Guideline to improve diagnosis of chronic fatigue syndrome

CFS/ME is a relatively common illness, affecting up to an estimated 193,000 people.  The condition can be disabling, involving a complex range of symptoms, the most common being fatigue, but including headaches, sleep disturbance and muscle pain.  

The guideline provides recommendations to help diagnose and manage the condition, aimed at maintaining, and if possible, gradually extending an individual's physical capacity.  Recommendations include:
Diagnosis:
·    If a child or young person under 18 years old has symptoms of possible CFS/ME they should be referred to a paediatrician within 6 weeks of first seeing their doctor about the symptoms.
·    After other possible causes have been excluded, a CFS/ME diagnosis should be made after symptoms have persisted for 4 months in adults, and after 3 months in a child or young person (in consultation with a paediatrician).
Management:
·    An individualised management plan should be developed with the person with CFS/ME and they are in charge of the aims and goals of the overall management plan.
·    Health professionals should provide care in ways suitable for the individual, which may include providing some tests or treatments at home, or support and advice by telephone or email.
·    Clinicians should offer advice on managing activity, rest periods, sleep patterns, diet, equipment to help maintain independence like the blue badge, and advice on fitness to work or be in education.
·    People with CFS/ME should not be advised to simply “go the gym” or exercise more as this may worsen symptoms.
·    Cognitive behavioural therapy and/or graded exercise therapy should be offered to people with mild or moderate CFS/ME and provided for those who choose it, as there is the clearest evidence of benefit for these approaches.