hardcastle | first3 = Sharni L. | last4 = Fuller | first4 = Kirsty | last5 = Kaur | first5 = Manprit | last6 = Johnston | first6 = Samantha | last7 = Ramos | first7 = Sandra B. | last8 = Staines | first8 = Don R. | last9 = Marshall-Gradisnik | first9 = Sonya M. | date = Apr 2014 | title = Role of adaptive and innate immune cells in chronic fatigue syndrome/myalgic encephalomyelitis|url=http://www.ncbi.nlm.nih.gov/pubmed/24343819|journal=International Immunology|volume=26|issue=4|pages=233–242|doi=10.1093/intimm/dxt068|issn=1460-2377|pmid=24343819}}</ref><ref name="CDC-etiology"/>
*[[Natural Killer Cell (NKC) function|low natural killer cell function]]<ref name="Brenu2014" />
*low red blood cell [[magnesium]]<ref name="Cox1991">{{Cite journal | title = Red blood cell magnesium and chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/1672392|journal=Lancet (London, England) | date = 1991-03-30|issn=0140-6736|pmid=1672392 | pages = 757–760|volume=337|issue=8744 | first = I.M. | last=Cox | first2 = M.J. | last2 = Campbell | first3 = D. | last3 = Dowson}}</ref>
*[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia]] (POTS)<ref name="ICC2011primer" /><ref>{{Cite web|url=https://ammes.org/overlapping-conditions/ | title = Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}</ref>
*[[Post-exertional malaise|physical and mental exertion, sensory input cause relapse]] (PEM)<ref name="ICC2011primer" /><ref name="Arroll2014">{{Cite journal | last = Arroll | first = Megan A. | authorlink = Megan Arroll | last2 = Attree | first2 = Elizabeth A. | last3 = O'Leary | first3 = John M. | last4 = Dancey | first4 = Christine P. | date = 2014-04-03 | title = The delayed fatigue effect in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)|url=https://www.tandfonline.com/doi/abs/10.1080/21641846.2014.892755|journal = Fatigue: Biomedicine, Health & Behavior |language=en|volume=2|issue=2 | pages = 57–63|doi=10.1080/21641846.2014.892755|issn=2164-1846}}</ref><ref name="CDC-symptoms">{{Cite web|url=https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-05-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-11-21}}</ref>
</div>

==Diagnosis==
[[File:Tom Kindlon.png|300px|thumb|[[Tom Kindlon]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill at 16]] and never recovered. He is an ME/CFS advocate with published works in Research Gate and PubMed. Kindlon lives in [[Ireland]] and is Assistant Chairperson of the [[Irish ME/CFS Association]]. Tom and others analyzed the data for the PACE trial proving out that its published results were untrue. He uses a [[Severe and very severe ME|wheelchair and his full-time carer]] is his mother, Vera]]
{{Main article | page_name =Definitions of myalgic encephalomyelitis and chronic fatigue syndrome}}

There are several proposed criteria for diagnosing ME including the [[International Consensus Criteria]] (ICC) and the [[Canadian Consensus Criteria]] (CCC). The original criteria developed by [[Melvin Ramsay]], the [[Ramsay definition]], is not used for diagnosing ME today.

===Generally accepted criteria for diagnosing ME/CFS and ME===
*[[Canadian Consensus Criteria]] (CCC)<ref name="Carruthers, 2003">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://phoenixrising.me/wp-content/uploads/Canadian-definition.pdf }}</ref> A diagnosis of moderate and severe forms of [[ME/CFS]] are accurately made using this criterion. Adults can be diagnosed at 6 months while pediatric cases are diagnosed at three months.
*[[International Consensus Criteria]] (ICC)<ref name="ICC" /><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> This criteria will accurately diagnose myalgic encephalomyelitis (ME). There is no requirement that the individual have symptoms for a specified period of time for diagnosis, as opposed to CCC, [[Fukuda criteria|Fukuda]], and [[Systemic Exertion Intolerance Disease|SEID]], which all require 6 months in adults.
*[[Systemic Exertion Intolerance Disease]] (SEID)<ref name="IOM-full">{{Cite book | last = Institute of Medicine | first = | authorlink = Institute of Medicine | date = 2015 | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness.|location = Washington, DC|publisher =The National Academies Press|doi=10.17226/19012 | url = http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx}}</ref>

ME/CFS ([[Systemic Exertion Intolerance Disease|SEID]]) is accurately diagnosed when the [[Systemic Exertion Intolerance Disease#Diagnostic criteria|core symptoms]] are met. The [[Institute of Medicine report]] is a whole is a comprehensive review of the medical literature available at time of publication (2015). Adults can be diagnosed at 6 months while pediatric cases are diagnosed at three months.

=== Other diagnostic criteria ===
Several, overly broad criteria have been proposed and are in use. These criteria likely capture some patients with the disease characterized in the medical literature on [[Epidemic myalgic encephalomyelitis|epidemic ME]], exclude others, and also include patients with a wide range of other undiagnosed conditions including cancer, depression, and a range of autoimmune diseases. The United Kingdom's [[Oxford criteria|Oxford criteria for chronic fatigue syndrome]] is the broadest and likely least discerning definition and has been retired due to the risk of many different fatiguing illnesses being [[misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome|misdiagnosed]] as [[chronic fatigue syndrome]].<ref name="P2PPreview2015">{{Cite journal | last = Haney | first = Elizabeth | last2 = Smith | first2 = M.E. Beth | last3 = McDonagh | first3 = Marian | last4 = Pappas | first4 = Miranda | last5 = Daeges | first5 = Monica | last6 = Wasson | first6 = Ngoc | last7 = Nelson | first7 = Heidi D. | date = Jun 16, 2015 | title = Diagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop | url = http://annals.org/article.aspx?doi=10.7326/M15-0443|journal=Annals of Internal Medicine|language=en|volume=162|issue=12 | pages = 834|doi=10.7326/m15-0443|issn=0003-4819|via=}}</ref> The US [[Centers for Disease Control and Prevention|Centers for Disease Control]]'s (CDC) [[Fukuda criteria]], in use since 1994, is also overly broad. The Institute of Medicine report developed the criteria of [[Systemic Exertion Intolerance Disease]] (SEID) and although it can diagnose ME patients [[Systemic Exertion Intolerance Disease#Diagnostic criteria|with the minimum core symptoms]],<ref name="IOM-flowchart">{{Cite web|url=http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness - Diagnostic Algorithm | last = | first = | authorlink = | date = 2015 | website = nationalacademies.org|archive-url=|archive-date=|url-status=|access-date=}}</ref><ref name="IOM-clinicians">{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf | title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness: Clinicians' Guide | last = | first = | date = 2015 | website = National Academies|archive-url=|archive-date=|url-status=|access-date=}}</ref> it does not describe the array of symptoms those suffering with ME experience. Symptoms such as [[Nervous system|neurological]], [[Immune system|immune]]/[[Gastrointestinal system|gastrointestinal]]/genitourinary impairment, and [[Portal:Energy metabolism|energy metabolism]]/[[Ion transportation|ion transport]] impairment; these [[International Consensus Criteria#Criteria|symptoms are necessary for a diagnosis]] under the [[International Consensus Criteria|ICC]].<ref name="ICC" /> The [[Canadian Consensus Criteria|CCC]] requires neurological, [[Autonomic nervous system|autonomic]], neuroendocrine, immune system, and [[myalgia]] symptoms to meet [[Canadian Consensus Criteria#Definition|its ME/CFS diagnostic criteria]].<ref name="Carruthers, 2003" />

===Differential diagnosis===
The signs and symptoms of myalgic encephalomyelitis can be similar to other medical illnesses, including cancer, [[multiple sclerosis]], [[Systemic lupus erythematosus|lupus]], [[Hashimoto's thyroiditis (hypothyroidism)]], [[diabetes|diabetes mellitus]], [[brucellosis]], [[anemia]] and others.<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 and Prevention]]|language=en-us|access-date=2022-03-28}}</ref><ref name="Carruthers, 2003" /> Standard medical tests are needed to help distinguish ME from these other illnesses, and additional testing may also be needed.<ref name="IOM-clinicians" /><ref name="CDC-differentialdiagnosis"/><ref name="CDC-medicaltests">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html | title = Evaluation {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Apr 28, 2021 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2022-04-01}}</ref>

==Course and prognosis ==

{{Main article|page_name =Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome}}

The [[prognosis for myalgic encephalomyelitis and chronic fatigue syndrome]] (ME and CFS) is considered to be poor with only a small minority (a median estimate of 5%) returning to pre-morbid levels of functioning.<ref name="Cairns2005">{{Cite journal | last = Cairns | first = R. | last2 = Hotopf | first2 = M. | date = Jan 2005 | title = A systematic review describing the prognosis of chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/15699087|journal=Occupational Medicine (Oxford, England)|volume=55|issue=1|pages=20–31|doi=10.1093/occmed/kqi013|issn=0962-7480|pmid=15699087}}</ref> The majority of patients remains significantly impaired. A substantial improvement however is noted in an estimated 40% of patients<ref name="Joyce1997">{{Cite journal | last= Joyce | first = J. | last2 = Hotopf | first2 = M. | last3 = Wessely | first3 = S. | date = Mar 1997 | title = The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review | url =https://www.ncbi.nlm.nih.gov/pubmed/9093600|journal=QJM: monthly journal of the Association of Physicians|volume=90|issue=3|pages=223–233|issn=1460-2725|pmid=9093600|doi=|pmc=|quote= | authorlink2 = Matthew Hotopf|access-date= | authorlink3 = Simon Wessely|via=}}</ref> and the prognosis in [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|adolescents]] is considered to be better than in adults.<ref name="CDC-prognosis">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/prognosis.html | title = Prognosis {{!}} Presentation and Clinical Course {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-07-10 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-10-28}}</ref><ref name="Rowe2017>{{Cite journal | last = Rowe | first = Peter C. | last2 = Underhill | first2 = Rosemary A. | last3 = Friedman | first3 = Kenneth J. | last4 = Gurwitt | first4 = Alan | last5 = Medow | first5 = Marvin S. | last6 = Schwartz | first6 = Malcolm S. | last7 = Speight | first7 = Nigel | last8 = Stewart | first8 = Julian M. | last9 = Vallings | first9 = Rosamund | date = 2017 | title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer |url =https://www.frontiersin.org/articles/10.3389/fped.2017.00121/full|journal=Frontiers in Pediatrics|language=English|volume=5|doi=10.3389/fped.2017.00121|issn=2296-2360}}</ref>

==Pathophysiology==
[[File:Vanessa Li.jpg|thumb|right|[[Vanessa Li]] lived in Hong Kong, the UK, and the US. She became ill with a [[flu-like illness]] while skiing in [[Italy]] and never recovered. Vanessa founded a crowdfund for the [[Microbe Discovery Project]]. She was in [[Severe and very severe ME|excruciating pain, suffered from breathing issues, and occasional paralysis]] for 15 years. She took her own life in 2015]]
{{Main article | page_name =List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis}}

ME is a multi-system disease. Numerous biological abnormalities have been found in multiple bodily system, however no common, central cause or mechanism has yet been elucidated.

=== Central nervous system ===
[[File:Sophia mirza.jpg|thumb|right|[[Sophia Mirza]] was a [[Severe and very severe ME|very severely ill]] ME patient who lived in the UK. Sophia's death came not long after a forced entry into her mother's home and being forcibly taken to a mental hospital in 2003. An independent neuropathologist found Sophia's [[spine]] contained a massive inflammation. Her death certificate was the first in the UK to attribute a death to CFS.<ref name="Vink2015LA">{{Cite journal | last = Vink | first = Mark | date = 2015-09-10 | title = The Aerobic Energy Production and the Lactic Acid Excretion are both Impeded in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.researchgate.net/publication/282133390_The_Aerobic_Energy_Production_and_the_Lactic_Acid_Excretion_are_both_Impeded_in_Myalgic_EncephalomyelitisChronic_Fatigue_Syndrome|journal=Journal of Neurology and Neurobiology (ISSN 2379-7150)|volume=1|doi=10.16966/2379-7150.112}}</ref>]]
{{Main article |page_name =Central nervous system}}

=== Autonomic nervous system ===
{{Main article |page_name =Autonomic nervous system}}

=== Cardiovascular ===
{{Main article |page_name =Cardiovascular system}}

=== Gastrointestinal system ===
{{Main article |page_name = Gastrointestinal system}}

=== Immune system ===

{{Main article |page_name =Immune system}}

=== Musculoskeletal system ===
{{Main article |page_name =Muscle}}

=== Peripheral nervous system ===
{{Main article |page_name =Peripheral nervous system}}

== Sex differences ==
[[File:Florence Nightingale.png|200px|thumb|right|[[Florence Nightingale]] was a British citizen and pioneer of modern nursing. Nightingale was stationed in Crimea when she developed "Crimean fever" (a bacterial infection now known as [[brucellosis]]) and never recovered. She remained [[Severe and very severe ME|mostly bedbound]] the rest of her life. Although ME and CFS were not defined in her lifetime, many current physicians and medical historians believe she developed ME/CFS as a result of a chronic brucellosis infection]]

{{Main article |page_name = Sex differences in myalgic encephalomyelitis and chronic fatigue syndrome}}
A Norwegian [[CFS/ME]] study shows that the disease affects all ages, with two peak ages of 10-19 years and 30-39 years; it is more common in women than in men.<ref name="Bakken2014" /> Research by the [[Open Medicine Foundation]] cited in its paper, [[Metabolic features of chronic fatigue syndrome|''Metabolic features of chronic fatigue syndrome'']] which studied severe [[chronic fatigue syndrome|CFS]], found that the disease is different in men and women but this is not related to testosterone or estrogen. [[Michael VanElzakker]] notes there are [[Michael_VanElzakker#Male_and_female_differences_in_neuropathic_pain|male and female differences in neuropathic pain]]. A study of UK and Dutch cohorts found "younger children had a more equal gender balance compared to adolescents and adults."<ref name="Collin2015">{{Cite journal | last = Collin | first = Simon M. | last2 = Nuevo | first2 = Roberto | last3 = van de Putte | first3 = Elise M. | last4 = Nijhof | first4 = Sanne L. | last5 = Crawley | first5 = Esther | date = 2015-10-28 | title = Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10| pages = e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}</ref>

==Risk factors and potential causes==

{{Main article | page_name =Epidemiology of myalgic encephalomyelitis and chronic fatigue syndrome}}

===Genetic risks===

Myalgic encephalomyelitis and chronic fatigue syndrome have been reported to run in families, although ME and CFS are not considered inherited illnesses, there is evidence of a genetic predisposition.<ref name="Schlauch, 2016" /><ref name="Dibble2020">{{Cite journal | title = Genetic risk factors of ME/CFS: a critical review | date = 2020-08-03|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530519/|journal=Human Molecular Genetics|volume=29|issue=R1|pages=R117–R124 | last = Dibble | first = Joshua J | author-link = | last2 = McGrath | first2 = Simon J | authorlink2 = Simon McGrath | last3 = Ponting | first3 = Chris P | authorlink3 = Chris Ponting|doi=10.1093/hmg/ddaa169|pmc=7530519|pmid=32744306|access-date=|issn=0964-6906|quote=|via=}}</ref><ref name="Hajdarevic2022">{{Cite journal | title = Genetic association study in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) identifies several potential risk loci | date = 2022-05-01|url=https://www.sciencedirect.com/science/article/pii/S0889159122000782|journal=Brain, Behavior, and Immunity|volume=102|issue=|pages=362–369 | last = Hajdarevic | first = Riad | authorlink = Riad Hajdarevic | last2 = Lande | first2 = Asgeir | authorlink2 = Asgeir Lande | last3 = Mehlsen | first3 = Jesper | authorlink3 = | last4 = Rydland | first4 = Anne | authorlink4 = | last5 = Sosa | first5 = Daisy D. | authorlink5 = | last6 = Strand | first6 = Elin B. | authorlink6 = Elin Strand | last7 = Mella | first7 = Olav | authorlink7 = Olav Mella | last8 = Pociot | first8 = Flemming | last9 = Fluge | first9 = Øystein | authorlink9 = Øystein Fluge | last10 = Lie | first10 = Benedicte A. | last11 = Viken | first11 = Marte K.|language=en|doi=10.1016/j.bbi.2022.03.010|pmc=|pmid=|access-date=|issn=0889-1591|quote=|via=}}</ref>

{{Main article|page_name = Genetics of chronic fatigue syndrome}}

===Potential causes===
Although risk factors for myalgic encephalomyelitis have been identified, no single [[Vagus nerve infection hypothesis|definitive virus]] has been found in all cases, which has led to the claim that ME is a common end path of a variety of infectious insults.<ref name="Rasa2018">{{Cite journal | last = Rasa | first = Santa | authorlink = Santa Rasa | last2 = Nora-Krukle | first2 = Zaiga | authorlink2 = Zaiga Nora-Krukle | last3 = Henning | first3 = Nina | authorlink3 = | last4 = Eliassen | first4 = Eva | authorlink4 = | last5 = Shikova | first5 = Evelina | authorlink5 = Evelina Shikova | last6 = Harrer | first6 = Thomas | authorlink6 = Thomas Harrer | last7 = Scheibenbogen | first7 = Carmen | authorlink7 = Carmen Scheibenbogen | last8 = Murovska | first8 = Modra | authorlink8 = Modra Murovska | last9 = Prusty | first9 = Bhupesh K. | authorlink9 = Bhupesh Prusty | last10 = European Network on ME/CFS (EUROMENE) | first10 = | authorlink10 = EUROMENE | date = 2018-10-01 | title = Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)|url=https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1644-y|journal=Journal of Translational Medicine|language=en|volume=16|issue=1|pages=|doi=10.1186/s12967-018-1644-y|issn=1479-5876|pmc=|pmid=30285773|quote=|via=}}</ref><ref name="Magnus2015">{{Cite journal | last = Magnus | first = Per | last2 = Gunnes | first2 = Nina | last3 = Tveito | first3 = Kari | last4 = Bakken | first4 = Inger Johanne | last5 = Ghaderi | first5 = Sara | last6 = Stoltenberg | first6 = Camilla | last7 = Hornig | first7 = Mady | last8 = Lipkin | first8 = W. Ian | last9 = Trogstad | first9 = Lill | date = 2015-11-17 | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444/|journal=Vaccine|volume=33|issue=46 | pages = 6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}</ref> It is still possible ME involves some combination of both environmental and genetic factors. Various theories try to combine the known data into plausible explanations.<ref>{{Cite journal | last = Underhill | first = R.A. | date = 2015 | title=Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease|url=https://www.ncbi.nlm.nih.gov/pubmed/26604026|journal=Medical Hypotheses|volume=85|issue=6 | pages = 765–773|doi=10.1016/j.mehy.2015.10.011|issn=1532-2777|pmid=26604026|via=}}</ref><ref name="Schlauch, 2016">{{Cite journal | last1 = Schlauch | first1 = Karen A. | authorlink1 = Karen Schlauch | last2 = Khaiboullina | first2 = Svetlana F. | authorlink2 = Svetlana Khaiboullina | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny de Meirleir | last4 = Rawat | first4 = Shanti | authorlink4 = Shanti Rawat | last5 = Petereit | first5 = J | authorlink5 = | last6 = Rizvanov | first6 = Albert A | authorlink6 = Albert Rizvanov | last7 = Blatt | first7 = Nataliya | authorlink7 = Nataliya Blatt | last8 = Mijatovic | first8 = Tatjana | authorlink8 = Tatjana Mijatovic | last9 = Kulick | first9 = D | authorlink9 = | last10 = Palotás | first10 = András | authorlink10 = András Palotás | last11 = Lombardi | first11 = Vincent C. | authorlink11 = Vincent Lombardi | title = Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome | journal = Translational Psychiatry | volume = 6 | issue = 2 | page = e730 | date = 2016 | pmid = | doi = 10.1038/tp.2015.208 }}</ref> Several theories suggest that ME is an inappropriate immune response to an infection, a theory bolstered by the observation that there is sometimes a family history of [[autoimmune disease]].<ref name="Sotzny, 2018">{{Cite journal | last1 = Sotzny | first1 = Franziska | authorlink1 = Franziska Sotzny | last2 = Blanco | first2 = Julià | authorlink2 = Julià Blanco | last3 = Capelli | first3 = Enrica | authorlink3 = Enrica Capelli | last4 = Castro-Marrero | first4 = Jesús | authorlink4 = Jesús Castro-Marrero | last5 =Steiner | first5 = Sophie | authorlink5 = | last6 = Murovska | first6 = Modra | authorlink6 = Modra Murovska | last7 = Scheibenbogen | first7 = Carmen | authorlink7 = Carmen Scheibenbogen| title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease | url = https://www.sciencedirect.com/science/article/pii/S1568997218300880 | journal = Autoimmunity Reviews | volume = 17 | issue = 6 | page = 601-609 | date = 2018 | pmid = | doi = 10.1016/j.autrev.2018.01.009}}</ref><ref>{{Cite web|url=https://www.facebook.com/permalink.php?story_fbid=564532390371988&id=564526123705948 | title = Klimas ME CFS Genes Study | last = | first = | date = Nov 23, 2015 | website = facebook.com|language=en|archive-url=|archive-date=|url-status=|access-date=2018-09-08}}</ref> There is also a shift from the [[Th1]] type of helper [[T cell]]s, which fight infection, to the [[Th2]] type, which are more active in [[allergy]] and more likely to attack the body.<ref>{{Cite journal | date = 2015-03-01 | title = Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis|url=https://www.sciencedirect.com/science/article/abs/pii/S1043466614006024|journal=Cytokine|language=en|volume=72|issue=1|pages=1–8|doi=10.1016/j.cyto.2014.11.019|issn=1043-4666}}</ref><ref name="Hardcastle2014">{{Cite journal|url=http://www.m-hikari.com/bmgt/bmgt2014/bmgt1-4-2014/hardcastleBMGT1-4-2014.pdf | title=Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and the Potential Role of T Cells | last = Hardcastle | first = S.L. | last2 = Brenu | first2 = E.W. | last3 = Staines | first3 = D.R. | authorlink3 = Donald Staines | last4 = Marshall-Gradisnik | first4 = S. | authorlink4 = Sonya Marshall-Gradisnik| date = 2014 |journal=Biological Markers and Guided Therapy|volume=1|issue=1=|pages=25|doi=10.12988/bmgt.2014.3122}}</ref>

