ICD-CFS & ME/CFS
Making The Distinction Between The Psychological And Neurological
Approach
This page discusses the emergence of the terms 'ICD-CFS' and 'ME/CFS'.
It has become more and more important that a clear distinction
is made between the two approaches to the name Chronic Fatigue
Syndrome - i.e. the psychological approach versus
the neurological approach...
People who follow the controversial Wesseley School of thinking,
have come to refer to Chronic
Fatigue Syndrome as
a psychological disorder.
What confuses matters is that the World Health Organisation
(WHO) formally classifies CFS as another name by which ME is known.
And ME is classified as a neurological disorder in
the WHO's International Classification Of Diseases
(ICD G93.3).
So clearly there's a confusion here - when someone says 'Chronic
Fatigue Syndrome', are they referring to the (proven)
neurological illness ... or the controversial Wessely
School's psychiatric approach? Because these two approaches
describe two groups of different
illnesses!
So to avoid confusion, many people
now refer to CFS as ICD-CFS,
to stress that they are referring to it as a neurological disorder.
It's worth mentioning at this point, that when we refer
to Chronic Fatigue Syndrome ( CFS ) on this web site,
we are referring to CFS as a neurological disorder (as classified
by the WHO International Classification of Diseases -
otherwise known as ICD-CFS ) - and NOT
to the Wessely School's psychological approach to CFS.
You can read more about WHO's
definitions of Myalgic Encephalomyelitis (M.E.), Chronic Fatigue
Syndrome (ICD-CFS), Post Viral Fatigue Syndrome (PVFS), and Fatigue
Syndrome, here...
For more about why ME/CFS is a real, physical, biological illness,
click here..
The Importance Of Emphasizing Exercise Intolerance
Still, many feel that ICD-CFS is not an adequate name.
Why?
Because by definition (CDC), it is not required that a
sufferer experiences exercise intolerance in order to be diagnosed
with 'Chronic Fatigue Syndrome'. And it is
exercise intolerance that largely (but not solely) distinguishes
this illness from other illnesses (both medical and psychiatric),
in which fatigue is a prominent symptom.
OK so, why not use the term M.E. then? By definition,
a diagnosis of M.E. requires that a sufferer does not
tolerate exercise. This is part of what makes it distinctly
different to other medical and psychiatric illnesses…
So surely we can just all go back to using the name M.E., right?
Urm… no…
The Problem: If You Don't Have An Inflammation Or Infection
Of The Brain, You Don't Have 'Real' M.E.
So why not use the name M.E. instead?
Well, it's because many people are not satisfied with the
actual name, Myalgic Encephalomyelitis (M.E. ) - or more
specifically, its ending, -myelitis.
What??? 
OK, hang on, let me explain…
The suffix -myelitis means 'an inflammation
or infection of the brain and spinal cord'. But scientists
say that this is not always present in all sufferers.
So this is why people think it is incorrect to include -myelitis
in the name.
But hang on...
Scientists say that '-myelitis' is not always present
in all sufferers... of what? Let's not forget what exactly
we're talking about here...
You see, it seems that this illness is made up of subgroups
of illnesses (some unknown). In other words, it's an 'umbrella'
illness which can be sub-divided into further similar, but different
illnesses. And it is generally agreed that M.E. is one of
those subgroups.
Now, don't get me wrong - there is proof
that an inflammation or infection of the brain exists in M.E. ;
it does come up in 'true M.E. sufferers' if
more advanced tests are run [ref 24].
But the problem is that it does not appear in all sufferers
of this 'umbrella' illness …
... or to put it another way, the inflammation/infection
doesn't necessarily occur in the other subgroups of this
complex 'umbrella' illness.
People argue that this 'discrepancy' could well have
contributed to the medical scepticism that exists today - doctors
run basic tests for an inflammation or infection of the brain, and
more often than not, don't find anything.
So it's for this reason that when it comes to finding a suitable
term for the 'umbrella' illness, the name Myalgic
Encephalomyelitis is not suitable because not everyone seems
to experience the -myelitis part.
So what are people going to call this 'umbrella' illness (or group
of illnesses) until a suitable name can be agreed upon?
The answer: ME/CFS …
A Compromise: The Term ME/CFS
There seems to have been a general compromise worldwide to use
the term ME/CFS until a more suitable name can be found.
This, it is hoped, will make it clearer that the illness
being referred to, is ICD-CFS - a
real, physical, neurological disorder. But also makes it
clear that the illness being referred to does not necessarily
include an inflammation or infection of the brain.
For more about why ME/CFS is a real, physical, biological illness,
click here…
Category: ICD-CFS, M.E., ME/CFS
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