Misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome

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The misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome are very common, this takes the form of misdiagnosis, underdiagnosis or overdiagnosis.

Many ME/CFS patients wait too long for a confirmatory diagnosis. This may be because doctors receive very little training on how to recognise and treat the illness.[1] —Geraghty (2020)

Misdiagnosis[edit | edit source]

Misdiagnosing of ME or CFS involves diagnosing another illness or medical condition instead of diagnosing ME or CFS, for example erroneously diagnosing depression, medically unexplained physical symptoms, the symptom chronic fatigue or even a different fatiguing illness, or diagnosing ME or CFS when another illness or symptom is the cause of the symptoms, and diagnostic criteria for ME/CFS are not met.

Underdiagnosis[edit | edit source]

Underdiagnosis means failing to diagnose ME or CFS in patients meeting diagnostic criteria, e.g. blaming lifestyle factors for symptoms, or referring to patients as tired all the time.
Patients may even be told they are in "good health" resulting in no medical care, or be diagnosed as having another illness or "medically unexplained symptoms".


Overdiagnosis[edit | edit source]

Overdiagnosis involves diagnosing ME or CFS when it is not present, meaning when the patient does not meet the diagnostic criteria for ME or CFS, especially diagnosing CFS instead of chronic fatigue or idiopathic chronic fatigue is the cause of the symptoms.

While there is no diagnostic medical test for ME or CFS, medical tests must be run to identify illness that have similar symptoms but can be identified by particular tests.[2][3]

Overdiagnosis of chronic fatigue syndrome can also result when CFS is diagnosed or referred interchangably with either chronic fatigue (CF), or another illness, e.g., regarding all fibromyalgia patients as having CFS or using myalgic encephalomyelitis (ME) to refer to patients meeting CFS diagnostic criteria but not ME diagnostic criteria.
Sometimes an CFS diagnosis is when chronic fatigue or chronic pain (or both) are present and fully explained by another fatiguing illness.

Evidence[edit | edit source]

Notable articles[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Geraghty, Keith (July 2, 2020). "The negative impact of the psychiatric model of chronic fatigue syndrome on doctors' understanding and management of the illness" (PDF). Fatigue: Biomedicine, Health & Behavior. 8 (3): 167–180. doi:10.1080/21641846.2020.1834295. ISSN 2164-1846.
  2. ↑ "Other Conditions for Evaluation | Information for Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Centers for Disease Control. July 12, 2018. Retrieved March 28, 2022.
  3. ↑ Centers for Disease Control and Prevention (November 19, 2019). "Presentation and Clinical Course of ME/CFS | Information for Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome ME/CFS". CDC. Retrieved December 18, 2021.
  4. ↑ Bateman, Lucinda; Bested, Alison C.; Bonilla, Hector F.; Chheda, Bela V.; Chu, Lily; Curtin, Jennifer M.; Dempsey, Tania T.; Dimmock, Mary E.; Dowell, Theresa G.; Felsenstein, Donna; Kaufman, David L. (November 1, 2021). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management". Mayo Clinic Proceedings. 96 (11): 2861–2878. doi:10.1016/j.mayocp.2021.07.004. ISSN 0025-6196.
  5. ↑ O'Leary, Diane; Geraghty, Keith (August 27, 2021). "Ethical Psychotherapeutic Management of Patients with Medically Unexplained Symptoms: The Risk of Misdiagnosis and Harm". Oxford Handbook of Psychotherapy Ethics. doi:10.1093/oxfordhb/9780198817338.013.72. Retrieved January 13, 2022.
  6. ↑ Pilkington, Karen; Ridge, Damien T.; Igwesi-Chidobe, Chinonso N.; Chew-Graham, Carolyn A.; Little, Paul; Babatunde, Opeyemi; Corp, Nadia; McDermott, Clare; Cheshire, Anna (November 1, 2020). "A relational analysis of an invisible illness: A meta-ethnography of people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and their support needs". Social Science & Medicine. 265: 113369. doi:10.1016/j.socscimed.2020.113369. ISSN 0277-9536.
  7. ↑ McManimen, Stephanie; McClellan, Damani; Stoothoff, Jamie; Gleason, Kristen; Jason, Leonard A. (March 4, 2019). "Dismissing chronic illness: A qualitative analysis of negative health care experiences". Health Care for Women International: 1–18. doi:10.1080/07399332.2018.1521811. ISSN 0739-9332.
  8. ↑ 8.0 8.1 Jason, LA; Ohanian, D; Brown, A; Sunnquist, M; McManimen, S; Klebek, L; Fox, P; Sorenson, M (2017). "Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome". Insights in Biomedicine. 2 (2). doi:10.21767/2572-5610.100011.
  9. ↑ McManimen, Stephanie L.; Jason, Leonard A. (2017). "Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia". SRL neurology & neurosurgery. 3 (1): 22–27. PMID 28603794.
  10. ↑ McManimen, Stephanie L.; Jason, Leonard A. (2017). "Post-Exertional Malaise in Patients with ME and CFS with Comorbid Fibromyalgia". SRL neurology & neurosurgery. 3 (1): 22–27. PMID 28603794.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

medically unexplained physical symptoms (MUPS) - Technically, this term means that no cause or explanation for the patient's symptoms has yet been found. However, patients diagnosed with "MUPS" are generally lumped into a psychosomatic, or psychologically-caused category by those in the medical profession, without any scientific basis for doing so.

See ME/CFS.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

See Centers for Disease Control and Prevention.

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