[[File:Naomi Whittingham .png|300px|thumb|[[Naomi Whittingham]] lives in the UK with a [[Severe and very severe ME|severe case of ME]]. Naomi became ill at [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|age 12]] with a routine virus and never recovered. She advocates for ME by doing interviews, writing the blog [[A Life Hidden]], and supporting her brother [[Tom Whittingham]]'s marathon fund raising for [[ME Research UK]]]]

===Viruses===
{{Main article |page_name = Virus}}

Other theories describe ME as an immune response to a chronic infection. The association between ME and the [[Coxsackie B]], [[Human herpesvirus 6]], and [[HHV-7]] viruses<ref>{{Cite journal | last = Bell | first = E.J. | last2 = McCartney | first2 = R.A. | last3 = Riding | first3 = M.H. | date = 1988 | title = Coxsackie B viruses and myalgic encephalomyelitis|url=https://www.ncbi.nlm.nih.gov/pubmed/2841461|journal=Journal of the Royal Society of Medicine|volume=81|issue=6|pages=329–331|doi=10.1177/014107688808100609|issn=0141-0768|pmid=2841461|via=}}</ref><ref>{{Cite news | url=http://solvecfs.org/ramsay-research-team-5-the-potential-role-of-hhv-6-in-mecfs/ | title = Ramsay Research Team 5 – The Potential Role of HHV-6 in ME/CFS - Solve ME/CFS Initiative | last = | first = | date = 2016-12-16|work=Solve ME/CFS Initiative|access-date=2018-09-08|archive-url=|archive-date=|url-status=|publisher=VOLKMEDIA|language=en-US}}</ref><ref name="Chapenko2012">{{Cite journal | last = Chapenko | first = Svetlana | last2 = Krumina | first2 = Angelika | last3 = Logina | first3 = Inara | last4 = Rasa | first4 = Santa | last5 = Chistjakovs | first5 = Maksims | last6 = Sultanova | first6 = Alina | last7 = Viksna | first7 = Ludmila | last8 = Murovska | first8 = Modra | date = 2012 | title = Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/22927850|journal=Advances in Virology|volume=|pages=205085|doi=10.1155/2012/205085|issn=1687-8647|pmid=22927850|via=}}</ref> suggests a potential viral contribution in at least some individuals. Some researchers have stated that evidence from [[epidemic myalgic encephalomyelitis]] strongly point to an enterovirus, however, in most outbreaks, no virus was successfully isolated.<ref name="Chia2005"/><ref name="Hanson2021">{{Cite journal | title = The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review | date = 2021 | url=https://www.frontiersin.org/article/10.3389/fmed.2021.688486|journal=Frontiers in Medicine|volume=8|issue= | pages = 688486 | last = O'Neal | first = Adam J. | authorlink = | last2 = Hanson | first2 = Maureen R. | authorlink2 = Maureen Hanson|doi=10.3389/fmed.2021.688486/abstract|pmc=|pmid=|access-date=|issn=2296-858X|quote=|via=}}</ref>

=== Bacteria ===
{{Main article |page_name = Bacteria}}

Others believe ME may sometimes result from a chronic infection with spirochetal bacteria, such as [[lyme disease]]. Another bacterium that has been implicated in ME is [[chlamydia pneumoniae]].<ref name="Tovey2018">{{Cite journal | date = 2018-09-05 | last = Tovey | first = JE | title = Chlamydia pneumoniae infection a treatable cause of Chronic Fatigue Syndrome|url=https://www.bmj.com/rapid-response/2011/11/01/chlamydia-pneumoniae-infection-treatable-cause-chronic-fatigue-syndrome|journal=The BMJ|language=en|volume=|pages=|via=}}</ref><ref>{{Cite news | url=https://www.prohealth.com/library/new-me-cfs-study-at-stanford-dr-montoya-to-test-for-scores-of-infections-27346 | title = New ME/CFS Study at Stanford: Dr. Montoya to test for scores of Infections - Prohealth | date = 2010-06-04|work=Prohealth|access-date=2018-09-08|language=en-US}}</ref> Protein findings relating to several infections have seen found in the oligoclonal bands ME of patients.<ref name="Nicholson2009">{{Cite journal|url=http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au | title = Role of Chronic Bacterial and Viral Infections in Neurodegenerative, Neurobehavioral, Psychiatric, Autoimmune and Fatiguing Illnesses: Part 1 | first = Garth L. | last=Nicolson | first2 = Jörg | last2 = Haier | date = 2009|journal=British Journal of Medical Practitioners|volume=2|issue=4|pages = 20-28|doi=|pmid=}}</ref>

The [[vagus nerve infection hypothesis]] (VNIH) accounts for why so many different infectious onsets could be responsible. The [[vagus nerve]] runs from the brain stem and throughout the body and has an impact on many body systems.{{citation needed|date=2023-11-17}}

===Transmission via blood===
{{Main article|Blood donation}}
Given the uncertainty regarding the cause, ME and CFS patients are barred from [donating blood or organs in the [[United Kingdom]] (even after recovery),<ref name="BloodUK">{{Cite web | url = https://my.blood.co.uk/KnowledgeBase | title = Knowledgebase|website=My Donor Record - Health, Eligibility & Travel | last = | first = | authorlink = |archive-url=|archive-date=|url-status=|access-date=2021-10-08}}</ref> most of [[Canada]],<ref name="Wilson2014">{{Cite journal | title = The Use of Preliminary Scientific Evidence in Public Health: A Case Study of XMRV | date = 2014-04-08 | url = https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001623|journal=PLOS Medicine|volume=11|issue=4| pages = e1001623 | last = Wilson | first = Kumanan | last2 = Atkinson | first2 = Katherine | last3 = Keelan | first3 = Jennifer|language=en|doi=10.1371/journal.pmed.1001623|pmc=PMC3979645|pmid=24714396|issn=1549-1676}}</ref> [[Australia]],<ref name="RedCrossAus">{{cite web | url = https://www.lifeblood.com.au/faq/eligibility/medical-conditions-and-procedures/chronic-fatigue-syndrome| website = Australian Red Cross|title = Chronic Fatigue Syndrome|access-date=2023-11-17}}</ref><ref name="donate">{{Cite web|url = https://www.donateblood.com.au/faq/chronic-fatigue-syndrome |title=Chronic fatigue syndrome – I have/had chronic fatigue syndrome. Can I donate?|access-date=2022-05-25|website = Australian Red Cross}}</ref> [[New Zealand]] (while symptoms persist), and and for a time also in the [[United States]].<ref name="post">{{Cite web | url = http://voices.washingtonpost.com/checkup/2010/12/red_cross_bars_chronic_fatique.html | title = Red Cross bars chronic fatigue patients from donating blood | last = Stein | first = Rob | authorlink = | date = Dec 3, 2010 | website = Washington Post|archive-url=|archive-date=|access-date=2022-05-25}}</ref><ref name="USblood">{{Cite news | url=http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html | title = Chronic fatigue patients barred from blood donation|publisher=Washington Post | last = Stein | first = Rob | date = 2010-12-03|access-date=2018-09-08|language=en-US|issn=0190-8286}}</ref><ref name="NZblood">{{Cite web|url=http://www.nzblood.co.nz/Give-blood/Donating/Detailed-eligibility-criteria#C | title = Detailed eligibility criteria|website=NZ Blood|language=en-NZ|access-date=2018-09-08}}</ref>

In the US, the American Association of Blood Banks advises to either accept or defer ME/CFS donors based on "clinical judgment of the donor's health status".<ref name="AABBOct2012">{{Cite web | last = American Association of Blood Banks | url = https://www.aabb.org/docs/default-source/default-document-library/regulatory/eid/xmrvfactsheet.pdf?sfvrsn=cd162fa3_2 | date = October 2012 | title = Xenotropic Murine Leukemia Virus-Related Virus (XMRV) and other Polytropic Murine Leukemia Viruses (pMLV)|pages = 3 |quote=An updated AABB Association Bulletin #12-05 (November 2012) states that individual collectors of blood and cellular therapy products should accept or defer donors with a history of CFS based on their clinical judgment of the donor's health status.|access-date=2022-05-25}}</ref> Patient charities discourage ME/CFS patients from donating blood,<ref name="MassBlood2015">{{Cite web | url = https://www.massmecfs.org/research/recent-research/19-xmrv/237-aabbs-recommendation-on-cfidsme-and-blood-donation | title = AABB's recommendation on ME/CFS and blood donation | date = Nov 25, 2015 |website=[[Massachusetts ME/CFS & FM Association]]|access-date=2022-05-25}}</ref>

==Treatments==
[[File:Karina Hansen.jpg|200px|thumb|right|[[Karina Hansen]] became [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|ill as an adult teenager]] and is [[Severe and very severe ME|severely ill]] with ME. She was forcibly institutionalized for 3 1/2 years as the [[Denmark]] healthcare system designates ME as psychosomatic. Karina is now home with her family where she received cards from well-wishers from around the world. Karina's Danish High Court case and return home were featured in the documentary film [[Unrest|''Unrest'']]]]
{{Main article |page_name=Treatments|Potential treatments for myalgic encephalomyelitis and chronic fatigue syndrome}}

There is no cure for ME and no country has approved any pharmacological treatment for the disease except, [[Argentina]] which has approved [[Ampligen]] for the treatment of severe ME/CFS.<ref name="Hemispherx" /> However the effectiveness of Ampligen is under dispute.<ref name="FDA-2009">{{Cite web|url=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html | title = FDA rejects Hemispherx’s chronic fatigue drug Ampligen | website = bizjournals.com|access-date=2018-08-12 | date =Dec 2, 2009 | last = George | first = John|archive-url=|archive-date=|url-status=}}</ref> Other medications have been used off-label for ME with varying effectiveness in some patients.<ref name="Carruthers, 2003" /><ref name="ICC" />

Treatments for sleep problems, headaches, pain or other symptoms are utilized by some doctors for some patients although these are treating symptoms and not ME itself.<ref name="ICC" />

Success of treating symptoms of ME is not well researched or documented.

An immune system modulator drug called [[Rituximab]] has failed in a phase III clinical trial.<ref>{{Cite news | url=http://simmaronresearch.com/2017/11/norwegian-rituximab-chronic-fatigue-syndrome-mecfs-trial-fails/ | title = Norwegian Rituximab Chronic Fatigue Syndrome (ME/CFS) Trial Fails - Simmaron Research | last = Johnson | first =Cort | date = 2017-11-26|work=Simmaron Research|access-date=2018-09-07|archive-url=|archive-date=|url-status=|language=en-US}}</ref> The antiviral Valganciclovir failed in a controlled nine month study against ME patients positive for Herpes Simplex 6 and Epstein Barr viral infections.<ref>{{Cite journal | last = Montoya | first = Jose G. | last2 = Kogelnik | first2 = Andreas M. | last3 = Bhangoo | first3 = Munveer | last4 = Lunn | first4 = Mitchell R. | last5 = Flamand | first5 = Louis | last6 = Merrihew | first6 = Lindsey E. | last7 = Watt | first7 = Tessa | last8 = Kubo | first8 = Jessica T. | last9 = Paik | first9 = Jane | date = Dec 2013 | title = Randomized clinical trial to evaluate the efficacy and safety of valganciclovir in a subset of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/23959519|journal=Journal of Medical Virology|volume=85|issue=12|pages=2101–2109|doi=10.1002/jmv.23713|issn=1096-9071|pmid=23959519|pmc=|quote= | author-link = Jose Montoya | authorlink2 = Andreas Kogelnik|access-date=|via=}}</ref>

==Epidemiology ==
{{Main article |page_name = Epidemiology of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome}}
ME has been found world-wide, in at least 75 [[Outbreaks|epidemics]] documented in published papers from the 1930s to the 1980s.<ref name="HFME">{{Cite web|url=http://www.hfme.org/methemedicalfacts.htm | title = M.E.: The medical facts | last = Bassett | first = Jodi | authorlink=Jodi Bassett | date = Sep 2010 | website = The Hummingbirds' Foundation for M.E.|archive-url=|archive-date=|url-status=|access-date=2018-09-08}}</ref> Epidemics often occur in enclosed communities such as schools and hospitals.

As observed in many autoimmune disorders, ME is more common in females than males; the mean sex ratio is approximately 2-3 females for every male.<ref name="Bakken2014" /> In children the sex ratio is approximately equal.<ref name="Collin2015" />

== Co-morbidities ==
[[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, author at [[Chronically Hopeful]], must use sunglasses due to light sensitivity ([[photophobia]]) and noise canceling ear protection due to sound sensitivity ([[hyperacusis]])]]
{{main article|Comorbidities of Myalgic Encephalomyelitis}}
Clinicians have observed several predisposing conditions, co-morbidities, overlapping conditions, and increased risks for secondary diseases in patients with ME.<ref name="Carruthers, 2003" /><ref name="CDC-symptoms" /> However, as no large-scale [[Epidemiology of myalgic encephalomyelitis and chronic fatigue syndrome|epidemiological]] studies, genetic studies, or family studies have been done, there is little that can be said definitively about the rate or underlying biological reasons for these potentially related conditions. Overlapping [[:Category:Definitions|diagnostic criteria]] and the lack of a [[Diagnostic biomarker|biomarker]] in many of these conditions add to the confusion and diagnostic uncertainty. Moreover, certain conditions such as [[postural orthostatic tachycardia syndrome]] (POTS) and [[neurally mediated hypotension]] (NMH) and idiopathic [[intracranial hypertension]] (IIH/IH) and [[fibromyalgia]] (FM/FMS) can occur in or be co-morbid with numerous conditions, including ME.<ref name="CDC-etiology">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/etiology-pathophysiology.html | title = Etiology and Pathophysiology {{!}} Presentation and Clinical Course {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-11-08 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-02-17}}</ref><ref name="Dankaerts2018">{{Cite web|url=https://www.dovepress.com/the-link-between-idiopathic-intracranial-hypertension-fibromyalgia-and-peer-reviewed-article-JPR | title = The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of a shared pathophysiology | last = Dankaerts | first = Wim | last2 = Bruyninckx | first2 = Frans | date = 2018-12-10 | website = Journal of Pain Research|language=English|access-date=2019-02-17 | last3 = Stalmans | first3 = Ingeborg | last4 = Vansant | first4 = Greet | last5 = Rasschaert | first5 = Ricky | last6 = Hulens | first6 = Mieke}}</ref>

The following are some syndromes and diseases that have been associated with or misdiagnosed as ME:
<div style="column-count:2;">
*[[fibromyalgia]]<ref name="CDC-comorbid">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/comorbid-conditions.html | title = Comorbid Conditions {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-11-08 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-02-26}}</ref>
* [[Lyme disease]] and [[Chronic lyme disease|chronic Lyme disease]]<ref name="ICC" />
*[[Intracranial hypertension|idiopathic intracranial hypertension]]<ref name="Dankaerts2018" />
*[[Postural orthostatic tachycardia syndrome|postural orthostatic tachychardia syndrome]]<ref name="ICC" /><ref name="Hoad2008">{{Cite journal | last = Hoad | first = A. | authorlink = | last2 = Spickett | first2 = G. | authorlink2 = Gavin Spickett‎ | last3 = Elliott | first3 = J. | authorlink3 = | last4 = Newton | first4 = J. | authorlink4 = Julia Newton | date = 2008 | title = Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/18805903|journal=QJM: monthly journal of the Association of Physicians|volume=101|issue=12 | pages = 961–965|doi=10.1093/qjmed/hcn123|issn=1460-2393|pmid=18805903|quote=|via=}}</ref>
*[[irritable bowel syndrome]]<ref name="CDC-comorbid" /><ref name="Carruthers, 2003" />
*[[Hashimoto's thyroiditis (hypothyroidism)]]<ref name="CDC-differentialdiagnosis" />
*[[Ehlers-Danlos syndrome]]<ref name="CDC-differentialdiagnosis" />
*[[Sjögren's syndrome]]<ref name="CDC-differentialdiagnosis" />
*[[multiple chemical sensitivity]]<ref name="CDC-comorbid" /><ref name="ICC2011primer" />
</div>

A Swedish study of 234 ME/CFS patients meeting the [[Canadian Consensus Criteria]] found that 13.2% had tonsillar herniations severe enough to be considered a [[Chiari malformation|Chiari Malformation]]. 49% had hypermobility and 20% met criteria for hEDS (Ehlers-Danlos syndrome with hypermobility), while 96% had fibromyalgia trigger point pain, with 67% meeting the diagnostic criteria for fibromyalgia.<ref name="Bragee2020">{{Cite journal | last = Bragée | first = Björn | authorlink = Björn Bragée | last2 = Michos | first2 = Anastasios | authorlink2 = | last3 = Drum | first3 = Brandon | authorlink3 = | last4 = Fahlgren | first4 = Mikael | authorlink4 = | last5 = Szulkin | first5 = Robert | authorlink5 = | last6 = Bertilson | first6 = Bo C. | authorlink6 = | date = 2020 | title=Signs of Intracranial Hypertension, Hypermobility, and Craniocervical Obstructions in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.frontiersin.org/articles/10.3389/fneur.2020.00828/full|journal=Frontiers in Neurology|language=English|volume=11|issue=|pages=|doi=10.3389/fneur.2020.00828|issn=1664-2295|pmc=|pmid=|access-date=|quote=|via=}}</ref>

== Notable studies ==
{{Main article |page_name = Notable studies}}
Due to lack of [[funding]] by governments around the world there has been little biological research into [[ME/CFS]]. There are studies which do reveal [[Nervous system|neurological]] involvement, [[metabolic]] features, and other abnormalities.
* 2016, [[Metabolic features of chronic fatigue syndrome]]
* 2016, [[CDC Multi-site Clinical Assessment of CFS]]
* 2019, [[Evidence of widespread metabolite abnormalities in Myalgic encephalomyelitis/chronic fatigue syndrome: assessment with whole-brain magnetic resonance spectroscopy (2019) Mueller, et al|Evidence of widespread metabolite abnormalities in Myalgic encephalomyelitis/chronic fatigue syndrome: assessment with whole-brain magnetic resonance spectroscopy]]
* [[List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis]]

==News and articles==
*2015, [http://theargusreport.com/us-nih-report-calls-uk-definition-mecfs-scrapped/ US NIH Report Calls for UK Definition of ME/CFS to be Scrapped] - The Argus Report
* 2014, [[Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder - New York Times: Well (2014)|Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder]]
*2010, [http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html Chronic fatigue patients barred from blood donation] - Washington Post
*1987, [https://www.nytimes.com/1987/07/28/science/fatigue-virus-has-experts-more-baffled-and-skeptical-than-ever.html Fatigue 'Virus' Has Experts More Baffled And Skeptical Than Ever] - The New York Times

== See also ==
* [[Chronic fatigue syndrome]]
* [[Misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome]]
* [[ME/CFS]]
* [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome]]
* [[Severe and very severe ME]]
*[[Systemic Exertion Intolerance Disease]]

== Learn more ==
*[https://www.cdc.gov/me-cfs/about/index.html What is ME/CFS?] - CDC
*[https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/other-conditions.html Diagnosis - Other conditions for evaluation] - CDC
*[https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html Evaluation] - medical tests needed to rule out other illnesses from ME/CFS - CDC
*[https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x M.E. International Consensus Criteria]

== References ==
{{reflist}}

[[Category:Diagnoses]]
[[Category:Disease names]]
[[Category:Disease names and definitions]]
[[Category:Neurological diseases and disorders]]
[[Category:Multilingual pages]]

Español:Encefalomielitis-Mialgica

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La Encefalomielitis Miálgica (EM), también conocida como Síndrome de Fatiga Crónica (SFC), es frecuentemente denominada por las siglas combinadas EM/SFC, mismas que se emplearán a lo largo de este texto.

Se trata de una enfermedad crónica multisistémica de carácter '''inflamatorio''' (mediada por el sistema inmunitario), con afectaciones físicas y '''neurológicas'''. Suele desencadenarse tras una '''infección viral''', incluidas las '''enfermedades similares a la influenza.''' <ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="CDC-causes">{{Cite web|url=https://www.cdc.gov/me-cfs/about/possible-causes.html | title = Possible Causes {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> [[Onset of ME/CFS|New onset]] has been [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|observed in children]]<ref name="CDC-children">{{Cite web|url=https://www.cdc.gov/me-cfs/me-cfs-children/index.html | title = ME/CFS in Children {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> and in adults usually between the ages of 40-60.<ref name="what-is">{{Cite web|url=https://www.cdc.gov/me-cfs/about/index.html | title = What is ME/CFS? {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> La EM/SFC presenta síntomas en los '''sistemas nervioso central''' (SNC), '''nervioso autónomo''' (SNA), '''inmunitario''', '''cardiovascular''', '''endocrino''', '''digestivo''' y '''musculoesquelético'''. <ref name="ICC2011primer" /> <ref name="CDC-symptoms">{{Cite web|url=https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-05-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-11-21}}</ref>

En 1969, la '''Organización Mundial de la Salud''' (OMS) clasificó por primera vez la EM (sin la inclusión de nombres alternativos) como una '''enfermedad neurológica''', publicándola en su '''manual CIE-8''' (ICD-8, por sus siglas en inglés).<ref name="ICD-8">{{Cite book |url=https://apps.who.int/iris/bitstream/handle/10665/70934/ICD_10_1969_eng_v2a.pdf | title=Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death Based on the Recommendations of the Eighth Revision Conference | last = World Health Organization | first = | authorlink = World Health Organization|publisher=WHO| year = 1969|isbn=|editor-link=|edition=8th|volume=2|location=Geneva | page = 173|chapter=|quote=Encephalomyelitis (chronic),<br>(myalgic, benign) 323}}</ref>

La EM/SFC se ha manifestado tanto en '''casos aislados''' como en '''brotes'''.

