Chronic fatigue syndrome, fibromyalgia, and related illnesses: a clinical model of assessment and intervention

Abstract

A clinically informative behavioral literature on chronic fatigue syndrome (CFS) and fibromyalgia (FM) has emerged over the past decade. The purpose of this article is to (a) define these conditions and their less severe counterparts, i.e., unexplained chronic fatigue (UCF) and chronic widespread pain; (b) briefly review the behavioral theory and intervention literature on CFS and FM; and (c) describe a user-friendly clinical model of assessment and intervention for these illnesses. The assessments described will facilitate understanding of the somewhat unusual and puzzling somatic presentations that characterize these patients. Using an individualized cognitive-behavioral approach the mental health clinician can offer significant help to these often stigmatized and medically underserved patients.

Perspectives of Time and Occupation: Experiences of People with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

“…The predominance of a sympathetic autonomic nervous system state, which is the physiological state for action, could hypothetically be influencing biological rhythms and sense of time. Reestablishing balance in daily rhythms, including sleep-wake cycles, have been highlighted as an important element of intervention (Friedberg, 2010). Thus, occupation becomes an important means of synchronising biological rhythms and physiological clocks (Christiansen & Matuska, 2006).…”

Cognitive-behavior therapy: why is it so vilified in the chronic fatigue syndrome community?

“…One plausible interpretation of this finding is that 'recovered' individuals may have replaced illness-exacerbating activities with illness-moderating behaviors, resulting in no net increase in total activity levels. [18] As suggested in illness management-oriented trials in CFS, patients may still be living within a safety 'envelope' that avoids prolonged post-exertional symptom flare-ups, [19] rather than enjoying resilient levels of recovered function and symptom alleviation. Such a management strategy could still lead to substantive improvements in fatigue and function.…”

Fibromyalgie et psychiatrie : 35 ans plus tard… Quoi de neuf ?

“…Par ailleurs, les comorbidités générales sont nombreuses et la pathologie FM peut s'associer à des maladies rhumatologiques, endocriniennes, infectieuses, neurologiques ou de système [15,20,21]. La FM peut être selon certains auteurs dite secondaire ou primaire à ces maladies comorbides qu'il faut différencier et identifier,…”

“…Les études scientifiques confirment toutes le bénéfice de ce type d'approche [8,22,[57][58][59]. Mais cela n'est pas simple en pratique clinique car la FM met à mal le clinicien qui se trouve face à un patient qui souffre, mais dont il ne connaît pas l'étiologie exacte [20,60]. En effet, dans le cadre d'une affection physique classique, l'individu présente une plainte, source d'une demande de soins au médecin qui possède le savoir théorique et le savoir-faire et qui saura répondre correctement et de façon précise au patient.…”