Submission to the Working Group

Draft Clinical Practice Guidelines
on the Evaluation of Prolonged Fatigue
and the Diagnosis and Management of
Chronic Fatigue Syndrome

A Review of Draft Version 1

Jim Oakley

January 1998

Contents

1 Introduction 1

2 Overview 1

3 Strengths 2

4 Major Areas for Improvement 3

Diagnostic Criteria 3

CBT and Graded Aerobic Exercise 5

Management of Sleep Disorder 11

Natural History 12

Treatment and Placebo Effect 20

Pathophysiology 24

Symptoms 28

Diet 29

Heterogeneity 30

Support Groups 31

Depression 31

Nomenclature 32

References 32

Consumer Input 32

5 Minor Areas for Improvement 33

6 Conclusion 36

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1	Introduction	1
2	Overview	1
3	Strengths	2
4	Major Areas for Improvement	3
	Diagnostic Criteria	3
	CBT and Graded Aerobic Exercise	5
	Management of Sleep Disorder	11
	Natural History	12
	Treatment and Placebo Effect	20
	Pathophysiology	24
	Symptoms	28
	Diet	29
	Heterogeneity	30
	Support Groups	31
	Depression	31
	Nomenclature	32
	References	32
	Consumer Input	32
5	Minor Areas for Improvement	33
6	Conclusion	36