De acuerdo con los criterios del '''Centros para el Control y Prevención de Enfermedades de EE.UU''' (CDC, por sus siglas en inglés) el síntoma distintivo de la EM/SFC es la '''exacerbación de síntomas post-esfuerzo''' (PEM/PESE, por sus siglas en inglés), que es el empeoramiento de los síntomas tras un '''esfuerzo''' mínimo ya sea físico, mental o emocional. <ref name="CDC-symptoms" /><ref name="CDC-doctors">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/index.html | title = Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Dec 27, 2021 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2022-03-28}}</ref><ref name="Friedman2021">{{Cite journal | title = Our Evolving Understanding of ME/CFS | date = Mar 2021|url=https://www.mdpi.com/1648-9144/57/3/200/htm|journal=Medicina|volume=57|issue=3|pages=200 | last = Friedman | first = Kenneth J. | authorlink = Kenneth Friedman | last2 = Murovska | first2 = Modra | authorlink2 = Modra Murovska | last3 = Pheby | first3 = Derek F.H. | authorlink3 = Derek Pheby | last4 = Zalewski | first4 = Paweł | authorlink4 = Paweł Zalewski|language=en|doi=10.3390/medicina57030200|pmc=|pmid=33652622|access-date=|issn=1648-9144|quote=|via=}}</ref><ref name="Carruthers, 2003">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://phoenixrising.me/wp-content/uploads/Canadian-definition.pdf }}</ref><ref name="Speight2013">{{Cite journal|url=https://www.sjmms.net/article.asp?issn=1658-631X;year=2013;volume=1;issue=1;spage=11;epage=13;aulast=Speight | title = Myalgic encephalomyelitis/chronic fatigue syndrome: Review of history, clinical features, and controversies | last = Speight | first = Nigel | authorlink=Nigel Speight | date = 2013|pages=11-13|doi=10.4103/1658-631x.112905|archive-url=|archive-date=|url-status=|access-date=|volume=1|issue=1|journal=Saudi J Med Med Sci}}</ref> Otros síntomas clave incluyen '''debilidad''' y '''fácil fatigabilidad muscular''', y '''trastornos del sueño''', además de '''intolerancia ortostática''' o '''disfunción cognitiva'''. La intolerancia ortostática es una disfunción del '''sistema nervioso autónomo''', que causa el empeoramiento de los síntomas al pasar de una posición supina (de espaldas) a sentarse o pararse con la espalda recta, y puede incluir '''sensación de desmayo''', '''mareo''', sensación de debilidad, '''visión borrosa''', '''taquicardia postural ortostática''' (POTS, por sus siglas en inglés), reducción nocturna de la '''variabilidad de la frecuencia cardíaca''' e '''intolerancia tanto al frío como al calor'''. Otros síntomas comunes de la EM/SFC incluyen '''dolor muscular'''; '''dolor a lo largo de un nervio''' (neuralgia), rigidez de la columna y el cuello; síntomas sensoriales como la '''sensibilidad a la luz''', el '''sonido''' y el '''tacto'''; '''hormigueo, entumecimiento''', hiperestesia (aumento de la sensibilidad ante los estímulos, incluso los de baja intensidad) y '''alodinia cutánea''' (percepción de dolor en respuesta a estímulos que normalmente no lo provocan, en este caso en la piel). Existe una forma progresiva la EM/SFC, pero es menos común que el tipo de remisión-recaída<ref name="Howes2015">{{Cite journal|url=http://www.meassociation.org.uk/wp-content/uploads/fulltext_pmr-v2-id10521.pdf | title=Progressive Myalgic Encephalomyelitis (ME) or A New Disease? A Case Report | last = Howes | first = S | authorlink = Sandra Howes | last2 = Goudsmit | first2 = EM | authorlink2 = Ellen Goudsmit | date = Jul 7, 2015 |journal=Physical Medicine and Rehabilitation - International|volume=2|issue=6|pages=1052|doi=}}</ref>

En adultos, la EM/SFC es '''más común en mujeres''' que en hombres.<ref name="CDC-causes" /> Algunos estudios muestran que suele '''aparecer por primera vez''' durante '''la infancia,''' o en adultos entre los 40 y 60 años de edad.<ref name="CDC-children">{{Cite web|url=https://www.cdc.gov/me-cfs/me-cfs-children/index.html | title = ME/CFS in Children {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref><ref name="what-is">{{Cite web|url=https://www.cdc.gov/me-cfs/about/index.html | title = What is ME/CFS? {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2019-01-18 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-04-13}}</ref> Sin embargo, '''Bakken''' y sus colegas han notado dos picos etarios para la aparición de la '''EM/SFC''': el primero entre los 10 y 19 años, y el segundo en personas de 30 a 39 años de edad.<ref name="Bakken2014">{{Cite journal | last1 = Bakken | first1 = Inger Johanne | authorlink=Inger Johanne Bakken | last2 = Tveito | first2 = Kari | last3 = Gunnes | first3 = Nina | last4 = Ghaderi | first4 = Sara | last5 = Stoltenberg | first5 = Camilla | last6 = Trogstad | first6 = Lill | last7 = Håberg | first7 = Siri Eldevik | last8 = Magnus | first8 = Per | date = 2014-10-01 | title = Two age peaks in the incidence of chronic fatigue syndrome/myalgic encephalomyelitis: a population-based registry study from Norway 2008-2012|url=https://doi.org/10.1186/s12916-014-0167-5|journal=BMC Medicine|volume=12|issue=1|pages=167|doi=10.1186/s12916-014-0167-5|issn=1741-7015|pmc=4189623|pmid=25274261}}</ref>

'''Argentina''' es el único país en el mundo con un tratamiento farmacológico aprobado para la '''EM/SFC severa'''. Se trata del inmunomodulador '''Ampligen''' (rintatolimod), aprobado el 23 de agosto del 2016.<ref name="Hemispherx">{{Cite news | title = Hemispherx Biopharma Announces Major Breakthrough: Approval for Commercial Sale of Rintatolimod (U.S. Tradename: Ampligen®) to Treat Severe Cases of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in the Argentine Republic|url=http://www.globenewswire.com/news-release/2016/08/23/866212/0/en/Hemispherx-Biopharma-Announces-Major-Breakthrough-Approval-for-Commercial-Sale-of-Rintatolimod-U-S-Tradename-Ampligen-to-Treat-Severe-Cases-of-Myalgic-Encephalomyelitis-Chronic-Fat.html|work=GlobeNewswire News Room|access-date=2018-08-12|language=en-US | first = | last = Hemispherx Biopharma, Inc | date = Aug 23, 2016|archive-url=|archive-date=|url-status=}}</ref>
[[File:Linda Crowhurst.JPG|thumb|[[Linda Crowhurst]] y su esposo, [[Greg Crowhurst]]; residen en Belfast, [[Northern Ireland|Irlanda del Norte]]. Greg es el cuidador primario de tiempo completo de Linda, quien padece una [[Severe and very severe ME|EM/SFC muy severa]]enfermedad que alcanzó 25 años de evolución en junio de 2018. Image source: [https://www.youtube.com/watch?v=Z1z5O_cgQ7I Wasteland (video)] es el título de un video que documenta de manera visual la gravedad de la enfermedad de Linda. Greg publicó en [https://www.youtube.com/watch?v=rVsOeZjhMFY YouTube un video (republicado en 2007)] donde Linda describe su condición y muestra sus síntomas '''neurológicos'''. Este material se convirtió en el primer documento visual público sobre una EM/SFC muy severa. Actualmente, Linda permanece postrada en cama, prácticamente incapaz de moverse o alimentarse por sí misma.]]

[[File:Jenny Spotlia.jpg|300px|thumb|right|[[Jennie Spotila]] es una paciente estadounidense que se enfermó de EM/SFC el 6 de octubre de 1994. A pesar de que Jennie está [[Severe and very severe ME|discapacitada, mayoritariamente postrada en cama y usa silla de ruedas,]] ha sido una gran defensora y promotora de la problemática de la [[ME/CFS|EM/SFC]] durante muchos años. Tiene un blog titulado [[Occupy M.E.]] (un juego de palabras donde la siglas en inglés de la EM, ME, pueden leerse como “yo o para mí” y que, por tanto, se traduce como “OcúpaME”). Fue miembro de la Mesa Directiva de la [[Solve ME/CFS Initiative|Asociación Americana de la CFIDS]] (síndrome de disfunción inmunológica, nombre alternativo de la EM/SFC) y testificó ante la [[Chronic Fatigue Syndrome Advisory Committee|CFSAC]] (Chronic Fatigue Syndrome Advisory Committee o Comité Consultivo del Síndrome de Fatiga Crónica).]]

= Historia =
[[File:Hillary Johnson.jpg|200px|thumb|[[Hillary Johnson]] es una periodista [[United States|estadounidense]] que escribió el libro [[Osler's Web]] (La telaraña de Osler) estando enferma. Es un relato histórico del brote de una “nueva” enfermedad con los mismos síntomas que ella padecía, que surgió en la [[1984 Incline Village chronic fatigue syndrome outbreak|Villa de Incline]]. Esta enfermedad comenzó a ser identificada bajo el nombre de [[chronic fatigue syndrome|Síndrome de Fatiga Crónica]] (SFC o CFS, por sus siglas en inglés). Johnson pasó nueve años investigando este brote, así como la total renuencia del [[Centers for Disease Control and Prevention|Centro para el Control y la Prevención de Enfermedades de los EE.UU.]] (CDC, por sus siglas en inglés) para reconocer esta devastadora enfermedad, que puede diseminarse a través del contacto casual y que provocó que los pobladores de la Villa de Incline que la padecieron fueran considerados como partícipes de un evento de [[mass hysteria|"histeria colectivaa"]]. Hillary Johnson aparece en el documental [[Forgotten Plague|La Plaga Olvidada]].]]

En 1969, la '''Organización Mundial de la Salud''' (OMS) clasificó por primera vez la EM como una '''enfermedad neurológica''', publicándola en su '''manual CIE-8''' (clasificación internacional de enfermedades-8, ICD-8, por sus siglas en inglés). <ref name="ICD-8" />

El manual '''CIE-8''' de la OMS no incluyó ningún nombre alternativo para la EM, a pesar de que la Encefalomielitis Postinfecciosa y otros tipos de Encefalomielitis se clasificaron bajo el mismo código. Los nombres alternativos relacionados con la fatiga tampoco fueron añadidos en ninguna de las actualizaciones subsecuentes. <ref name="ICD-8" /><ref name="icd10-2016">{{Cite web|url=https://icd.who.int/browse10/2016/en#/G93 | title = G93 Other diseases of the nervous system - ICD-10 Version:2016 | last = World Health Organization | first = | authorlink = World Health Organization | date = 2016 | website = World Health Organization|archive-url=|archive-date=|url-status=|access-date=2019-04-13}}</ref> El nombre alternativo de “'''Síndrome de Fatiga Crónica'''” (SFC) no se usaba en esos momentos, sino que fue propuesto en 1987 por los '''CDC''', quienes adoptaron '''nuevos criterios diagnósticos''' al año siguiente.<ref name="IOM-full">{{Cite book | last = Institute of Medicine | first = | authorlink = Institute of Medicine | date = 2015 | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness.|location = Washington, DC|publisher =The National Academies Press|doi=10.17226/19012 | url = http://iom.nationalacademies.org/Reports/2015/ME-CFS.aspx}}</ref><ref name="P2P2016" />

En el CIE-9, publicado en 1989, la EM está ligada al código 323.9<ref name="ICD-9">{{Cite book |url=https://apps.who.int/iris/bitstream/handle/10665/40492/9241540052_eng_v2_p1.pdf?sequence=3&isAllowed=y| title = Manual of the international statistical classification of diseases, injuries, and causes of death : based on the recommendations of the ninth revision conference, 1975, and adopted by the Twenty-ninth World Health Assembly, 1975 revision: alphabetic index | first = | last = World Health Organization & International Conference for the Ninth Revision of the International Classification of Diseases|publisher=World Health Organization | year = 1978|isbn=9241540044|editor-link=|edition=9th|volume=2|location=Geneva | page = 182|chapter=|quote=}}</ref>.

Artículo principal: '''Historia de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica.'''

La EM se ha manifestado tanto en casos aislados como en brotes desde al menos los años treinta, aunque es muy probable que hayan ocurrido previamente sin haber sido reconocidos formalmente. El primer '''brote de EM''' se registró en '''1934 en Los Ángeles''', cuando se pensó que era un brote de '''poliomielitis''' atípica. Después del brote de '''Akureyri''' en Islandia en 1946, se le comenzó a llamar “'''''Enfermedad de Akureyri'''''” o “Enfermedad Islandesa”, lo que continuó durante la mayor parte de los años cuarenta y cincuenta. No fue sino a partir del '''brote del Royal Free Hospital''' de Londres en 1955, que la enfermedad comenzó a llamarse Encefalomielitis Miálgica. También se utilizaron otros nombres como Encefalomielitis Miálgica benigna y '''Neuromiastenia Epidémica'''.

Después del brote de la '''Villa de Incline''' (Incline Village) en Nevada en 1984, el nombre de la enfermedad se redefinió bajo el término de '''Síndrome de Fatiga Crónica''' (SFC). El brote más reciente de EM/SFC fue causado por la '''pandemia del coronavirus SARS-CoV2 entre 2019 y 2022'''.

= Nombre de la enfermedad =
Artículo principal: '''''Los nombres de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica'''''

[[File:ES-ME-name.png|thumb|left|alt=Encefalomielitis Miálgica]]

Estas son las raíces etimológicas y el significado de los componentes del término Encefalomielitis Miálgica:

* Miálgica.- Relativo a la '''mialgia''' o dolor muscular.<ref name="Terminology">{{Cite web|url=https://www.investinme.org/Article%20010-Encephalopathy%20Hooper.shtml | title = The Terminology of ME & CFS | first = Malcolm | last = Hooper | authorlink = Malcolm Hooper}}</ref>
* Encéfalo.- Se refiere al '''cerebro'''.<ref name="Terminology" />
* -miel.- Relativo a la '''médula espinal'''.<ref name="Terminology" />
* -itis.- Significa '''inflamación'''.<ref name="Terminology" />

El término Encefalomielitis Miálgica fue utilizado por primera vez en 1956 en un artículo de la revista médica ''The Lancet'', para describir los hallazgos del brote de '''1955 del Royal Free Hospital''' de Londres, en el Reino Unido.<ref name="Terminology" /><ref name="MyalgicEncephalomyelitis-first-coines">{{Cite journal | journal = Lancet|volume=1|issue= | pages = 789–790 | date = 1956 | title = A new clinical entity?|url=https://mecfsj.files.wordpress.com/2019/05/lancet_e383a9e383b3e382bbe38383e383881956_me.pdf}}</ref><ref name="Ramsay1965">{{Cite journal | last = Ramsay | first = A. Melvin | authorlink = Melvin Ramsay | date = 1965-10-30 | title = Hysteria and “Royal Free Disease.”|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1847119/|journal=British Medical Journal|volume=2|issue=5469|pages=1062|doi=|issn=0007-1447|pmc=1847119|pmid=|access-date=|quote=|via=}}</ref> Este nombre es el resultado de la combinación de varios de los signos y síntomas clave de la enfermedad: miálgica (dolor muscular), encéfalo (cerebro), -miel (médula espinal) e -itis (inflamación), es decir, el '''sistema nervioso central''' (cerebro y médula espinal) están inflamados y hay dolor muscular.<ref name="Terminology" /><ref name="Smith1989">{{Cite book | title = Understanding M.E.: The Phenomenon of Myalgic Encephalomyelitis and Acute Onset Post Viral Fatigue Syndrome | page = 20 | last = Smith | first = David G | date = 1989}}</ref>

== Encefalomielitis Miálgica Benigna ==

Encefalomielitis Miálgica Benigna fue el término utilizado por la '''OMS''' a partir de 1969. <ref name="ICD-8" /> La connotación “benigna” se usó para denotar que la EM/SFC no es fatal, pero fue eliminada posteriormente debido a que esta enfermedad '''sí puede causar la muerte''', como en los casos de '''Merryn Crofts''' y '''Sophia Mirza'''.<ref name="Terminology" /><ref name="Vindication">{{Cite web |url=https://www.bbc.co.uk/news/health-44969741 | title = 'Vindication' for woman who wanted ME on death certificate | first = Jim | last = Taylor|publisher=BBC Radio 5 Live | date = Jul 27, 2018}}</ref><ref name="ICD-11">{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/569175314 | title = 8E49 Postviral fatigue syndrome {{!}} ICD-11 - Mortality and Morbidity Statistics | last = World Health Organization | first = | authorlink = World Health Organization | date = |website=World Health Organization|language=en|archive-url=|archive-date=|access-date=2022-03-19|quote='''8E49 Postviral fatigue syndrome'''<br />Other disorders of the nervous system<br />Inclusions<br/>chronic fatigue syndrome<br/>myalgic encephalomyelitis<br />Exclusions<br/>Fatigue (MG22)}}</ref> '''Merryn Crofts''' sufría de '''EM/SFC severa''', estaba postrada en cama y era incapaz de comer. Al momento de su muerte, Merryn tenía tan sólo 21 años y pesaba menos de 84 libras (38 Kg). Su certificado de defunción fue el segundo en el '''Reino Unido''' que atribuyó la muerte a la EM/SFC. <ref name="Vindication" />

== La enfermedad de los mil nombres ==

La EM/SFC ha sido conocida como la “enfermedad de los mil nombres”.<ref name="Bell1991">{{Cite book | last = Bell | first = David S. | authorlink = David Bell | title = Chronic Fatigue/Immune Dysfunction Syndrome. CFIDS: The disease of a thousand names|location = Lyndonville, NY|publisher=Pollard Publications | date = 1991 | url=https://books.google.com/books/about/Chronic_Fatigue_immune_Dysfunction_Syndr.html?id=QYvkugAACAAJ|archive-url=https://archive.org/details/cfidsdiseaseofth00bell|archive-date=2010-02-16}}</ref> A lo largo de la historia, se han propuesto o utilizados los siguientes: '''poliomielitis atípica''', '''Enfermedad Islandesa''', EM benigna, '''Neuromiastenia Epidémica''', '''Síndrome de Fatiga Crónica''' (SFC), '''Síndrome de la Fatiga Crónica y Disfunción Inmunitaria''' (CFIDS, por sus siglas en inglés), y '''Enfermedad de Intolerancia al Esfuerzo Sistémico''' (EIES o SEID, por sus siglas en inglés). <ref name="IOM-full" /><ref name="Bell1991" /> Esto ha provocado mucha confusión, ya que diferentes nombres se han utilizado en distintos momentos para describir tanto brotes pequeños como grandes, así como los casos esporádicos en poblaciones potencialmente más heterogéneas, utilizando una gran variedad de '''criterios diagnósticos'''. Algunos de los nombres han querido enfatizar ciertos síntomas o patologías, como es el caso del Síndrome de Fatiga Crónica y la propia Encefalomielitis Miálgica.<ref name="Terminology" />

Una encuesta realizada en 2016 por la '''Red MEAction''', encontró que la mayoría de los pacientes prefiere el nombre de Encefalomielitis Miálgica (EM), incluso sobre el de Síndrome de Fatiga Crónica (SFC).<ref>{{Cite news | url=http://www.meaction.net/2016/08/07/meaction-rfi-poll-report-1-of-3/ | title = #MEAction RFI Poll Report (Part 1 of 3) - #MEAction | date = 2016-08-07|work=#MEAction|access-date=2018-09-08|language=en-US}}</ref>

Encefalomielitis Miálgica (EM) fue el nombre original del '''Síndrome de Fatiga Crónica''' (SFC). Estos dos nombres suelen usarse de manera indistinta e intercambiable, o con el acrónimo '''EM/SFC'''. <ref name="Smith1989" />

= Aparición de la enfermedad =

Artículo principal: '''Aparición de la EM/SFC'''

De acuerdo con el Dr. Byron Hyde, tras un período de incubación de 4 a 7 días, la fase prodrómica* generalmente incluye síntomas gripales con fiebre leve.<ref name="Evans2018">{{Cite journal | last = Evans | first = Meredyth | authorlink = Meredyth Evans | last2 = Jason | first2 =Leonard | authorlink2 = Leonard Jason | date = 2018 | title = Onset patterns of chronic fatigue syndrome and myalgic encephalomyelitis|url=https://www.openaccessjournals.com/articles/Onset%20patterns%20of%20chronic%20fatigue%20syndrome%20and%20myalgic%20encephalomyelitis.pdf | journal=Research on Chronic diseases|volume=2|issue=1|pages=2-3|quote=|via=}}</ref> En la mayoría, pero no en todos los casos, es evidente la presencia de un proceso infeccioso. <ref name="Evans2018" /> La fase crónica, que comienza de 2 a 7 días después, implica un cambio difuso pero medible en la función del SNC, siendo esta persistencia la que caracteriza a la EM/SFC. <ref name="Evans2018" /><ref name="Nightingale">{{Citation | title = The Nightingale Research Foundation Definition of Myalgic Encephalomyelitis (M.E.)|pages=|language=en|title-link=Nightingale Research Foundation definition | date = 2016 | publisher=IACFS/ME | last = Hyde | first = Byron | authorlink = Byron Hyde|others=|oclc=|quote=|location=}}</ref><br />
<br />
*Etapa inicial de una enfermedad en la que aparecen síntomas inespecíficos que anuncian el comienzo de un proceso patológico, pero que aún no permiten un diagnóstico específico.

