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The term Myalgic Encephalomyelitis pre-dates Chronic Fatigue Syndrome by three decades

Posted by tkindlon on 02 Jan 2009 at 00:21 GMT

While the methodology of this study seems to be reasonably sound, the suggestion that Chronic Fatigue Syndrome is a "recently medicalized" condition is questionable.

The authors say that "in order to validate the category assignment of these disorders, a Lexis Nexis search was conducted sampling from 1997 and 2007 for frequency of use of both the medial and lay labels for each disorder in popular news media (defined as print media publicly available in North America). When examining the recently medicalized disorders in print media, we see a six-fold
increase in the ratio of medicalese to lay labeling, where we see only a 1.2 fold increase in the same ratio for recognized medical disorders".

However if they had looked at the popular news media in the UK and Ireland, they would have seen the opposite i.e. a large increase in the ratio of media coverage that used Chronic Fatigue Syndrome as opposed to Myalgic Encephalomyelitis (or Encephalopathy - the authors use each term interchangeably; for the purposes of brevity I will henceforth generally use the recognized acronyms of CFS
and ME).

The term myalgic encephalomyelitis was used in The Lancet in 1956[1] and has been in continuous use in the UK since then. The World Health Organisation (WHO) has had an entry for M.E. since 1969 (G93;3).

On the other hand, the term chronic fatigue syndrome wasn't introduced till over three decades later, around 1987[2].

While the term ME may not be perfect, the term chronic fatigue syndrome is probably more problematic. It concentrates on one particular symptom, fatigue, when there are many symptoms and many systems involved. It gives the impression that chronic fatigue syndrome is on a spectrum of chronic fatigue while many unusual abnormalities have been found in ME or CFS patients.

The term chronic fatigue syndrome does not get across how disabling the condition is. For example, Schweitzer, Kelly, Foran, Terry and Whiting (1995)[3] found that the degree of impairment was more severe in individuals with CFS than in patients with hyperthyroidism, end-stage renal disease (ESRD) and heart disease. Another study recently published used a sample comprised of 140 women with CFS (CDC criteria ’94) recruited from two ME charities in the UK. The mean illness intrusiveness rating scale (IIRS) score was 65.84 (SD= 13.91.). This meant "CFS/ME" (to use the term authors used) was found to be more intrusive than other chronic illnesses such as Multiple Sclerosis, laryngeal cancer, ESRD (End Stage Renal Disease) and Rheumatoid Arthritis.

The compromise term "ME/CFS" or "CFS/ME" is increasingly being used which means both terms are used at the one time e.g. [5-7].

[1] (1956). "A new clinical entity?" (Editorial). Lancet 270 (6926): 789–90. PMID 13320887

[2] Buchwald D, Sullivan JL, Komaroff AL. Frequency of 'chronic active Epstein-Barr virus infection' in a general medical practice. JAMA. 1987 May 1;257(17):2303-7.

[3] Schweitzer, R., Kelly, B., Foran, A., Terry, D., & Whiting, J. (1995). Quality of life in chronic fatigue syndrome. Social Science and Medicine, 41, 1367-1372.

[4] Dancy, CP and Friend, J. Symptoms, impairment and illness intrusiveness - their relationship with depression in women with CFS/ME. Psychology and Health, 2008, 23, 8, 983-999.

[5] Carruthers BM, Jain AK, De Meirleir KL, Petersn DL, Klimas MD, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, Sherkey JA, van de Sande MI (2003). "Myalgic encephalomyalitis/chronic fatigue syndrome: Clinical working definition, diagnstic and treatment protocols". Journal of Chronic Fatigue Syndrome 11 (1): 7-36. DOI:10.1300/J092v11n01_02.

[6] Jason LA, Porter N, Shelleby E, Bell DS, Lapp CW, Rowe K, De Meirleir K. A Case Definition for Children with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Clinical Medicine: Pediatrics, Nov 11, 2008:1 53-57.

[7] The association for researchers and clinicians involved in the area is called the International Association for CFS/ME (IACFS/ME).