Chronic fatigue syndrome
Fatigue is a common symptom. When it is chronic, disabling and unexplained by another condition, a diagnosis of chronic fatigue syndrome (CFS) may be appropriate. There is no known simple cause for CFS, but there is evidence for multiple contributing factors. Illness perpetuating factors include inactivity, a fear of making oneself worse and belief that the illness is permanent, and depression. Management should be directed to the perpetuating factors relevant to the particular patient. Much can be achieved by education and gentle encouragement back to normal activity. If specialist management is required, graded exercise therapy (GET) or cognitive-behavioural therapy (CBT) are of proven value. © 2008 Elsevier Ltd. All rights reserved.