= Signos y Síntomas =

La Encefalomielitis Miálgica es una '''enfermedad neurológica''' que afecta a múltiples órganos y sistemas, causando una gran variedad de síntomas en sus diferentes combinaciones.<ref name="ICC">{{Cite journal | last = Carruthers | first = Bruce M. | authorlink = Bruce Carruthers | last2 = van de Sande | first2 = Marjorie I. | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Klimas | first4 = Nancy G. | author-link4 = Nancy Klimas | last5 = Broderick | first5 = Gordon | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = Terry | authorlink6 = Terry Mitchell | last7 = Staines | first7 = Donald | author-link7 = Donald Staines | last8 = Powles | first8 = A.C. Peter | authorlink8 = A C Peter Powles | last9 = Speight | first9 = Nigel | authorlink9 = Nigel Speight | last10 = Vallings | first10 = Rosamund | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = Lucinda | authorlink11 = Lucinda Bateman | last12 = Baumgarten-Austrheim | first12 = Barbara | authorlink12 = Barbara Baumgarten-Austrheim | last13 = Bell | first13 = David | author-link13 = David Bell | last14 = Carlo-Stella | first14 = Nicoletta | author-link14 = Nicoletta Carlo-Stella | last15 = Chia | first15 = John | author-link15 = John Chia | last16 = Darragh | first16 = Austin | author-link16 = Austin Darragh | last17 = Jo | first17 = Daehyun | author-link17 = Daehyun Jo | last18 = Lewis | first18 = Donald | author-link18 = Donald Lewis | last19 = Light | first19 = Alan | author-link19 = Alan Light | last20 = Marshall-Gradisnik | first20 = Sonya | author-link20 = Sonya Marshall-Gradisnik | last21 = Mena | first21 = Ismael | author-link21 = Ismael Mena | last22 = Mikovits | first22 = Judy | author-link22 = Judy Mikovits | last23 = Miwa | first23 = Kunihisa | author-link23 = Kunihisa Miwa | last24 = Murovska | first24 = Modra | author-link24 = Modra Murovska | last25 = Pall | first25 = Martin | author-link25 = Martin Pall | last26 = Stevens | first26 = Staci | author-link26 = Staci Stevens | date = 2011-08-22 | title=Myalgic encephalomyelitis: International Consensus Criteria|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x|journal=Journal of Internal Medicine|language=en|volume=270|issue=4|pages=327–338|doi=10.1111/j.1365q-2796.2011.02428.x|issn=0954-6820|pmc=3427890|pmid=21777306|via=}}</ref> Los síntomas varían desde leves hasta muy severos y pueden incluir:

<div style="column-count:2;">
* '''Ataxia''' (dificultades en la coordinación muscular)
* '''Disfunción cognitiva'''
* '''Fatigabilidad'''
* Síntomas '''gastrointestinales'''
* '''Dolor de cabeza'''
* '''Fiebre leve''', '''inestabilidad de la temperatura corporal'''
* '''Debilidad''' y '''fatigabilidad muscular'''<br />
* '''Mialgia''' (dolor muscular)
* Rigidez del cuello, la espalda o la '''médula espinal'''
* '''Neuralgia''' (dolor a lo largo de un nervio)
* '''Intolerancia ortostática''' (OI, por sus siglas en inglés)
* '''Exacerbación de Síntomas Post-Esfuerzo''' (PEM/PESE, por sus siglas en inglés)
* Hipersensibilidad al '''frío''' o al '''calor'''
* Hipersensibilidad a la '''luz''', al '''sonido''' o al '''tacto'''
* '''Alteraciones del sueño''' <ref name="ICC" />
</div>
[[File:ES-ME-ICC.png|alt=Encefalomielitis Mialgica es una enfermedad neurologica adquirda, que presenta disfunciones generalizadas complejas. Se caracteriza por una desregulacion patologica de los sistemas nervioso, inmunitario y endocrino, acompanada de alteraciones en el metabolismo energetico y el transporte de iones - Criterios de Consenso Internacional|thumb|upright=1.6|left]]

La presentación y '''severidad''' de los síntomas puede variar considerablemente de un día a otro, e incluso a diferentes horas a lo largo del día. <ref name="CDC-symptoms" /><ref name="Primer2014">{{Citation | date = 2014 |url=https://www.massmecfs.org/images/pdf/Primer_2014.pdf | title=Chronic Fatigue Syndrome Myalgic Encephalomyelitis Primer for Clinical Practitioners | last1 = ((International Association for Chronic Fatigue Syndrome / Myalgic Encephalomyelitis)) | author-link = International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis | last2 = Friedberg | first2 = Fred | authorlink2 = Fred Friedberg | last3 = Bateman | first3 = Lucinda | authorlink3 = Lucinda Bateman | last4 = Bested | first4 = Alison C | authorlink4 = Alison Bested | last5 = Davenport | first5 = Todd | authorlink5 = Todd Davenport | last6 = Friedman | first6 = Kenneth J | authorlink6 = Kenneth Friedman | last7 = Gurwitt | first7 = Alan R | authorlink7 = Alan Gurwitt | last8 = Jason | first8 = Leonard A | authorlink8 = Leonard Jason | last9 = Lapp | first9 = Charles W | authorlink9 = Charles Lapp | last10 = Stevens | first10 = Staci R | authorlink10 = Staci Stevens | last11 = Underhill | first11 = Rosemary A | authorlink11 = Rosemary Underhill | last12 = Vallings | first12 = Rosamund | authorlink12 = Rosamund Vallings|location=Chicago, USA|publisher= International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis |quote=The illness can vary from mild to severe, with symptoms that may fluctuate significantly from hour to hour and day to day.}}</ref> Cualquier sobreesfuerzo, por mínimo que sea, puede exacerbar todos los síntomas. La '''exacerbación de síntomas post-esfuerzo''' (PEM/PESE, por sus siglas en inglés) suele manifestarse al menos '''24 horas después''' del sobreesfuerzo. <ref name="CDC-symptoms" /> '''Los Institutos Nacionales de Salud de EE.UU.''' (National Institutes of Health, NIH, por sus siglas en inglés) señalan que la sensibilidad al ruido, a la luz y a '''compuestos químicos''' pueden obligar a los pacientes a aislarse de la sociedad.<ref name="P2P2016">{{Cite web|url=https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs | title = ME/CFS - Pathways to Prevention - Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | last = | first = | date = Dec 8, 2016 | website = [[National Institutes of Health]]|access-date=2022-03-28|quote=Effects of the illness can range from moderate to debilitating, and can substantially impact everyday functioning. Routine daily activities such as cooking meals, brushing teeth, and caring for children become difficult. Additionally, sensitivity to environmental factors (e.g., noise, light, chemicals) may force many individuals with ME/CFS into seclusion or withdrawal from society.|archive-url=|archive-date=|url-status=|language=en}}</ref>

== Exacerbación de Síntomas Post-Esfuerzo ==

'''Artículo principal:''' '''''Exacerbación de Síntomas Post-Esfuerzo.'''''

El síntoma central de la EM/SFC es la '''Exacerbación de Síntomas Post-Esfuerzo''' (PEM/PESE por sus siglas en inglés). El PEM se define como la intolerancia a esfuerzos mentales o físicos que solían ser triviales, como asistir a un evento en la escuela de los hijos; hacer un mandado o la compra; darse un baño o lavarse los dientes. Estos sobreesfuerzos, que provocan un empeoramiento de los síntomas, pueden generar un deterioro en la salud cuando se realizan de manera persistente o repetida. <ref name="ICC2011primer" /><ref name="CDC-symptoms" />

Algunos estudios muestran que los pacientes que han estado enfermos por más tiempo son más propensos a desarrollar una forma '''más severa de EM/SFC'''. Esto ocurre cuando los pacientes intentan '''sobreponerse a sus síntomas''' excediendo constantemente sus '''límites''' físicos y cognitivos, por ejemplo, al intentar mantener un empleo, lo que comúnmente implica realizar actividad '''anaeróbica'''.<ref name="Vink2015LA">{{Cite journal | last = Vink | first = Mark | date = 2015-09-10 | title = The Aerobic Energy Production and the Lactic Acid Excretion are both Impeded in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.researchgate.net/publication/282133390_The_Aerobic_Energy_Production_and_the_Lactic_Acid_Excretion_are_both_Impeded_in_Myalgic_EncephalomyelitisChronic_Fatigue_Syndrome|journal=Journal of Neurology and Neurobiology (ISSN 2379-7150)|volume=1|doi=10.16966/2379-7150.112}}</ref><ref name="Vink2019">{{Cite journal | last = Vink | last2 = Vink-Niese | date = 2019-09-20 | title = Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies|url=https://www.mdpi.com/2075-4418/9/4/124|journal=Diagnostics|language=en|volume=9|issue=4|pages=124|doi=10.3390/diagnostics9040124|issn=2075-4418 | first = Mark | first2 = Alexandra|pmc=|pmid= | author-link = Mark Vink | authorlink2 = Alexandra Vink-Niese|access-date=|quote=People with ME/CFS often feel under pressure to continue working when they first become ill or when their symptoms worsen. Unfortunately, trying to push through this illness is counterproductive, potentially causing longer sickness absences and slower recovery.}}</ref>

= Hallazgos en estudios clínicos =

'''Artículo principal''': '''''Lista de las anormalidades detectadas en el Síndrome de Fatiga Crónica y la Encefalomielitis Miálgica.'''''

A pesar de la carencia de biomarcadores específicos para la EM/SFC, diversos signos y síntomas han sido detectados con frecuencia en los estudios clínicos:

<ul>
<li>Títulos elevados de '''anticuerpos''' específicos contra ciertos virus, incluidos el virus del Epstein Barr, el herpes humano 6 ('''EBV''' y '''HHV-6''', respectivamente, por sus siglas en inglés) y el '''Coxsackie B'''. <ref>{{Cite journal | last = Schmaling | first = K.B. | last2 = Jones | first2 = J.F. | date = Jan 1996 | title = MMPI profiles of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/8730646|journal=Journal of Psychosomatic Research|volume=40|issue=1 | pages = 67–74|issn=0022-3999|pmid=8730646}}</ref><ref name="Cuende1997">{{cite journal| vauthors=Cuende JI, Civeira P, Diez N, Prieto J| title=[High prevalence without reactivation of herpes virus 6 in subjects with chronic fatigue syndrome]. | journal=An Med Interna | year= 1997 | volume= 14 | issue= 9 | pages = 441-4 | pmid=9453750 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/pubmed/9453750}}</ref><ref name="Komaroff2006">{{cite journal | last=Komaroff | first = AL | authorlink = Anthony Komaroff | title=Is human herpesvirus-6 a trigger for chronic fatigue syndrome? | journal=J Clin Virol | year= 2006 | volume= 37 | issue= Suppl 1 | pages = S39-46 | pmid=17276367 | doi=10.1016/S1386-6532(06)70010-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/pubmed/17276367}}</ref><ref>{{Cite journal | last = Landay | first = AL | date = September 1991 | title = Chronic fatigue syndrome: clinical condition associated with immune activation | url =https://www.ncbi.nlm.nih.gov/pubmed/1679864|journal=Lancet|volume=|pages=|via=}}</ref><ref name="Chia2005">{{Cite journal | last = Chia | first = John | date = November 2005 | title = The role of enterovirus in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1770761/|journal=Journal of Clinical Pathology|volume=|pages=|via=}}</ref></li>
<li>Desequilibrio '''hormonal'''.<ref name="Ruiz-Núñez, 2018">{{Cite journal | last1 = Ruiz-Núñez | first1 = Begoña | authorlink1 = | last2 = Tarasse | first2 = Rabab | authorlink2 = | last3 = Vogelaar | first3 = Emar F. | authorlink3 = | last4 = Janneke Dijck-Brouwer | first4 = D.A. | authorlink4 = | last5 =Muskiet | first5 = Frits A. J. | authorlink5 = | title = Higher Prevalence of “Low T3 Syndrome” in Patients With Chronic Fatigue Syndrome: A Case–Control Study | url = https://doi.org/10.3389%2Ffendo.2018.00097 | journal = Frontiers in Endocrinology | volume = 9 | issue = | page = 97 | date = 2018 | pmid = 29615976 | doi = 10.3389/fendo.2018.00097}}</ref></li>
<li>'''Anormalidades inmunitarias'''. <ref name="ICC" /><ref name="Brenu2014">{{Cite journal | last = Brenu | first = Ekua Weba | last2 = Huth | first2 = Teilah K. | last3 = Hardcastle | first3 = Sharni L. | last4 = Fuller | first4 = Kirsty | last5 = Kaur | first5 = Manprit | last6 = Johnston | first6 = Samantha | last7 = Ramos | first7 = Sandra B. | last8 = Staines | first8 = Don R. | last9 = Marshall-Gradisnik | first9 = Sonya M. | date = Apr 2014 | title = Role of adaptive and innate immune cells in chronic fatigue syndrome/myalgic encephalomyelitis|url=http://www.ncbi.nlm.nih.gov/pubmed/24343819|journal=International Immunology|volume=26|issue=4|pages=233–242|doi=10.1093/intimm/dxt068|issn=1460-2377|pmid=24343819}}</ref><ref name="CDC-etiology">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/etiology-pathophysiology.html | title = Etiology and Pathophysiology {{!}} Presentation and Clinical Course {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-11-08 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-02-17}}</ref></li>
<li>'''Disminución en la función de las células asesinas naturales''' (células NK, por sus siglas en inglés). <ref name="Brenu2014" /></li>
<li>Bajas concentraciones de '''magnesio''' en glóbulos rojos.<ref name="Cox1991">{{Cite journal | title = Red blood cell magnesium and chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/1672392|journal=Lancet (London, England) | date = 1991-03-30|issn=0140-6736|pmid=1672392 | pages = 757–760|volume=337|issue=8744 | first = I.M. | last=Cox | first2 = M.J. | last2 = Campbell | first3 = D. | last3 = Dowson}}</ref></li>
<li>'''Taquicardia Postural Ortostática''' (POTS, por sus siglas en inglés). <ref name="ICC2011primer" /><ref>{{Cite web|url=https://ammes.org/overlapping-conditions/ | title = Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}</ref></li>
<li>Recaídas tras esfuerzo físico, mental o estimulación sensorial, conocidas como '''Exacerbación de Síntomas Post-Esfuerzo''' (PEM/PESE, por sus siglas en inglés). <ref name="ICC2011primer" /><ref name="CDC-symptoms" /><ref name="Arroll2014">{{Cite journal | last = Arroll | first = Megan A. | authorlink = Megan Arroll | last2 = Attree | first2 = Elizabeth A. | last3 = O'Leary | first3 = John M. | last4 = Dancey | first4 = Christine P. | date = 2014-04-03 | title = The delayed fatigue effect in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)|url=https://www.tandfonline.com/doi/abs/10.1080/21641846.2014.892755|journal = Fatigue: Biomedicine, Health & Behavior |language=en|volume=2|issue=2 | pages = 57–63|doi=10.1080/21641846.2014.892755|issn=2164-1846}}</ref></li></ul>

= Diagnóstico =

'''Artículo principal''': '''''Definiciones de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica.'''''

Se han propuesto varias guías diagnósticas para la EM/SFC, incluyendo los '''Criterios de Consenso Internacional''' y los '''Criterios Canadienses de Consenso''' (ICC y CCC, respectivamente, por sus siglas en inglés). Los criterios originales desarrollados por '''Melvin Ramsay''', conocidos como la '''definición de Ramsay''', ya no se utilizan para diagnosticar la EM/SFC.

== Criterios comúnmente aceptados para el diagnóstico de la Encefalomielitis Miálgica/Síndrome de Fatiga Crónica (EM/SFC) y la Encefalomielitis Miálgica (EM) ==

<ol style="list-style-type: decimal;">
<li>Los '''Criterios Canadienses de Consenso''' (CCC, por sus siglas en inglés) permiten el diagnóstico preciso de presentaciones moderadas y severas de '''EM/SFC'''. <ref name="Carruthers, 2003" /> Los adultos y pacientes pediátricos pueden ser diagnosticados tras padecer la enfermedad durante un mínimo de 6 y 3 meses, respectivamente.</li>
<li>Los '''Criterios de Consenso Internacional''' (ICC, por sus siglas en inglés) permiten el diagnóstico preciso de la EM. A diferencia de los criterios de '''Fukuda''', '''SEID''' y CCC, que requieren que los pacientes experimenten síntomas durante al menos 6 meses, los ICC no exigen tiempo mínimo alguno. <ref name="ICC" /><ref name="ICC2011primer" /> Estos criterios eliminan el uso del término SFC, considerándolo una fuente constante de confusión que pone un énfasis inadecuado en este síntoma.</li>
<li>La '''Enfermedad de Intolerancia al Esfuerzo Sistémico''' (EIES o SEID, por sus siglas en inglés) permite el diagnóstico preciso siempre que el mínimo de los síntomas centrales estén presentes. '''El reporte del Instituto de Medicina''' constituye una revisión exhaustiva de la literatura médica disponible sobre la EM/SFC al momento de su publicación en 2015. Los adultos y pacientes pediátricos pueden ser diagnosticados tras padecer la enfermedad durante un mínimo de 6 y 3 meses, respectivamente.</li></ol>

== Otros criterios diagnósticos ==

Una gran variedad de criterios, demasiado amplios, sigue utilizándose. Es muy probable que estos se basen en la caracterización de reportes médicos escritos durante los '''brotes de EM/SFC''', lo que provoca que, además de diagnosticar a algunos pacientes con EM/SFC, excluyan a muchos otros e incluyan de manera inespecífica a personas cuyos padecimientos aún no han sido diagnosticados adecuadamente, como cáncer, depresión y diversas enfermedades autoinmunes. '''Los criterios del Síndrome de Fatiga Crónica (SFC) de Oxford''', Reino Unido, han sido retirados por ser los más amplios y con la definición menos estricta, lo que representa un riesgo significativo de '''diagnosticar erróneamente''' muchas condiciones que causan fatiga como si fueran '''SFC'''. <ref name="P2PPreview2015">{{Cite journal | last = Haney | first = Elizabeth | last2 = Smith | first2 = M.E. Beth | last3 = McDonagh | first3 = Marian | last4 = Pappas | first4 = Miranda | last5 = Daeges | first5 = Monica | last6 = Wasson | first6 = Ngoc | last7 = Nelson | first7 = Heidi D. | date = Jun 16, 2015 | title = Diagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop | url = http://annals.org/article.aspx?doi=10.7326/M15-0443|journal=Annals of Internal Medicine|language=en|volume=162|issue=12 | pages = 834|doi=10.7326/m15-0443|issn=0003-4819|via=}}</ref>

Los '''Criterios de Fukuda''', desarrollados por los '''CDC''' y utilizados desde 1994, también son demasiado amplios. El reporte del Instituto de Medicina propuso los Criterios de la '''Enfermedad de Intolerancia al Esfuerzo Sistémico''' (EIES o SEID, por sus siglas en inglés), que, aunque permiten un diagnóstico basado en el '''mínimo de los síntomas centrales''', no abarcan la amplia variedad de síntomas que experimentan las personas con EM/SFC. Estos criterios excluyen síntomas '''neurológicos''', así como disfunciones '''inmunitarias''', '''gastrointestinales''', genitourinarias y del '''metabolismo energético''' o '''transporte de iones''', considerados '''esenciales para el diagnóstico''' según los '''ICC'''. <ref name="ICC" /><ref name="IOM-flowchart">{{Cite web|url=http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2015/MECFS/MECFS_DiagnosticAlgorithm | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness - Diagnostic Algorithm | last = | first = | authorlink = | date = 2015 | website = nationalacademies.org|archive-url=|archive-date=|url-status=|access-date=}}</ref><ref name="IOM-clinicians">{{Cite web|url=http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/MECFS/MECFScliniciansguide.pdf | title=Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome - Redefining an Illness: Clinicians' Guide | last = | first = | date = 2015 | website = National Academies|archive-url=|archive-date=|url-status=|access-date=}}</ref>

Por otro lado, el cumplimiento de los '''CCC''' requiere que los pacientes presenten síntomas neurológicos, '''autonómicos''', neuroendocrinos, inmunitarios y '''mialgia''' (dolor muscular) para ser '''diagnosticados con EM/SFC'''. <ref name="Carruthers, 2003" />

== Diagnóstico diferencial ==

Los signos y síntomas de la EM/SFC pueden parecerse a los de otros padecimientos médicos, como el cáncer, la '''esclerosis múltiple''', el '''lupus''', la '''tiroiditis de Hashimoto (hipotiroidismo)''', la '''diabetes mellitus''', la '''brucelosis''' y la '''anemia'''. <ref name="Carruthers, 2003" /><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 and Prevention]]|language=en-us|access-date=2022-03-28}}</ref> La diferenciación requiere estudios médicos estandarizados y, en ocasiones, pruebas clínicas adicionales. <ref name="IOM-clinicians" /><ref name="CDC-differentialdiagnosis" /><ref name="CDC-medicaltests">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html | title = Evaluation {{!}} Information for Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = Apr 28, 2021 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2022-04-01}}</ref>

= Curso y pronóstico =

'''Artículo principal''': '''''Pronóstico de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica.'''''

La EM/SFC tiene un '''pronóstico''' desfavorable, con solo una pequeña minoría, cuya media estimada es del 5%, que logra recuperarse y alcanzar los niveles funcionales previos a la enfermedad.<ref name="Cairns2005">{{Cite journal | last = Cairns | first = R. | last2 = Hotopf | first2 = M. | date = Jan 2005 | title = A systematic review describing the prognosis of chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/15699087|journal=Occupational Medicine (Oxford, England)|volume=55|issue=1|pages=20–31|doi=10.1093/occmed/kqi013|issn=0962-7480|pmid=15699087}}</ref> La mayoría de los pacientes mantiene una disfunción significativa. Sin embargo, se observa una mejoría sustancial en aproximadamente el 40% de los pacientes adultos, siendo aún más prometedora en los '''adolescentes'''.<ref name="Joyce1997">{{Cite journal | last= Joyce | first = J. | last2 = Hotopf | first2 = M. | last3 = Wessely | first3 = S. | date = Mar 1997 | title = The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review | url =https://www.ncbi.nlm.nih.gov/pubmed/9093600|journal=QJM: monthly journal of the Association of Physicians|volume=90|issue=3|pages=223–233|issn=1460-2725|pmid=9093600|doi=|pmc=|quote= | authorlink2 = Matthew Hotopf|access-date= | authorlink3 = Simon Wessely|via=}}</ref><ref name="CDC-prognosis">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/presentation-clinical-course/prognosis.html | title = Prognosis {{!}} Presentation and Clinical Course {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-07-10 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-10-28}}</ref><ref name="Rowe2017>{{Cite journal | last = Rowe | first = Peter C. | last2 = Underhill | first2 = Rosemary A. | last3 = Friedman | first3 = Kenneth J. | last4 = Gurwitt | first4 = Alan | last5 = Medow | first5 = Marvin S. | last6 = Schwartz | first6 = Malcolm S. | last7 = Speight | first7 = Nigel | last8 = Stewart | first8 = Julian M. | last9 = Vallings | first9 = Rosamund | date = 2017 | title=Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer |url =https://www.frontiersin.org/articles/10.3389/fped.2017.00121/full|journal=Frontiers in Pediatrics|language=English|volume=5|doi=10.3389/fped.2017.00121|issn=2296-2360}}</ref>

= Patofisiología =

'''Artículo principal''': '''''Lista de las anormalidades detectadas en el Síndrome de Fatiga Crónica y la Encefalomielitis Miálgica.'''''

La EM/SFC es una enfermedad multisistémica. Se han detectado numerosas anormalidades biológicas en diversos sistemas del organismo. Sin embargo, aún no se ha identificado una causa o mecanismo central que explique todas estas afectaciones.

== Sistema Nervioso Central (SNC) ==

'''Artículo principal''': '''''Sistema Nervioso Central'''''

== Sistema Nervioso Autónomo (SNA) ==

'''Artículo principal''': '''''Sistema Nervioso Autónomo'''''

== Sistema cardiovascular ==

'''Artículo principal''': '''''Sistema cardiovascular'''''

== Sistema gastrointestinal ==

'''Artículo principal''': '''''Sistema gastrointestinal'''''

== Sistema inmunitario ==

'''Artículo principal''': '''''Sistema inmunitario'''''

== Sistema musculoesquelético ==

'''Artículo principal''': '''''Sistema musculoesquelético'''''

== Sistema Nervioso Periférico (SNP) ==

'''Artículo principal''': '''''Sistema Nervioso Periférico'''''

= Diferencias por sexo =

'''Artículo principal''': '''''Diferencias por sexo en la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica'''''

Un estudio noruego muestra que la '''EM/SFC''' es más común entre las mujeres, afectando a personas de todas las edades, con dos grupos mayoritarios: de 10 a 19 años y de 30 a 39 años. <ref name="Bakken2014" /> Las investigaciones de la '''Open Medical Foundation''', reportadas en su artículo '''''Metabolic Features of Chronic Fatigue Syndrome''''' ''(Las características metabólicas del Síndrome de Fatiga Crónica''), donde se estudiaron pacientes con '''SFC''' severo, indican que la enfermedad difiere entre hombres y mujeres, pero esta diferencia no depende de la testosterona ni de los estrógenos. '''Michael VanElzakker''' señala que existen '''diferencias entre hombres y mujeres en relación con el dolor neuropático'''. Un estudio con cohortes del Reino Unido y Dinamarca encontró que “los niños más jóvenes presentan menos diferencias entre los dos sexos en comparación con adolescentes y adultos”.<ref name="Collin2015">{{Cite journal | last = Collin | first = Simon M. | last2 = Nuevo | first2 = Roberto | last3 = van de Putte | first3 = Elise M. | last4 = Nijhof | first4 = Sanne L. | last5 = Crawley | first5 = Esther | date = 2015-10-28 | title = Chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is different in children compared to in adults: a study of UK and Dutch clinical cohorts|url=https://www.ncbi.nlm.nih.gov/pubmed/26510728|journal=BMJ open|volume=5|issue=10| pages = e008830|doi=10.1136/bmjopen-2015-008830|issn=2044-6055|pmid=26510728|via=}}</ref>
= Factores de riesgo y posibles causas =

'''Artículo principal''': '''''Epidemiología de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica'''''

== Riesgos genéticos ==

Se ha reportado que la EM/SFC puede presentarse en varios miembros de una misma familia. Aunque no se considera una enfermedad hereditaria, existe evidencia que sugiere una predisposición genética.<ref name="Schlauch, 2016">{{Cite journal | last1 = Schlauch | first1 = Karen A. | authorlink1 = Karen Schlauch | last2 = Khaiboullina | first2 = Svetlana F. | authorlink2 = Svetlana Khaiboullina | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny de Meirleir | last4 = Rawat | first4 = Shanti | authorlink4 = Shanti Rawat | last5 = Petereit | first5 = J | authorlink5 = | last6 = Rizvanov | first6 = Albert A | authorlink6 = Albert Rizvanov | last7 = Blatt | first7 = Nataliya | authorlink7 = Nataliya Blatt | last8 = Mijatovic | first8 = Tatjana | authorlink8 = Tatjana Mijatovic | last9 = Kulick | first9 = D | authorlink9 = | last10 = Palotás | first10 = András | authorlink10 = András Palotás | last11 = Lombardi | first11 = Vincent C. | authorlink11 = Vincent Lombardi | title = Genome-wide association analysis identifies genetic variations in subjects with myalgic encephalomyelitis/chronic fatigue syndrome | journal = Translational Psychiatry | volume = 6 | issue = 2 | page = e730 | date = 2016 | pmid = | doi = 10.1038/tp.2015.208 }}</ref><ref name="Dibble2020">{{Cite journal | title = Genetic risk factors of ME/CFS: a critical review | date = 2020-08-03|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530519/|journal=Human Molecular Genetics|volume=29|issue=R1|pages=R117–R124 | last = Dibble | first = Joshua J | author-link = | last2 = McGrath | first2 = Simon J | authorlink2 = Simon McGrath | last3 = Ponting | first3 = Chris P | authorlink3 = Chris Ponting|doi=10.1093/hmg/ddaa169|pmc=7530519|pmid=32744306|access-date=|issn=0964-6906|quote=|via=}}</ref><ref name="Hajdarevic2022">{{Cite journal | title = Genetic association study in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) identifies several potential risk loci | date = 2022-05-01|url=https://www.sciencedirect.com/science/article/pii/S0889159122000782|journal=Brain, Behavior, and Immunity|volume=102|issue=|pages=362–369 | last = Hajdarevic | first = Riad | authorlink = Riad Hajdarevic | last2 = Lande | first2 = Asgeir | authorlink2 = Asgeir Lande | last3 = Mehlsen | first3 = Jesper | authorlink3 = | last4 = Rydland | first4 = Anne | authorlink4 = | last5 = Sosa | first5 = Daisy D. | authorlink5 = | last6 = Strand | first6 = Elin B. | authorlink6 = Elin Strand | last7 = Mella | first7 = Olav | authorlink7 = Olav Mella | last8 = Pociot | first8 = Flemming | last9 = Fluge | first9 = Øystein | authorlink9 = Øystein Fluge | last10 = Lie | first10 = Benedicte A. | last11 = Viken | first11 = Marte K.|language=en|doi=10.1016/j.bbi.2022.03.010|pmc=|pmid=|access-date=|issn=0889-1591|quote=|via=}}</ref>

'''Artículo principal''': '''''Genética del Síndrome de Fatiga Crónica'''''

== Posibles Causas ==

A pesar de que se han identificado algunos factores de riesgo de la EM/SFC, no se ha encontrado una infección '''viral común y definitiva''' en todos los casos. Esto ha llevado a considerar que la EM/SFC podría ser una consecuencia compartida de diversas amenazas infecciosas.<ref name="Rasa2018">{{Cite journal | last = Rasa | first = Santa | authorlink = Santa Rasa | last2 = Nora-Krukle | first2 = Zaiga | authorlink2 = Zaiga Nora-Krukle | last3 = Henning | first3 = Nina | authorlink3 = | last4 = Eliassen | first4 = Eva | authorlink4 = | last5 = Shikova | first5 = Evelina | authorlink5 = Evelina Shikova | last6 = Harrer | first6 = Thomas | authorlink6 = Thomas Harrer | last7 = Scheibenbogen | first7 = Carmen | authorlink7 = Carmen Scheibenbogen | last8 = Murovska | first8 = Modra | authorlink8 = Modra Murovska | last9 = Prusty | first9 = Bhupesh K. | authorlink9 = Bhupesh Prusty | last10 = European Network on ME/CFS (EUROMENE) | first10 = | authorlink10 = EUROMENE | date = 2018-10-01 | title = Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)|url=https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-018-1644-y|journal=Journal of Translational Medicine|language=en|volume=16|issue=1|pages=|doi=10.1186/s12967-018-1644-y|issn=1479-5876|pmc=|pmid=30285773|quote=|via=}}</ref><ref name="Magnus2015">{{Cite journal | last = Magnus | first = Per | last2 = Gunnes | first2 = Nina | last3 = Tveito | first3 = Kari | last4 = Bakken | first4 = Inger Johanne | last5 = Ghaderi | first5 = Sara | last6 = Stoltenberg | first6 = Camilla | last7 = Hornig | first7 = Mady | last8 = Lipkin | first8 = W. Ian | last9 = Trogstad | first9 = Lill | date = 2015-11-17 | title = Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is associated with pandemic influenza infection, but not with an adjuvanted pandemic influenza vaccine|url=https://www.ncbi.nlm.nih.gov/pubmed/26475444/|journal=Vaccine|volume=33|issue=46 | pages = 6173–6177|doi=10.1016/j.vaccine.2015.10.018|issn=1873-2518|pmid=26475444}}</ref> Es posible que la enfermedad implique una combinación de factores ambientales y genéticos. Algunas teorías han intentado integrar la evidencia existente para ofrecer una explicación coherente. <ref name="Schlauch, 2016" /><ref>{{Cite journal | last = Underhill | first = R.A. | date = 2015 | title=Myalgic encephalomyelitis, chronic fatigue syndrome: An infectious disease|url=https://www.ncbi.nlm.nih.gov/pubmed/26604026|journal=Medical Hypotheses|volume=85|issue=6 | pages = 765–773|doi=10.1016/j.mehy.2015.10.011|issn=1532-2777|pmid=26604026|via=}}</ref>

Varias hipótesis sugieren que la EM/SFC es el resultado de una respuesta inmunitaria inadecuada frente a una infección, lo que se respalda en aquellos casos con antecedentes familiares de '''enfermedades autoinmunes'''. [<ref name="Sotzny, 2018">{{Cite journal | last1 = Sotzny | first1 = Franziska | authorlink1 = Franziska Sotzny | last2 = Blanco | first2 = Julià | authorlink2 = Julià Blanco | last3 = Capelli | first3 = Enrica | authorlink3 = Enrica Capelli | last4 = Castro-Marrero | first4 = Jesús | authorlink4 = Jesús Castro-Marrero | last5 =Steiner | first5 = Sophie | authorlink5 = | last6 = Murovska | first6 = Modra | authorlink6 = Modra Murovska | last7 = Scheibenbogen | first7 = Carmen | authorlink7 = Carmen Scheibenbogen| title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome – Evidence for an autoimmune disease | url = https://www.sciencedirect.com/science/article/pii/S1568997218300880 | journal = Autoimmunity Reviews | volume = 17 | issue = 6 | page = 601-609 | date = 2018 | pmid = | doi = 10.1016/j.autrev.2018.01.009}}</ref><ref>{{Cite web|url=https://www.facebook.com/permalink.php?story_fbid=564532390371988&id=564526123705948 | title = Klimas ME CFS Genes Study | last = | first = | date = Nov 23, 2015 | website = facebook.com|language=en|archive-url=|archive-date=|url-status=|access-date=2018-09-08}}</ref> También se ha observado una diferenciación preferencial de las '''células T''' cooperadoras del sistema inmunitario hacia el '''fenotipo Th2''', que es más activo en casos de '''alergias''' y tiene una mayor propensión a atacar al propio organismo, en lugar del '''fenotipo Th1''', encargado de la defensa contra infecciones y más adecuado para combatir infecciones virales.<ref>{{Cite journal | date = 2015-03-01 | title = Cytokine expression provides clues to the pathophysiology of Gulf War illness and myalgic encephalomyelitis|url=https://www.sciencedirect.com/science/article/abs/pii/S1043466614006024|journal=Cytokine|language=en|volume=72|issue=1|pages=1–8|doi=10.1016/j.cyto.2014.11.019|issn=1043-4666}}</ref><ref name="Hardcastle2014">{{Cite journal|url=http://www.m-hikari.com/bmgt/bmgt2014/bmgt1-4-2014/hardcastleBMGT1-4-2014.pdf | title=Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and the Potential Role of T Cells | last = Hardcastle | first = S.L. | last2 = Brenu | first2 = E.W. | last3 = Staines | first3 = D.R. | authorlink3 = Donald Staines | last4 = Marshall-Gradisnik | first4 = S. | authorlink4 = Sonya Marshall-Gradisnik| date = 2014 |journal=Biological Markers and Guided Therapy|volume=1|issue=1=|pages=25|doi=10.12988/bmgt.2014.3122}}</ref>

== Infecciones virales ==

'''Artículo principal''': '''''Infecciones virales<br />
'''''

Otras teorías describen a la EM/SFC como una respuesta inmunitaria a una infección crónica. La asociación entre la enfermedad y los '''virus Coxsackie B''' y del herpes humano 6 y 7 ('''HHV-6''' y '''HHV-7''', por sus siglas en inglés) sugiere una posible contribución viral al menos en ciertos casos.<ref>{{Cite journal | last = Bell | first = E.J. | last2 = McCartney | first2 = R.A. | last3 = Riding | first3 = M.H. | date = 1988 | title = Coxsackie B viruses and myalgic encephalomyelitis|url=https://www.ncbi.nlm.nih.gov/pubmed/2841461|journal=Journal of the Royal Society of Medicine|volume=81|issue=6|pages=329–331|doi=10.1177/014107688808100609|issn=0141-0768|pmid=2841461|via=}}</ref><ref>{{Cite news | url=http://solvecfs.org/ramsay-research-team-5-the-potential-role-of-hhv-6-in-mecfs/ | title = Ramsay Research Team 5 – The Potential Role of HHV-6 in ME/CFS - Solve ME/CFS Initiative | last = | first = | date = 2016-12-16|work=Solve ME/CFS Initiative|access-date=2018-09-08|archive-url=|archive-date=|url-status=|publisher=VOLKMEDIA|language=en-US}}</ref><ref name="Chapenko2012">{{Cite journal | last = Chapenko | first = Svetlana | last2 = Krumina | first2 = Angelika | last3 = Logina | first3 = Inara | last4 = Rasa | first4 = Santa | last5 = Chistjakovs | first5 = Maksims | last6 = Sultanova | first6 = Alina | last7 = Viksna | first7 = Ludmila | last8 = Murovska | first8 = Modra | date = 2012 | title = Association of active human herpesvirus-6, -7 and parvovirus b19 infection with clinical outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/22927850|journal=Advances in Virology|volume=|pages=205085|doi=10.1155/2012/205085|issn=1687-8647|pmid=22927850|via=}}</ref> Algunos investigadores afirman que la evidencia claramente sugiere el involucramiento de un enterovirus; sin embargo, en la mayoría de los '''brotes de EM/SFC''', no se ha logrado aislar ningún virus específico. <ref name="Chia2005" /><ref name="Hanson2021">{{Cite journal | title = The Enterovirus Theory of Disease Etiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Critical Review | date = 2021 | url=https://www.frontiersin.org/article/10.3389/fmed.2021.688486|journal=Frontiers in Medicine|volume=8|issue= | pages = 688486 | last = O'Neal | first = Adam J. | authorlink = | last2 = Hanson | first2 = Maureen R. | authorlink2 = Maureen Hanson|doi=10.3389/fmed.2021.688486/abstract|pmc=|pmid=|access-date=|issn=2296-858X|quote=|via=}}</ref>

== Infecciones bacterianas ==

'''Artículo principal''': '''''Infecciones bacterianas'''''

Algunos investigadores plantean que la EM/SFC podría ser el resultado de una infección crónica causada por una bacteria de la familia de las espiroquetas, como ocurre en la '''enfermedad de Lyme'''. Otra bacteria implicada en el desarrollo de la EM/SFC es '''Chlamydia pneumoniae'''.<ref name="Tovey2018">{{Cite journal | date = 2018-09-05 | last = Tovey | first = JE | title = Chlamydia pneumoniae infection a treatable cause of Chronic Fatigue Syndrome|url=https://www.bmj.com/rapid-response/2011/11/01/chlamydia-pneumoniae-infection-treatable-cause-chronic-fatigue-syndrome|journal=The BMJ|language=en|volume=|pages=|via=}}</ref><ref>{{Cite news | url=https://www.prohealth.com/library/new-me-cfs-study-at-stanford-dr-montoya-to-test-for-scores-of-infections-27346 | title = New ME/CFS Study at Stanford: Dr. Montoya to test for scores of Infections - Prohealth | date = 2010-06-04|work=Prohealth|access-date=2018-09-08|language=en-US}}</ref> Además, en muestras biológicas de pacientes con EM/SFC, se han identificado bandas oligoclonales correspondientes a anticuerpos específicos contra las proteínas de ciertas bacterias.<ref name="Nicholson2009">{{Cite journal|url=http://www.bjmp.org/content/role-chronic-bacterial-and-viral-infections-neurodegenerative-neurobehavioral-psychiatric-au | title = Role of Chronic Bacterial and Viral Infections in Neurodegenerative, Neurobehavioral, Psychiatric, Autoimmune and Fatiguing Illnesses: Part 1 | first = Garth L. | last=Nicolson | first2 = Jörg | last2 = Haier | date = 2009|journal=British Journal of Medical Practitioners|volume=2|issue=4|pages = 20-28|doi=|pmid=}}</ref>

La '''hipótesis de la infección del nervio vago''' (VNIH, por sus siglas en inglés) propone una explicación de cómo una variedad de infecciones podría ser responsable de la aparición de la EM/SFC. El '''nervio vago''' se extiende desde el tronco encefálico a lo largo de todo el cuerpo, afectando múltiples sistemas del organismo, haciéndolo propenso para la detección y consecuente infección a partir de cualquiera de ellos. [Añadir referencia(s)]

== Transmisión sanguínea ==

'''Artículo principal''': '''''Donación de sangre'''''

Debido a la incertidumbre sobre la causa de la EM/SFC, a los pacientes se les prohíbe donar sangre y órganos en el '''Reino Unido''' (incluso después de su recuperación), en gran parte de '''Canadá''', '''Australia''', '''Nueva Zelanda''' (mientras persistan los síntomas), y por un tiempo determinado en los '''EE.UU.''' <ref name="BloodUK">{{Cite web | url = https://my.blood.co.uk/KnowledgeBase | title = Knowledgebase|website=My Donor Record - Health, Eligibility & Travel | last = | first = | authorlink = |archive-url=|archive-date=|url-status=|access-date=2021-10-08}}</ref><ref name="Wilson2014">{{Cite journal | title = The Use of Preliminary Scientific Evidence in Public Health: A Case Study of XMRV | date = 2014-04-08 | url = https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001623|journal=PLOS Medicine|volume=11|issue=4| pages = e1001623 | last = Wilson | first = Kumanan | last2 = Atkinson | first2 = Katherine | last3 = Keelan | first3 = Jennifer|language=en|doi=10.1371/journal.pmed.1001623|pmc=PMC3979645|pmid=24714396|issn=1549-1676}}</ref><ref name="RedCrossAus">{{cite web | url = https://www.lifeblood.com.au/faq/eligibility/medical-conditions-and-procedures/chronic-fatigue-syndrome| website = Australian Red Cross|title = Chronic Fatigue Syndrome|access-date=2023-11-17}}</ref><ref name="donate">{{Cite web|url = https://www.donateblood.com.au/faq/chronic-fatigue-syndrome |title=Chronic fatigue syndrome – I have/had chronic fatigue syndrome. Can I donate?|access-date=2022-05-25|website = Australian Red Cross}}</ref><ref name="post">{{Cite web | url = http://voices.washingtonpost.com/checkup/2010/12/red_cross_bars_chronic_fatique.html | title = Red Cross bars chronic fatigue patients from donating blood | last = Stein | first = Rob | authorlink = | date = Dec 3, 2010 | website = Washington Post|archive-url=|archive-date=|access-date=2022-05-25}}</ref><ref name="USblood">{{Cite news | url=http://www.washingtonpost.com/wp-dyn/content/article/2010/12/03/AR2010120305888.html | title = Chronic fatigue patients barred from blood donation|publisher=Washington Post | last = Stein | first = Rob | date = 2010-12-03|access-date=2018-09-08|language=en-US|issn=0190-8286}}</ref><ref name="NZblood">{{Cite web|url=http://www.nzblood.co.nz/Give-blood/Donating/Detailed-eligibility-criteria#C | title = Detailed eligibility criteria|website=NZ Blood|language=en-NZ|access-date=2018-09-08}}</ref>

En los EE.UU., la Asociación Americana de Bancos de Sangre recomienda aceptar o rechazar la donación de sangre de pacientes con EM/SFC según el “juicio clínico sobre el estado de salud del donante”.<ref name="AABBOct2012">{{Cite web | last = American Association of Blood Banks | url = https://www.aabb.org/docs/default-source/default-document-library/regulatory/eid/xmrvfactsheet.pdf?sfvrsn=cd162fa3_2 | date = October 2012 | title = Xenotropic Murine Leukemia Virus-Related Virus (XMRV) and other Polytropic Murine Leukemia Viruses (pMLV)|pages = 3 |quote=An updated AABB Association Bulletin #12-05 (November 2012) states that individual collectors of blood and cellular therapy products should accept or defer donors with a history of CFS based on their clinical judgment of the donor's health status.|access-date=2022-05-25}}</ref> Las organizaciones de la sociedad civil relacionadas con la EM/SFC desaconsejan a los pacientes donar sangre.<ref name="MassBlood2015">{{Cite web | url = https://www.massmecfs.org/research/recent-research/19-xmrv/237-aabbs-recommendation-on-cfidsme-and-blood-donation | title = AABB's recommendation on ME/CFS and blood donation | date = Nov 25, 2015 |website=[[Massachusetts ME/CFS & FM Association]]|access-date=2022-05-25}}</ref>

= Tratamientos =

'''Artículo principal''': '''''Tratamientos'''''

No existe una cura para la EM/SFC, y ningún país ha aprobado un tratamiento farmacológico específico, con excepción de '''Argentina''', que autorizó '''Ampligen''' (rintatolimod) para el tratamiento de la EM/SFC severa.<ref name="Hemispherx" /> Sin embargo, la eficacia de Ampligen sigue siendo objeto de debate.<ref name="FDA-2009">{{Cite web|url=https://www.bizjournals.com/philadelphia/stories/2009/11/30/daily23.html | title = FDA rejects Hemispherx’s chronic fatigue drug Ampligen | website = bizjournals.com|access-date=2018-08-12 | date =Dec 2, 2009 | last = George | first = John|archive-url=|archive-date=|url-status=}}</ref> Medicamentos aprobados para otras enfermedades se han utilizado sin indicación específica para la EM/SFC, con eficacias variables según el paciente. <ref name="Carruthers, 2003" /><ref name="ICC" />

Los tratamientos dirigidos a las alteraciones del sueño, el dolor general, el dolor de cabeza y otros síntomas son empleados por algunos médicos en pacientes seleccionados, pero estos enfoques no tratan la EM/SFC en su totalidad. <ref name="ICC" />

El tratamiento exitoso de los síntomas de la EM/SFC no ha sido investigado ni documentado adecuadamente.

Un ensayo clínico de fase III sobre '''Rituximab''', un medicamento modulador del sistema inmunitario, no demostró eficacia.<ref>{{Cite news | url=http://simmaronresearch.com/2017/11/norwegian-rituximab-chronic-fatigue-syndrome-mecfs-trial-fails/ | title = Norwegian Rituximab Chronic Fatigue Syndrome (ME/CFS) Trial Fails - Simmaron Research | last = Johnson | first =Cort | date = 2017-11-26|work=Simmaron Research|access-date=2018-09-07|archive-url=|archive-date=|url-status=|language=en-US}}</ref> De igual forma, el antiviral Valganciclovir no mostró eficacia en un estudio controlado de 9 meses realizado en pacientes positivos para los virus del herpes humano 6 (HHV-6) y el virus de Epstein-Barr (VEB).<ref>{{Cite journal | last = Montoya | first = Jose G. | last2 = Kogelnik | first2 = Andreas M. | last3 = Bhangoo | first3 = Munveer | last4 = Lunn | first4 = Mitchell R. | last5 = Flamand | first5 = Louis | last6 = Merrihew | first6 = Lindsey E. | last7 = Watt | first7 = Tessa | last8 = Kubo | first8 = Jessica T. | last9 = Paik | first9 = Jane | date = Dec 2013 | title = Randomized clinical trial to evaluate the efficacy and safety of valganciclovir in a subset of patients with chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/23959519|journal=Journal of Medical Virology|volume=85|issue=12|pages=2101–2109|doi=10.1002/jmv.23713|issn=1096-9071|pmid=23959519|pmc=|quote= | author-link = Jose Montoya | authorlink2 = Andreas Kogelnik|access-date=|via=}}</ref>

= Epidemiología =

'''Artículo principal''': '''''Epidemiología de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica'''''

La EM/SFC tiene presencia mundial documentada en artículos científicos publicados desde las décadas de 1930 a 1980, con al menos 75 '''brotes''' registrados.<ref name="HFME">{{Cite web|url=http://www.hfme.org/methemedicalfacts.htm | title = M.E.: The medical facts | last = Bassett | first = Jodi | authorlink=Jodi Bassett | date = Sep 2010 | website = The Hummingbirds' Foundation for M.E.|archive-url=|archive-date=|url-status=|access-date=2018-09-08}}</ref> Estos brotes suelen ocurrir en comunidades cerradas, como escuelas y hospitales.

Al igual que muchas enfermedades autoinmunes, la EM/SFC es más común en mujeres que en hombres, con una proporción promedio de 2 a 3 mujeres por cada hombre. <ref name="Bakken2014" /> En niños, esta proporción se mantiene aproximadamente igual. <ref name="Collin2015" />

= Comorbilidades =

'''Artículo principal''': '''''Comorbilidades de la Encefalomielitis Miálgica'''''

Los médicos han identificado diversas condiciones predisponentes, comorbilidades, enfermedades superpuestas y un aumento en el riesgo de enfermedades secundarias en pacientes con EM/SFC. <ref name="CDC-symptoms" /><ref name="Carruthers, 2003" /> Sin embargo, la falta de estudios '''epidemiológicos''', genéticos y familiares a gran escala impide determinar con precisión la prevalencia o las causas biológicas asociadas a estas condiciones posiblemente relacionadas con la EM/SFC. Los '''criterios diagnósticos''' coincidentes y la ausencia de '''biomarcadores''' específicos para muchas de estas condiciones contribuyen a la confusión e incertidumbre en el diagnóstico. Además, algunas condiciones como el '''Síndrome de Taquicardia Postural Ortostática''' (POTS, por sus siglas en inglés), la '''hipotensión mediada neuralmente''' (HMN o NHM, por sus siglas en inglés), la '''hipertensión intracraneal''' idiopática (IIH/IH, por sus siglas en inglés) y la '''fibromialgia''' (FM), pueden formar parte o ser comorbilidades de diversas enfermedades, incluida la EM/SFC. <ref name="CDC-etiology" /><ref name="Dankaerts2018">{{Cite web|url=https://www.dovepress.com/the-link-between-idiopathic-intracranial-hypertension-fibromyalgia-and-peer-reviewed-article-JPR | title = The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of a shared pathophysiology | last = Dankaerts | first = Wim | last2 = Bruyninckx | first2 = Frans | date = 2018-12-10 | website = Journal of Pain Research|language=English|access-date=2019-02-17 | last3 = Stalmans | first3 = Ingeborg | last4 = Vansant | first4 = Greet | last5 = Rasschaert | first5 = Ricky | last6 = Hulens | first6 = Mieke}}</ref>

A continuación, se enumeran algunos de los síndromes y enfermedades que han sido asociados con la EM/SFC o que, en ocasiones, han sido diagnosticados erróneamente como tal:

<ul>
<li>'''Fibromialgia'''<ref name="CDC-comorbid">{{Cite web|url=https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/comorbid-conditions.html | title = Comorbid Conditions {{!}} Diagnosis {{!}} Healthcare Providers {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | date = 2018-11-08 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2019-02-26}}</ref></li>
<li>'''Enfermedad de Lyme y enfermedad crónica de Lyme <ref name="ICC" />'''</li>
<li>'''Hipertensión intracraneal idiopática <ref name="Dankaerts2018" />'''</li>
<li>'''Síndrome de Taquicardia Postural Ortostática <ref name="ICC" /><ref name="Hoad2008">{{Cite journal | last = Hoad | first = A. | authorlink = | last2 = Spickett | first2 = G. | authorlink2 = Gavin Spickett‎ | last3 = Elliott | first3 = J. | authorlink3 = | last4 = Newton | first4 = J. | authorlink4 = Julia Newton | date = 2008 | title = Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/18805903|journal=QJM: monthly journal of the Association of Physicians|volume=101|issue=12 | pages = 961–965|doi=10.1093/qjmed/hcn123|issn=1460-2393|pmid=18805903|quote=|via=}}</ref>'''</li>
<li>'''Síndrome del Intestino Irritable <ref name="Carruthers, 2003" /><ref name="CDC-comorbid" />'''</li>
<li>'''Tiroiditis de Hashimoto (hipotiroidismo) <ref name="CDC-differentialdiagnosis" />'''</li>
<li>'''Síndrome de Ehlers-Danlos <ref name="CDC-differentialdiagnosis" />'''</li>
<li>'''Síndrome de Sjögren <ref name="CDC-differentialdiagnosis" />'''</li>
<li>'''Sensibilidad química múltiple <ref name="ICC2011primer" /><ref name="CDC-comorbid" />'''</li></ul>

Un estudio sueco con 234 pacientes con EM/SFC, diagnosticados según los '''Criterios de Consenso Canadiense''' (CCC), encontró que el 13.2% presentaba hernias tonsilares lo suficientemente severas para considerarse '''Malformaciones de Chiari'''. Además, el 49% mostró hipermovilidad, el 20% cumplió con los criterios para el Síndrome de Ehlers-Danlos Hiperlaxo (hEDS, por sus siglas en inglés), el 96% tenía puntos hipersensibles relacionados con fibromialgia, y el 67% cumplió con los criterios diagnósticos para esta última.<ref name="Bragee2020">{{Cite journal | last = Bragée | first = Björn | authorlink = Björn Bragée | last2 = Michos | first2 = Anastasios | authorlink2 = | last3 = Drum | first3 = Brandon | authorlink3 = | last4 = Fahlgren | first4 = Mikael | authorlink4 = | last5 = Szulkin | first5 = Robert | authorlink5 = | last6 = Bertilson | first6 = Bo C. | authorlink6 = | date = 2020 | title=Signs of Intracranial Hypertension, Hypermobility, and Craniocervical Obstructions in Patients With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.frontiersin.org/articles/10.3389/fneur.2020.00828/full|journal=Frontiers in Neurology|language=English|volume=11|issue=|pages=|doi=10.3389/fneur.2020.00828|issn=1664-2295|pmc=|pmid=|access-date=|quote=|via=}}</ref>

= Investigaciones más relevantes sobre la Encefalomielitis Miálgica =

'''Artículo principal''': '''''Investigaciones más relevantes sobre la Encefalomielitis Miálgica'''''

Debido a la falta de '''financiamiento''' gubernamental en todo el mundo, la investigación biológica sobre la '''EM/SFC''' ha sido muy limitada. Algunos de los siguientes estudios revelan la implicación '''neurológica''', características '''metabólicas''' y otras anormalidades.

<ul>
<li>2016, '''''Metabolic features of chronic fatigue syndrome''''' (Características Metabólicas del Síndrome de Fatiga Crónica).</li>
<li>2016, '''''CDC Multi-site Clinical Assessment of CFS''''' (Valoración Clínica del SFC en Múltiples Centros de los CDC).</li>
<li>2019, '''''Evidence of widespread metabolite abnormalities in Myalgic encephalomyelitis/chronic fatigue syndrome: assessment with whole-brain magnetic resonance spectroscopy''''' (Evidencia de la diseminación de las anormalidades metabólicas en la Encefalomielitis Miálgica/Síndrome de Fatiga Crónica: evaluación de cerebro completo por espectroscopia de resonancia magnética).</li>
<li>'''''Lista de las anormalidades detectadas en el Síndrome de Fatiga Crónica y la Encefalomielitis Miálgica.'''''</li></ul>

= Principales artículos periodísticos =

<ul>
<li>2015, '''''US NIH Report Calls for UK Definition of ME/CFS to be Scrapped''''' (El Reporte de los Institutos Nacionales de Salud de los EE.UU. pide que la Definición de la EM/SFC del Reino Unido sea Eliminada) - The Argus Report.</li>
<li>2014, '''''Brains of People With Chronic Fatigue Syndrome Offer Clues About Disorder''''' (El Cerebro de las Personas con Síndrome de Fatiga Crónica Provee Pistas sobre esta Condición) - The New York Times.</li>
<li>2010, '''''Chronic fatigue patients barred from blood donation''''' (Los pacientes con Fatiga Crónica son excluidos de donar sangre) - The Washington Post.</li>
<li>1987, '''''Fatigue 'Virus' Has Experts More Baffled And Skeptical Than Ever''''' (El “virus” de la Fatiga mantiene a los Expertos más Desconcertados y Escépticos que Nunca) - The New York Times.</li></ul>

= Véase también =
* [[Chronic fatigue syndrome|Síndrome de Fatiga Crónica]]
* [[Misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome|Diagnósticos equivocados de la Encefalomielitis Miálgica y el Síndrome de Fatiga Crónica]]
* [[ME/CFS|EM/SFC]]
* [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|Encefalomielitis Miálgica y el Síndrome de Fatiga pediátricas]]
* [[Severe and very severe ME|EM severa y muy severa]]
*[[Systemic Exertion Intolerance Disease|Enfermedad de Intolerancia al Esfuerzo Sistémico (EIES o SEID, por sus siglas en inglés)]]

= Más información =
*[https://www.cdc.gov/me-cfs/about/index.html ¿Qué es la EM/SFC?] - CDC
*[https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/other-conditions.html Diagnóstico de la EM/SFC - Otras condiciones para la evaluación] - CDC
*[https://www.cdc.gov/me-cfs/healthcare-providers/diagnosis/evaluation.html Evaluación de la EM/SFC] - pruebas médicas requeridas para el diagnóstico de exclusión para la EM/SFC - CDC
*[https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2796.2011.02428.x Criterios de Consenso Internacional para la EM]

[[File:J Brea TED.JPG|200px|thumb|right|[[Jen Brea|Jennifer Brea]] es una estudiante estadounidense de Harvard que enfermó gravemente de lo que eventualmente fue diagnosticada como [[ME/CFS|EM/SF,]] durante un viaje a [[Kenya|Kenia]]. Brea comenzó padeciendo problemas [[Nervous system|neurológicos]]. Su neurólogo le diagnosticó un “trastorno por conversión” ([[hysteria|histeria]]). Un día colapsó mientras caminaba de su trabajo a su casa. [[Severe and very severe ME|Jen requirió usar una silla de ruedas]] para mantener sus piernas en alto, ya que su sangre se acumula en estas debido a que padece [[Postural orthostatic tachycardia syndrome|Síndrome de Taquicardia Postural Ortostática]] (POTS, por sus siglas en inglés). En este enlace puedes ver la charla que dio en TED Talks, titulada ''[https://www.ted.com/talks/jen_brea_what_happens_when_you_have_a_disease_doctors_can_t_diagnose What happens when you have a disease doctors can't diagnose]'' (''Qué pasa cuando tienes una enfermedad que los doctores son incapaces de diagnosticar'').]]

[[File:Alem Matthee.png|200px|thumb|right|[[Alem Matthees]] es un paciente [[Australia|australiano]] con EM/SFC que solicitó acceso a los datos del [[PACE trial|ensayo clínico PACE]] bajo la Ley de Transparencia y Acceso a la Información (Freedom of Information o FOI, por sus siglas en inglés). Alem tuvo que apelar la negativa inicial de proporcionar esta información, lo que, junto con su comparecencia en el tribunal, [[Severe and very severe ME|le causó un grave deterioro en su salud]]. Los datos obtenidos demostraron que los resultados publicados en la revista [[The Lancet|''The Lancet'']] no eran correctos]]

[[File:Tom Kindlon.png|300px|thumb|[[Tom Kindlon]] [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|enfermó a los 16 años]] y nunca se recuperó. Es un defensor de los derechos de las personas con EM/SFC y ha publicado su trabajo en plataformas como ResearchGate y PubMed. Kindlon vive en [[Ireland|Irlanda]] y es el vicepresidente de la [[Irish ME/CFS Association|Asociación Irlandesa de EM/SFC]]. Al igual que otras personas, Tom analizó los datos del ensayo clínico ''PACE'', demostrando que los resultados publicados no son correctos. Tom utiliza una [[Severe and very severe ME|silla de ruedas]], y su madre, Vera, es su cuidadora de tiempo completo.]]

[[File:Vanessa Li.jpg|thumb|right|[[Vanessa Li]] vivió en Hong Kong, el Reino Unido y los EE. UU. Contrajo lo que [[flu-like illness|parecía ser una influenza]] mientras esquiaba en [[Italy|Italia]] y nunca se recuperó. Vanessa fundó una campaña de recaudación comunitaria para el [[Microbe Discovery Project|Proyecto de Descubrimiento de Microbios]]. Vivió durante 15 años con un [[Severe and very severe ME|dolor insoportable, además de problemas respiratorios y parálisis ocasional]] for 15 years. She took her own life in 2015]], y finalmente se suicidó en 2015.]]

[[File:Sophia mirza.jpg|thumb|right|[[Sophia Mirza]] fue una paciente con una [[Severe and very severe ME|EM/SFC muy severa]] que vivió en el Reino Unido. Sophia murió poco después de ser sacada por la fuerza de la casa de su madre y obligada a permanecer en un hospital de salud mental en 2003. Un neuropatólogo independiente descubrió que su [[spine|médula espinal]] presentaba una inflamación masiva. Su certificado de defunción fue el primero en el Reino Unido en atribuir la causa de muerte al Síndrome de Fatiga Crónica. <ref name="Vink2015LA" />]]

[[File:Florence Nightingale.png|200px|thumb|right|[[Florence Nightingale]] fue una ciudadana británica y pionera de la enfermería moderna. Nightingale fue enviada a Crimea, donde contrajo la “fiebre de Crimea” (una infección bacteriana ahora conocida como [[brucellosis|brucelosis]]) y nunca se recuperó. Pasó la mayor parte de su vida [[Severe and very severe ME|postrada en cama]]. Aunque en esa época la EM/SFC aún no había sido identificada, muchos médicos e historiadores médicos creen que desarrolló esta enfermedad como consecuencia de la infección crónica por brucelosis.]]

[[File:Naomi Whittingham .png|300px|thumb|[[Naomi Whittingham]] vive en el Reino Unido y padece un caso [[Severe and very severe ME|severo de EM/SFC]]. Naomi enfermó a los [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|12 años]] tras contraer un virus común y nunca se recuperó. Es defensora de los derechos de las personas con EM/SFC y contribuye concediendo entrevistas, escribiendo el blog [[A Life Hidden]] (''Una Vida Escondida''), y apoyando a su hermano, [[Tom Whittingham]], quien corre maratones para la Fundación [[ME Research UK]] con el objetivo de recaudar fondos.]]

[[File:Karina Hansen.jpg|200px|thumb|right|[[Karina Hansen]] se enfermó cuando era una [[Pediatric myalgic encephalomyelitis and chronic fatigue syndrome|adolescente]] y vive con una [[Severe and very severe ME|EM/SFC severa]]. Fue forzada a permanecer durante tres años y medio en una institución pública, ya que el Sistema de Salud [[Denmark|Danés]] clasifica la EM/SFC como una enfermedad psicosomática. Karina vive actualmente en su casa con su familia, donde recibe tarjetas de personas de todo el mundo que le envían sus buenos deseos. El caso de Karina ante la Suprema Corte danesa y su regreso a casa se muestran en la película documental [[Unrest|''Unrest'']].]]

[[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, autora de [[Chronically Hopeful]] (''Crónicamente Esperanzada''), necesita usar lentes de sol y protección auditiva con cancelación de ruido debido a la hipersensibilidad a la luz ([[photophobia|fotofobia]]) y al sonido ([[hyperacusis|hiperacusia]]).]]

== References ==
{{reflist}}

[[Category:Diagnoses]]
[[Category:Disease names]]
[[Category:Disease names and definitions]]
[[Category:Neurological diseases and disorders]]

Español:Encefalomielitis miálgica

2026-09-28T18:22:40Z

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gap: .5rem;
background-color: var(--bs-border-color);
border-radius: 4px;
}
.dark-mode #language-selector {
background-blend-mode: luminosity;
}
#language-selector .plainlinks {
margin-left: auto;
margin-right: 12px;
}
@media ( max-width: 1100px ) {
#language-selector {
display: flex;
flex-direction: column;
align-items: center;
text-align: center;
padding: 2.35rem 1rem 0;
gap: 0;
line-height: 1.8rem;
background-position: 50% 6px;
}
#language-selector .plainlinks {
margin-left: auto;
margin-right: auto !important;
}
}
#category-banner {
border-radius: 4px !important;
margin: 0 0 1rem 0 !important;
color: rgba(255,255,255,0.85) !important;
text-align: center;
}
.dark-mode.contrast-on #mw-content #category-banner a,
.dark-mode.contrast-on #mw-content #category-banner a:visited,
#category-banner a {
color: #fff !important;
filter: invert(0);
}
.banner-potential-comorbidities {
background-color: #845b26 !important;
}
.banner-potential-treatments {
background-color: #198754 !important;
}
.banner-medical-hypotheses {
background-color: #2b1c77 !important;
}

#localNotice {
border: 0 !important;
box-shadow: none !important;
background: none !important;
}
.anonnotice,
.sitenotice {
text-align: left;
}
.join-cta,
.donate-cta {
background: #f8f9fa;
}
.join-cta {
border-left: 8px solid #FCD264;
padding-left: 16px;
}
.donate-cta {
border-left: 8px solid #e3291c;
padding-left: 16px;
}
.join-cta dt,
.donate-cta dt {
padding-top: 8px;
padding-bottom: 2px;
}
.donate-link-wrapper a {
text-decoration: none !important;
opacity: .92;
}
.donate-link-wrapper a:hover {
opacity: 1;
box-shadow: 0 0 4px rgba(0,0,0,0.2);
}
.donate-cta .donate-link {
background: #e3291c;
padding: 0 8px;
color: #fff;
font-weight: bold;
}
#n-donate a span {
visibility: hidden;
}

Module:Asbox

2026-09-28T18:09:23Z

WikiVisor:Adds some vertical margin to Stub

--[[
This module was created by User:CodeHydro (Alexander Zhikun He).
User:Jackmcbarn and User:Mr._Stradivarius provided a great deal of assistance in writting p.main()

p.main() draw heavily from the following version of Template:Asbox of the English Wikipedia, authored primarily by User:Rich_Farmbrough
https://en.wikipedia.org/w/index.php?title=Template:Asbox&oldid=619510287

p.templatepage() is derived from the following revision of Template:Asbox/templatepage, authored primarily by User:MSGJ
https://en.wikipedia.org/w/index.php?title=Template:Asbox/templatepage&oldid=632914791

Both templates had significant contributions from numerous others listed in the revision history tab of their respective pages.
--]]
-- Changed by Njt Aug 2019 - "qualifier" parameter now passes in the translated stub message from [[Template:Stub text]]

local WRAPPER_TEMPLATE, args = 'Template:Asbox'
local p, Buffer, stubCats = {
--Prevents dupli-cats... get it? Maybe not?
cats = setmetatable({}, {__newindex = function(t, i, v)
if not rawget(t, i) then
rawset(t, i, v)
table.insert(t, i)
end
end}),
--initializes variables required by both p.main and p.templatepage
init = function(self, frame, page)
args, page = args or require('Module:Arguments').getArgs(frame, {
wrappers = WRAPPER_TEMPLATE
}), page or mw.title.getCurrentTitle()
--Ensures demo parameter will never affect category() output for articles
self.demo = self.demo or page.namespace ~= 0 and args.demo
return args, page
end
}, require('Module:Buffer')

--[[
Formats category links. Stores them until called with cat.done=true
Takes multiple or single categories in the form of 'cat'
or a table of strings and/or tables containing parts. (See below)
]]
local attention, catTag, catKey = Buffer'Stub message templates needing attention', '[[Category:%s]]', '%s|%s%s'
local function category(cat)
for _, v in ipairs((tostring(cat) == cat or cat.t) and {cat} or cat) do
--[[
If v is a table:
[1] = full category name; defaults to local attention if blank
k = Category sort key. Prefix before v.t
t = page.text or args.tempsort#; appended after k (or in its place if omitted). Required if v is not a string
Basically the same as v = (v[1] or attention) .. ' | ' .. (v.k or '') .. v.t
]]
if v and v ~= true then--reject v = nil, false, or true
p.cats[catTag:format(tostring(v) == v and
v
or (v[1] and Buffer(v[1]) or attention):_in(v.k):_(v.t):_str(2, nil, nil, '|')
)] = true
end
end
return cat.done and table.concat(p.cats, p.demo and ' | ' or nil) or ''
end

--[[
Makes an ombox warning;
Takes table {ifNot = Boolean, text, {cat. sort key, cat. sort name}}
Will return an empty string instead when ifNot evaluates to true
]]
local function ombox(v)
if v.ifNot then return end
p.ombox = p.ombox or require('Module:Message box').ombox
category{v[2]}
return p.ombox{
type = 'content',
text = v[1]
}
end

--[[
Unlike original template, module now takes unlimited cats! This function also performs
most stub category error checks except for the ombox for when main |category= is omitted (See p.template())
]]
local function catStub(page, pageDoc)
stubCats = {missing = {}, v = {}}
local code
for k, _ in pairs(args) do
--Find category parameters and store the number (main cat = '')
table.insert(stubCats, string.match(k, '^category(%d*)$'))
end
table.sort(stubCats)
for k, v in ipairs(stubCats) do
--Get category names and, if called by p.templatepage, the optional sort key
local tsort, cat = args['tempsort' .. v], mw.ustring.gsub(args['category' .. v], '[^%w%p%s]', '')--remove all hidden unicode chars
--Do not place template in main category if |tempsort = 'no'. However, DO place articles of that template in the main category.
table.insert(stubCats.v,
page and (--p.templatepage passes page; p.main does not, i.e. articles are categorized without sort keys.
v=='' and tsort == 'no'--if true, inserts 'true' in table, which category() will reject
or tsort and {cat, k = ' ', t = tsort}
or {cat, k = ' *', t = page.text}--note space in front of sort key
)
or cat
)
--Check category existance only if on the template page (i.e. stub documentation)
if page then
if not mw.title.new('Category:' .. cat).exists then
code = code or mw.html.create'code':wikitext'|category'
table.insert(stubCats.missing, tostring(mw.clone(code):wikitext(v)))
end
--[[
Checks non-demo stub template for documentation and flags if doc is present.
All stub cats names are checked and flagged if it does not match 'Category: [] stub'.
The main stub cat is exempt from the name check if the stub template has its own doc
(presumably, this doc would have an explanation as to why the main stub cat is non-conforming).
]]
table.insert(stubCats.v, v == '' and not p.demo and pageDoc.exists and
'Stub message templates with documentation subpages'
or not cat:match' stubs$' and {k = 'S', t = page.text}
)
end
end
--Add category names after loop is completed
category(stubCats.v)
return #stubCats.missing > 0 and ombox{
--Changed, original msg:
--One or more of the stub categories defined in this template do not seem to exist!
--Please double-check the parameters {{para|category}}, {{para|category1}} and {{para|category2}}.
'The following parameter'
.. (#stubCats.missing == 1 and ' defines a stub category that does' or 's define stub categories that do')
.. ' not exist: ' .. mw.text.listToText(stubCats.missing),
{k = 'N', t = page.text}
}
end

--Shows population of categories found by catStub(). Outputs demo values if none
local function population()
local wikitext, base = {}, '* [[:Category:%s]] (population: %s)\n'
if not args.category and stubCats[1] ~= false then
table.insert(stubCats, 1, false)
end
for _, v in ipairs(stubCats) do
table.insert(wikitext, base:format(
v and args['category' .. v] or '{{{category}}}',
v and mw.site.stats.pagesInCategory(args['category' .. v], 'all') or 0
))
end
return table.concat(wikitext)
end

--Includes standard stub documention and flags stub templates with bad parameter values.
function p.templatepage(frame, page)
args, page = p:init(frame, page)
local tStubDoc = mw.title.new'Template:Stub documentation'
local pageDoc = page:subPageTitle('doc')
--Reorganization note: Original Asbox alternates between outputting categories and checking on params |category#=.
--Rather than checking multiple times and switching tasks, all stub category param operations have been rolled into catStub()
return Buffer(
ombox{--Show ombox warnings for missing args.
ifNot = args.category,
'The <code>|category</code> parameter is not set. Please add an appropriate stub category.',
{k = 'C', t = page.text}
})
:_(ombox{
ifNot = args.subject or args.article,
'This stub template contains no description! At least one of the parameters <code>|subject</code> or <code>|article</code> must be defined.',
{k = 'D', t = page.text}
})
:_(catStub(page, pageDoc))--catStub() may also return an ombox if there are non-existing categories
:_(category{
done = p.demo ~= 'doc',--Outputs categories if not doc demo
'Stub message templates',
'Exclude in print',
args.icon and
'Stub message templates using icon parameter'
or args.image and (
mw.title.new('Media:' .. mw.text.split(args.image, '|')[1]).exists--do nothing if exists. category() will reject true
or {k = 'B', t = page.text}
)
or 'Stub message templates without images',
args.imagealt and {k = 'I', t = page.text},
})
:_((not p.demo or p.demo == 'doc') and--Add standard stub template documentation
require('Module:Documentation').main{
content = Buffer(page.text ~= 'Stub' and--This comparison performed in {{Asbox/stubtree}} before it invokes Module:Asbox stubtree
require('Module:Asbox stubtree').subtree{args = {pagename = page.text}}
)
:_in'\n== About this template ==\nThis template is used to identify a':_(args.subject):_'stub':_(args.qualifier):_out' '--space
:_'. It uses {{[[Template:Asbox|asbox]]}}, which is a meta-template designed to ease the process of creating and maintaining stub templates.\n=== Usage ===\nTyping '
:_(mw.html.create'code'
:wikitext('{{', page.text == 'Stub' and 'stub' or page.text, '}}')
)
:_' produces the message shown at the beginning, and adds the article to the following categor'
:_(#stubCats > 1 and 'ies' or 'y')
:_':\n'
:_(population())
:_(pageDoc.exists and--transclusion of /doc if it exists
frame:expandTemplate{title = pageDoc.text}
)
:_'\n== General information ==\n'
:_(frame:expandTemplate{title = tStubDoc.text})
:_'\n\n'(),
['link box'] = Buffer'This documentation is automatically generated by [[Module:Asbox]].'
:_in'The general information is transcluded from [[Template:Stub documentation]]. '
:_(mw.html.create'span'
:cssText'font-size:smaller;font-style:normal;line-height:130%'
:node(('([%s edit] | [%s history])'):format(
tStubDoc:fullUrl('action=edit', 'relative'),
tStubDoc:fullUrl('action=history', 'relative')
))
)
:_out()
:_(page.protectionLevels.edit and page.protectionLevels.edit[1] == 'sysop' and
"This template is [[MEpedia:PROTECT|fully protected]] and any [[MEpedia:CAT|categories]] should be added to the template's ["
.. pageDoc:fullUrl('action=edit&preload=Template:Category_interwiki/preload', 'relative')
.. '| /doc] subpage, which is not protected.'
)' <br/>'
}
)()
end

function p.main(frame, page)
args, page = p:init(frame, page)
local output = mw.html.create'table'
:addClass'transparent metadata plainlinks stub'
:css{background = 'transparent'}
:css{margin = '1rem 0'}
:attr{role = 'presentation'}
:tag'tr'
:node((args.icon or args.image) and
mw.html.create'td'
:wikitext(args.icon or ('[[File:%s|%spx|alt=%s|class=transparent]]'):format(
args.image or '',
args.pix or '40x30',
args.imagealt or 'Stub icon'
))
)
:tag'td'
:tag'i'
:wikitext(args.qualifier)
:done()
:node(args.name and
require'Module:Navbar'._navbar{
args.name,
mini = 'yes',
style = 'position: absolute; right: 15px; display: none; background: transparent; border:none;'
}
)
:node(args.note and
mw.html.create()
:tag'br':done()
:tag'span'
:css{['font-style'] = 'normal', ['font-size'] = 'smaller'}
:wikitext(args.note)
:done()
)
:allDone()
--[[
Stub categories for templates include a sort key (Otherwise all will be indexed under the letter 'T' for 'Template:[] stubs')
Articles using the template do not need a sort key since they have unique names.
When p.demo equals 'doc', the demo stub categories will appear as those for a stub template.
Otherwise, any non-nil p.demo will emulate article space categories (plus any error cats unless set to 'art')
]]
if (page.namespace == 0 or page.namespace == 4 or page.namespace == 12) then -- Main, Help, or MEpedia namespaces (Edited by Pyrrhus 20september2019)
category'All stub articles'
catStub()
elseif p.demo then
if p.demo ~= 'doc' then catStub() end
--Unless p.demo is set to 'art', it will also include error categories normally only shown on
--the template but not in the article. The elseif after namespace == 0 means demo cats will never show in article space.
p.demodoc = p.demo ~= 'art' and p.templatepage(frame, page)
output = mw.html.create()
:node(output)
:tag'small':wikitext(
'Demo categories: ',
(category{done = true}:gsub('(%[%[)(Category:)([^|%]]-)(%|)', '%1%2%3|%2%3%4'):gsub('(%[%[)(Category:)', '%1:%2'))
):done()
:wikitext(p.demo == 'doc' and p.demodoc or nil)
else
--Checks for valid name; emulates original template's check using {{FULLPAGENAME:{{{name|}}}}}
local normalizedName = mw.title.new(args.name or '')
if normalizedName and normalizedName.fullText == page.fullText then
output = mw.html.create():node(output):wikitext(p.templatepage(frame, page))
elseif not page.isSubpage and page.namespace == 10 then-- Template namespace and not a subpage
category{{k = args.name and 'E' or 'W', t = page.text}}
end
end
return output:wikitext(not p.demo and category{done = true} or nil)
end

return p

MediaWiki:Top-notice-ns-4006

2026-09-28T18:06:16Z

WikiVisor:Created page with "{{Category banner}}<div id="language-selector">''Originalartikel:'' {{#explode:{{#ask: [[Translated page::{{FULLPAGENAME}}|default={{FULLPAGENAME}}|link=none}}|#|0}}]]<span class="plainlinks">[{{fullurl: Special:AllPages|from=&to=&namespace={{NAMESPACENUMBER}}}} Alla sidor på {{NAMESPACE}}]</span></div>"

{{Category banner}}<div id="language-selector">''Originalartikel:'' [[{{#explode:{{#ask: [[Translated page::{{FULLPAGENAME}}]]|default={{FULLPAGENAME}}|link=none}}|#|0}}]]<span class="plainlinks">[{{fullurl: Special:AllPages|from=&to=&namespace={{NAMESPACENUMBER}}}} Alla sidor på {{NAMESPACE}}]</span></div>

MediaWiki:Top-notice-ns-4004

2026-09-28T18:05:15Z

WikiVisor:Created page with "{{Category banner}}<div id="language-selector">''Article original:'' {{#explode:{{#ask: [[Translated page::{{FULLPAGENAME}}|default={{FULLPAGENAME}}|link=none}}|#|0}}]]<span class="plainlinks">[{{fullurl: Special:AllPages|from=&to=&namespace={{NAMESPACENUMBER}}}} Toutes les pages en {{NAMESPACE}}]</span></div>"

{{Category banner}}<div id="language-selector">''Article original:'' [[{{#explode:{{#ask: [[Translated page::{{FULLPAGENAME}}]]|default={{FULLPAGENAME}}|link=none}}|#|0}}]]<span class="plainlinks">[{{fullurl: Special:AllPages|from=&to=&namespace={{NAMESPACENUMBER}}}} Toutes les pages en {{NAMESPACE}}]</span></div>

Svenska:Insomni

2026-09-28T18:00:34Z

WikiVisor:Relocate lang link

{{DISPLAYTITLE:Insomni}}

'''Insomni''', också känt som '''sömnlöshet''', är en sömnstörning där man har svårt att somna eller sova så länge som önskat. Det kan förekomma oberoende av eller som ett resultat av ett annat problem. Det är ett vanligt symptom av [[ME/CFS]].<ref name=":0">{{Cite journal | last = Jackson | first = Melinda L. | authorlink = Melinda Jackson | last2 = Bruck | first2 = Dorothy | authorlink2 = Dorothy Bruck | date = 2012-12-15 | title = Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/|journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine|volume=8|issue=6 | pages = 719–728|doi=10.5664/jcsm.2276|issn=1550-9389|pmc=3501671|pmid=23243408|access-date=|quote=|via=}}</ref>

==Presentation==
Insomni förekommer när en patient har ovanligt svårt att somna, bibehålla sömnen, eller vaknar tidigt på morgonen utan att kunna somna om.

Insomni kan orsaka många sekundära symptom och problem, inklusive [[fatigue|utmattning]], sömnighet dagtid, känna sig outsövd efter sömn, lättretlighet, [[Sv:ångest|ångest]], orkeslöshet och [[Depression/sv|nedstämdhet]]. Långsiktig insomni kan resultera i muskeltrötthet, hallucinationer, [[brain fog|mental trötthet]] och [[double vision|dubbelseende]].

==Förekomst==

==Symptomigenkänning==
*I [[Holmes criteria|Holmeskriterierna]] är [[sleep disturbance|sömnstörning]] ([[hypersomnia|hypersomni]] eller '''insomni''') ett alternativt kriterium för diagnos under avsnittet ''Minor Symptom Criteria''.<ref>[http://www.cfids-me.org/holmes1988.html The 1988 Holmes Definition for CFS]</ref>

==Nämnvärda studier==
* 2012, Sleep Abnormalities in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Review<ref name=":0" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501671/ (Full text)]
*2015, Sleep quality and the treatment of intestinal microbiota imbalance in [[Chronic Fatigue Syndrome]]: A pilot study<ref>{{Citation | last1 = Jackson | first1 = Melinda L | authorlink1 = Melinda Jackson | last2 = Butt | first2 = Henry | authorlink2 = Henry Butt | last3 = Ball | first3 = Michelle | authorlink3 = Michelle Ball | last4 = Lewis | first4 = Donald | authorlink4 = Donald Lewis | last5 = Bruck | first5 = Dorothy | authorlink5 = Dorothy Bruck | title = Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. | journal = Sleep Science | volume = 8 | issue = 3 | page = 124-33 | date = November 2015 | pmid = 26779319 | doi = 10.1016/j.slsci.2015.10.001 }}</ref> - [http://www.sciencedirect.com/science/article/pii/S1984006315000632 (Full Text)]
*2017, Sleep Quality in Adolescents With [[ME/CFS|Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] (CFS/ME)<ref>{{Cite journal | last = Josev | first = Elisha K. | authorlink = Elisha Josev | last2 = Jackson | first2 = Melinda L. | authorlink2 = Melinda Jackson | last3 = Bei | first3 = Bei | authorlink3 = | last4 = Trinder | first4 = John | authorlink4 = | last5 = Harvey | first5 = Adrienne | authorlink5 = | last6 = Clarke | first6 = Cathriona | last7 = Snodgrass | first7 = Kelli | last8 = Scheinberg | first8 = Adam | authorlink8 = | last9 = Knight | first9 = Sarah J. | author-link9 = Sarah Knight | date = 2017-09-15 | title = Sleep Quality in Adolescents With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) | url = http://jcsm.aasm.org/ViewAbstract.aspx?pid=31079|journal=Journal of Clinical Sleep Medicine|language=en|volume=13|issue=09|pages=1057–1066|doi=10.5664/jcsm.6722|issn=1550-9389|pmc=5566461|pmid=28760189|quote=|via=}}</ref> - [[pubmed:28760189|(Full text)]]

==Möjliga orsaker==
*Hög [[stress/sv|stressnivå]]
*Ändringar i [[cytokines|cytokin-nivå]]
*Som ett [[sleep dysfunction|sömnstörningssymptom]] av [[ME/CFS]] eller någon annan sjukdom

==Möjliga behandlingar==
Beteendeförändringar, inklusive:
*[[Sleep hygiene|Sömnhygien]] råd
*[[Cognitive behavioral therapy for insomnia|Kognitiv beteendeterapi för insomni]]

Tillskott och naturliga botemedel, inklusive: Inga sidor möter dessa kriteria.
Läkemedel, inklusive

*[[:Category:Benzodiazepines|Bensodiazepiner]], t.ex. [[temezapam]]<ref name=SACFS-survey>{{Cite web | url = https://www.sacfs.asn.au/news/2014/02/02_28_survey_results_insomnia.htm | title = ME/CFS South Australia Inc: Survey results - insomnia | website = sacfs.asn.au|access-date=2021-02-11}}</ref>
*[[Non-benzodiazepine hypnotic|Bensodiazepinliknande preparat]], kända som z-preparat, t.ex. [[zopiclone|zopiklon]]
*Lugnande [[antidepressant|antidepressiva läkemedel]], speciellt [[amitriptyline|amitryptalin]]
*Lugnande [[:Category:Antihistamines|antihistaminer]] inklusive [[diphenhydramine|difenhydramin]]
*[[Melatonin]], antingen på recept eller som tillskott<ref>{{Cite web | url = https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work | title = Melatonin for Sleep: Does It Work? | website = hopkinsmedicine.org|language=en|access-date=2021-02-11}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref>
Off-label läkemedel, t.ex.:
* Låg dos [[quetiapine|kvetiapin]], men det bör inte användas av överviktiga personer med CFS
==Se även==
* [[Hypersomnia/sv|Hypersomni]]
* [[Sleep dysfunction|Sömnstörning]]
* [[Unrefreshing sleep|Oåterställande Sömn]]

==Vidare läsning==
*[https://www.drugs.com/condition/insomnia.html Läkemedel för insomni] - drugs.com
* [http://www.cfsselfhelp.org/library/solutions-sleep Solutions for Sleep] by Bruce Campbell for ME/CFS & Fibromyalgia Self Help

==Referenser==
{{Reflist}}

[[Category:Signs and symptoms]]
[[Category:Sleep signs and symptoms]]
[[Category:Sleep disorders]]
[[Category:Potential comorbidities]]
[[Category:Diagnoses]]
[[Category:Swedish-language articles]]

Svenska:Stress

2026-09-28T18:00:03Z

WikiVisor:Relocate lang link

Svenska:Ångest

2026-09-28T17:54:56Z

WikiVisor:Removes Display title

{{stub}}
'''Ångest''' är en generell term för flera störningar som orsakar nervositet, rädsla, oro, ängslan och olust. En plötslig våg av överväldigande ångest och rädsla kallas en [[panic attack|panikattack]].

Ångestsymptom förekommer med [[ME/CFS]], men de tenderar att härstamma från fysiologiska problem med det [[autonomic nervous system|autonoma nervsystemet]], [[sensory integration|sensorisk integration]], blodflöde eller blodvolym istället för emotionella eller psykiatriska faktorer.<ref>{{Cite web | url = https://www.healthrising.org/blog/2016/12/10/anxiety-question-chronic-fatigue-syndrome-fibromyalgia-autonomic-nervous-system-blame/ | title = The Anxiety Question in Chronic Fatigue Syndrome and Fibromyalgia: Is the Autonomic Nervous System to Blame? | last = Johnson | first = Cort | author-link = Cort Johnson | date = 2016-12-10 | website = [[Health Rising]]|language=en-GB|archive-url=|archive-date=|url-status= | access-date = 2019-02-18}}</ref>

Som Dr. [[David Bell]] uttryckt det: "Det är sant att många personer med CFS upplever ångest. Men eftersom CFSpatienter ofta inte har uppenbara, diagnostiserbara psykiatriska sjukdomar, misstänker jag att när panik förekommer i CFSpatienter är orsaken fysiologisk, inte psykiatrisk. Vad annat denna sjukdom än gör mot hjärnan, den inkluderar oro i sin repertoar."<ref name="Faces of CFS, 2000" />

Vissa ångestsymptom i de som lever med [[ME/CFS]] kan härröra från andra faktorer som patienter ofta möter, som att känna sig delegitimerad av den medicinska gemenskapen,<ref name="Daniels, 2017" /> dålig prognos, och förlust av inkomst, uppehälle, och relationer.

==Presentation==

==Förekomst==
*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av 70-90% för ångest.<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne/sv | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 | isbn= 978-0897931915}}</ref>

==Symptomigenkänning==
Ångest är ett potentiellt symptom av [[Long COVID|Postcovid]] i [[World Health Organization Long COVID diagnostic criteria|Världshälsoorganisationens]] definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | author-link4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Nämnvärda studier==
*Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME<ref name="Daniels, 2017" /> [https://www.ncbi.nlm.nih.gov/pubmed/28244209 (Abstract)]

==Möjliga orsaker==

==Möjliga behandlingar==

==Se även==
*[[Panic attack|Panikattack]]
==Vidare läsning==

==Referenser==
<references>
<ref name="Daniels, 2017">{{Citation | last = Daniels | first1 = J | author-link1 = | last2 = Brigden | first2 = A | author-link2 = | last3 = Kacorova | first3 = A | author-link3 = | title = Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME | journal = Psychol Psychother | volume = 90 | issue = 3 | pages = 502-509 | date = 2017 | pmid = | doi = 10.1111/papt.12118 }}</ref>
<ref name="Faces of CFS, 2000">{{cite book | first = David | last = Bell | title = Faces of CFS: case studies of chronic fatigue syndrome,
| type = print | date = Aug 30, 2000
| isbn = 978-0970770202 }}</ref>
</references>{
[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Swedish-language articles]]

Svenska:Ångest

2026-09-28T17:49:42Z

WikiVisor:WikiVisor moved page Anxiety/sv to Svenska:Ångest without leaving a redirect:MEpedia localization approach

{{DISPLAYTITLE:Ångest}}
{{stub}}
'''Ångest''' är en generell term för flera störningar som orsakar nervositet, rädsla, oro, ängslan och olust. En plötslig våg av överväldigande ångest och rädsla kallas en [[panic attack|panikattack]].

Ångestsymptom förekommer med [[ME/CFS]], men de tenderar att härstamma från fysiologiska problem med det [[autonomic nervous system|autonoma nervsystemet]], [[sensory integration|sensorisk integration]], blodflöde eller blodvolym istället för emotionella eller psykiatriska faktorer.<ref>{{Cite web | url = https://www.healthrising.org/blog/2016/12/10/anxiety-question-chronic-fatigue-syndrome-fibromyalgia-autonomic-nervous-system-blame/ | title = The Anxiety Question in Chronic Fatigue Syndrome and Fibromyalgia: Is the Autonomic Nervous System to Blame? | last = Johnson | first = Cort | author-link = Cort Johnson | date = 2016-12-10 | website = [[Health Rising]]|language=en-GB|archive-url=|archive-date=|url-status= | access-date = 2019-02-18}}</ref>

Som Dr. [[David Bell]] uttryckt det: "Det är sant att många personer med CFS upplever ångest. Men eftersom CFSpatienter ofta inte har uppenbara, diagnostiserbara psykiatriska sjukdomar, misstänker jag att när panik förekommer i CFSpatienter är orsaken fysiologisk, inte psykiatrisk. Vad annat denna sjukdom än gör mot hjärnan, den inkluderar oro i sin repertoar."<ref name="Faces of CFS, 2000" />

Vissa ångestsymptom i de som lever med [[ME/CFS]] kan härröra från andra faktorer som patienter ofta möter, som att känna sig delegitimerad av den medicinska gemenskapen,<ref name="Daniels, 2017" /> dålig prognos, och förlust av inkomst, uppehälle, och relationer.

==Presentation==

==Förekomst==
*[[Katrina Berne/sv|Katrina Berne]] rapporterar en förekomst av 70-90% för ångest.<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne/sv | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 | isbn= 978-0897931915}}</ref>

==Symptomigenkänning==
Ångest är ett potentiellt symptom av [[Long COVID|Postcovid]] i [[World Health Organization Long COVID diagnostic criteria|Världshälsoorganisationens]] definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | author-link4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Nämnvärda studier==
*Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME<ref name="Daniels, 2017" /> [https://www.ncbi.nlm.nih.gov/pubmed/28244209 (Abstract)]

==Möjliga orsaker==

==Möjliga behandlingar==

==Se även==
*[[Panic attack|Panikattack]]
==Vidare läsning==

==Referenser==
<references>
<ref name="Daniels, 2017">{{Citation | last = Daniels | first1 = J | author-link1 = | last2 = Brigden | first2 = A | author-link2 = | last3 = Kacorova | first3 = A | author-link3 = | title = Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME | journal = Psychol Psychother | volume = 90 | issue = 3 | pages = 502-509 | date = 2017 | pmid = | doi = 10.1111/papt.12118 }}</ref>
<ref name="Faces of CFS, 2000">{{cite book | first = David | last = Bell | title = Faces of CFS: case studies of chronic fatigue syndrome,
| type = print | date = Aug 30, 2000
| isbn = 978-0970770202 }}</ref>
</references>{
[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Swedish-language articles]]

Template:Language links

2026-09-28T17:44:39Z

WikiVisor:Adds fr and sv

<includeonly><div id="language-selector">This page is available in other languages: <span>{{#arraymap: de,es,fr,sv
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Anxiety

2026-09-28T17:43:59Z

WikiVisor:

{{Language links
|page_sv=Ångest
}}
{{stub}}
'''Anxiety''' is a general term for several disorders that cause nervousness, fear, apprehension, worrying and unease. A sudden surge of overwhelming anxiety and fear is called a [[panic attack]].

Anxiety symptoms occur with [[ME/CFS]], but their origin tends to be from physiologic problems with the [[autonomic nervous system]], [[sensory integration]], blood flow or blood volume as opposed to emotional or psychiatric factors.<ref>{{Cite web | url = https://www.healthrising.org/blog/2016/12/10/anxiety-question-chronic-fatigue-syndrome-fibromyalgia-autonomic-nervous-system-blame/ | title = The Anxiety Question in Chronic Fatigue Syndrome and Fibromyalgia: Is the Autonomic Nervous System to Blame? | last = Johnson | first = Cort | author-link = Cort Johnson | date = 2016-12-10 | website = [[Health Rising]]|language=en-GB|archive-url=|archive-date=|url-status= | access-date = 2019-02-18}}</ref>

In Dr. [[David Bell]]'s words: "It is true that many persons with [[Chronic fatigue syndrome|CFS]] experience anxiety. But because CFS patients tend not to have obvious, diagnosable psychiatric illnesses, I suspect that when panic occurs in [[Chronic fatigue syndrome|CFS]] patients, the cause is physiological, not psychiatric. Whatever else this disease does to the human brain, it includes agitation in its repertoire."<ref name="Faces of CFS, 2000" />

Some anxiety symptoms in those living with [[ME/CFS]] may stem from other factors often encountered by patients, such as feeling ‘[[delegitimized]]’ by the medical community,<ref name="Daniels, 2017" /> poor prognosis, and loss of income, livelihood, and relationships.

==Presentation==

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 70-90% for anxiety.<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 | isbn= 978-0897931915}}</ref>

==Symptom recognition==
Anxiety is a potential symptom of [[Long COVID]] in the [[World Health Organization Long COVID diagnostic criteria|World Health Organization]]'s definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | author-link4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Notable studies==
*Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME<ref name="Daniels, 2017" /> [https://www.ncbi.nlm.nih.gov/pubmed/28244209 (Abstract)]

==Possible causes==

==Potential treatments==

==See also==
*[[Panic attack]]
==Learn more==

==References==
<references>
<ref name="Daniels, 2017">{{Citation | last = Daniels | first1 = J | author-link1 = | last2 = Brigden | first2 = A | author-link2 = | last3 = Kacorova | first3 = A | author-link3 = | title = Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME | journal = Psychol Psychother | volume = 90 | issue = 3 | pages = 502-509 | date = 2017 | pmid = | doi = 10.1111/papt.12118 }}</ref>
<ref name="Faces of CFS, 2000">{{cite book | first = David | last = Bell | title = Faces of CFS: case studies of chronic fatigue syndrome,
| type = print | date = Aug 30, 2000
| isbn = 978-0970770202 }}</ref>
</references>{
[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Multilingual pages]]

Anxiety

2026-09-28T17:43:41Z

WikiVisor:Categorize as multiligual

{{stub}}
'''Anxiety''' is a general term for several disorders that cause nervousness, fear, apprehension, worrying and unease. A sudden surge of overwhelming anxiety and fear is called a [[panic attack]].

Anxiety symptoms occur with [[ME/CFS]], but their origin tends to be from physiologic problems with the [[autonomic nervous system]], [[sensory integration]], blood flow or blood volume as opposed to emotional or psychiatric factors.<ref>{{Cite web | url = https://www.healthrising.org/blog/2016/12/10/anxiety-question-chronic-fatigue-syndrome-fibromyalgia-autonomic-nervous-system-blame/ | title = The Anxiety Question in Chronic Fatigue Syndrome and Fibromyalgia: Is the Autonomic Nervous System to Blame? | last = Johnson | first = Cort | author-link = Cort Johnson | date = 2016-12-10 | website = [[Health Rising]]|language=en-GB|archive-url=|archive-date=|url-status= | access-date = 2019-02-18}}</ref>

In Dr. [[David Bell]]'s words: "It is true that many persons with [[Chronic fatigue syndrome|CFS]] experience anxiety. But because CFS patients tend not to have obvious, diagnosable psychiatric illnesses, I suspect that when panic occurs in [[Chronic fatigue syndrome|CFS]] patients, the cause is physiological, not psychiatric. Whatever else this disease does to the human brain, it includes agitation in its repertoire."<ref name="Faces of CFS, 2000" />

Some anxiety symptoms in those living with [[ME/CFS]] may stem from other factors often encountered by patients, such as feeling ‘[[delegitimized]]’ by the medical community,<ref name="Daniels, 2017" /> poor prognosis, and loss of income, livelihood, and relationships.

==Presentation==

==Prevalence==
*[[Katrina Berne]] reports a prevalence of 70-90% for anxiety.<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page = 60 | isbn= 978-0897931915}}</ref>

==Symptom recognition==
Anxiety is a potential symptom of [[Long COVID]] in the [[World Health Organization Long COVID diagnostic criteria|World Health Organization]]'s definition.<ref name="WHO-longcovid-criteria">{{citation | title = A clinical case definition of post COVID-19 condition by a Delphi consensus
| date =Oct 6, 2021 | publisher = [[World Health Organization]] | others = World Health Organization (WHO) clinical case definition working group on post COVID-19 condition | first1 = Joan B. | last1 = Soriano | first2 = Maya | last2 = Allan | first3 = Carine | last3 = Alsokhn | first4 = Nisreen A. | last4 = Alwan | author-link4 = Nisreen Alwan | first5 = Lisa | last5 = Askie | first6 = Hannah E. | last6 = Davis | author-link6 = Hannah Davis | first7 = Janet V. | last7 = Diaz | first8 = Tarun | last8 = Dua | first9 = Wouter | last9 = de Groote | first10 = Robert | last10 = Jakob | first11 = Marta | last11 = Lado | first12 = John | last12 = Marshall | first13 = Srin | last13 = Murthy | first14 = Jacobus | last14 = Preller | first15 = Pryanka | last15 = Relan | first16 = Nicoline | last16 = Schiess | first17 = Archana | last17 = Seahwag | ref = WHO reference number: WHO/2019-nCoV/Post_COVID-19_condition/Clinical_case_definition/2021.1 | url = https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1}}</ref>

==Notable studies==
*Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME<ref name="Daniels, 2017" /> [https://www.ncbi.nlm.nih.gov/pubmed/28244209 (Abstract)]

==Possible causes==

==Potential treatments==

==See also==
*[[Panic attack]]
==Learn more==

==References==
<references>
<ref name="Daniels, 2017">{{Citation | last = Daniels | first1 = J | author-link1 = | last2 = Brigden | first2 = A | author-link2 = | last3 = Kacorova | first3 = A | author-link3 = | title = Anxiety and depression in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): Examining the incidence of health anxiety in CFS/ME | journal = Psychol Psychother | volume = 90 | issue = 3 | pages = 502-509 | date = 2017 | pmid = | doi = 10.1111/papt.12118 }}</ref>
<ref name="Faces of CFS, 2000">{{cite book | first = David | last = Bell | title = Faces of CFS: case studies of chronic fatigue syndrome,
| type = print | date = Aug 30, 2000
| isbn = 978-0970770202 }}</ref>
</references>{
[[Category:Signs and symptoms]]
[[Category:Psychological signs and symptoms]]
[[Category:Diagnoses]]
[[Category:Potential comorbidities]]
[[Category:Mental disorders]]
[[Category:Long COVID signs and symptoms]]
[[Category:Multilingual pages]]

Form:Lang

2026-09-28T15:13:14Z

WikiVisor:Updated instructions

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Form:Lang

2026-09-28T15:12:00Z

WikiVisor:Adding inputs for Fr and Sv namespaces

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A form to manage language versions of the current page. To link the form to a page, categorize the page as [[:Category:Multilingual pages|multilingual]] one.
</noinclude>

MediaWiki:Mepedia.css

2026-09-28T14:52:54Z

WikiVisor:Added fr and sv messages for donation block

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#site-navigation #n-donate::after {
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div:not(.card) .thumb.tright * {
width: unset !important;
max-width: 400px;
}
}

#n-donate a {
background-image: url(/w/skins/MEpedia/resources/images/donate.png);
background-image: url(/w/skins/MEpedia/resources/images/donate.svg);
background-size: 172px;
}

[typeof="mw:File/Thumb"] {
float: right;
clear: both;
padding: 1rem;
text-align: center;
background-color: #f0f0f0;
width: 100%;
}

.gallerytext,
figcaption {
font-size: .94rem !important;
line-height: 1.6;
color: #444 !important;
text-align: left;
}
figcaption {
margin: .5rem 0 0 0;
}
@media screen and ( min-width: 640px ){
[typeof="mw:File/Thumb"] img {
width: 100%;
}
[typeof="mw:File/Thumb"] {
width: 270px;
background-color: revert;
}
}

@media screen and (max-width:550px) {
#p-logo-text {
position: absolute !important;
}
}

#mw-footer .cdx-button--size-large {
background: transparent;
border: none;
padding: 0;
}
#footer-poweredbyico .cdx-button--size-large:first-child img {
background: white;
padding: 3px;
border-radius: 4px;
}
#footer-poweredbyico {
display: flex;
align-items: baseline;
gap: .75rem;
}

/** Captcha **/
#wpCaptchaWord {
width: 100%;
}
label[for="wpCaptchaWord"] {
display: block;
}
label[for="wpCaptchaWord"] code {
display: block;
background: #e3291c;
font-size: 1.25rem;
letter-spacing: .9rem;
font-weight: bold;
color: #fff;
text-align: center;
border: 0;
border-radius: 2px;
}

.ve-ui-toolbar {
z-index: 1 !important;
}

@media screen {
.mw-editsection {
background-image: none !important;
}
.client-js .mw-editsection-divider,
.mw-editsection-bracket {
display: inherit;
}
.mw-editsection a {
margin-right: 0;
}
}

MediaWiki:Mepedia.css

2026-09-23T23:23:41Z

WikiVisor:Improve editsection block.

/* All CSS here will be loaded for users of the MEpedia skin */

/* Cards */

.row-cols {
display: flex;
flex-wrap: wrap;
gap: .5em;
}
.row-cols > * {
flex: 1 0 auto;
width: calc(30%);
}

/* Cardbox */

.card {
border: 1px solid rgba(0,0,0,.15);
border-bottom-width: 3px;
}
.card a.image {
display: block;
height: 100%;
}
.card a.image img {
object-fit: cover !important;
overflow: hidden;
height: 100% !important;
}

/* Sitenotice */

.mw-dismissable-notice {
background: unset;
border: 0;
box-shadow: unset;
}
.mw-dismissable-notice-body {
margin: 0 !important;
}
.mw-dismissable-notice-close {
z-index: 1;
position: relative;
right: 0;
display: flex;
}

/* Donate caption */

/** @TODO we need to refacor this so that is uses system messages rather than CSS **/

#site-navigation #n-donate::before {
content: 'Did this page help you?';
display: block;
text-align: center;
}
#site-navigation #n-donate::after {
content: 'Help us grow MEpedia.';
text-align: center;
display: block;
margin-top: .25em;
}
.ns-4001 #site-navigation #n-donate::before,
.ns-4000 #site-navigation #n-donate::before {
content: '¿Te ha sido útil esta página?';
}
.ns-4001 #site-navigation #n-donate::after,
.ns-4000 #site-navigation #n-donate::after {
content: 'Ayúdanos a hacer crecer MEpedia.';
}
.ns-4003 #site-navigation #n-donate::before,
.ns-4002 #site-navigation #n-donate::before {
content: 'Hat Ihnen diese Seite geholfen?';
}
.ns-4003 #site-navigation #n-donate::after,
.ns-4002 #site-navigation #n-donate::after {
content: 'Helfen Sie uns,\00a0MEpedia zu erweitern.';
}
@media screen and ( min-width: 1100px ){
#site-navigation #n-donate::before {
margin-bottom: -1em !important;
margin-top: 1em;
}
}

/* Mepedia boxes */

.mepedia-masonry-item {
flex: 1 1 300px !important;
}
.mepedia-box {
display: flex !important;
flex-direction: column;
justify-content: center;
}
.mepedia-box-title a {
color: #fff !important;
font-size: 2rem;
font-weight: bold;
text-shadow: 0 0 8px black, 0 0 8px black, 0 0 8px black, 0 0 8px black;
}
@media screen {
.mepedia-box-title {
text-align: center;
line-height: 2em;
position: absolute;
align-self: center;
display: flex !important;
justify-content: center;
width: min-content;
min-width: 240px;
}
}

.portal-cards .card {
flex: 1 1 350px;
}

/** Unify thumbs **/

div:not(.card) .thumb.tright * {
width: 250px !important;
height: auto;
}

@media all and ( max-width: 640px ) {
div:not(.card) .thumb.tright * {
width: unset !important;
max-width: 400px;
}
}

#n-donate a {
background-image: url(/w/skins/MEpedia/resources/images/donate.png);
background-image: url(/w/skins/MEpedia/resources/images/donate.svg);
background-size: 172px;
}

[typeof="mw:File/Thumb"] {
float: right;
clear: both;
padding: 1rem;
text-align: center;
background-color: #f0f0f0;
width: 100%;
}

.gallerytext,
figcaption {
font-size: .94rem !important;
line-height: 1.6;
color: #444 !important;
text-align: left;
}
figcaption {
margin: .5rem 0 0 0;
}
@media screen and ( min-width: 640px ){
[typeof="mw:File/Thumb"] img {
width: 100%;
}
[typeof="mw:File/Thumb"] {
width: 270px;
background-color: revert;
}
}

@media screen and (max-width:550px) {
#p-logo-text {
position: absolute !important;
}
}

#mw-footer .cdx-button--size-large {
background: transparent;
border: none;
padding: 0;
}
#footer-poweredbyico .cdx-button--size-large:first-child img {
background: white;
padding: 3px;
border-radius: 4px;
}
#footer-poweredbyico {
display: flex;
align-items: baseline;
gap: .75rem;
}

/** Captcha **/
#wpCaptchaWord {
width: 100%;
}
label[for="wpCaptchaWord"] {
display: block;
}
label[for="wpCaptchaWord"] code {
display: block;
background: #e3291c;
font-size: 1.25rem;
letter-spacing: .9rem;
font-weight: bold;
color: #fff;
text-align: center;
border: 0;
border-radius: 2px;
}

.ve-ui-toolbar {
z-index: 1 !important;
}

@media screen {
.mw-editsection {
background-image: none !important;
}
.client-js .mw-editsection-divider,
.mw-editsection-bracket {
display: inherit;
}
.mw-editsection a {
margin-right: 0;
}
}