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Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists

  [ 348 votes ]   [ Discuss This Article ] • November 15, 2006

There is a “best practice” guide that explains why ME/CFS is NOT a psychiatric disorder, and then outlines how anxiety and depression can be assessed and treated in CFS patients. Available in English, it is currently being translated into three additional languages.

The Author
Eleanor Stein, MD, FRCP(C), is a Canadian psychiatrist dedicated to the integrated treatment of patients with 'Chronic Fatigue Syndrome' (ME/CFS), Fibromyalgia, multiple chemical sensitivities, and toxic exposure – and a specialist in the diagnosis and treatment of co-existing anxiety and depression in ME/CFS and FM.

Dr. Stein formed the first multidisciplinary team in her country to provide integrated medical, cognitive, and sensory assessments of ME/CFS & FM patients.

Additionally, to support the world medical community in implementing an integrated approach to the care of ME/CFS patients, Dr. Stein wrote and made freely available for download a 29-page document titled Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists.

What the Guidelines Cover

Dr. Stein’s heavily-sourced and experience-based CFS guide for psychiatrists explains explicitly what CFS is and is not. Then it proceeds to outline how medical professionals may assess and treat anxiety and/or depression in their CFS patients – in the context of an integrated approach to care. Specific sections include:

1. Definition of ME/CFS

2. Explanation of why ME/CFS is not a psychiatric disorder, even though a significant subgroup of patients have psychiatric diagnoses.

3. Steps in differentiating the symptoms of ME/CFS from those of depression and anxiety.

4. Suggested treatment approaches for common psychiatric symptoms in patients with ME/CFS.

5. Summary of psychological treatment issues in patients with ME/CFS.

6. Explanation of issues relevant to children and adolescents with ME/CFS.

7. Discussion of treatment issues regarding drug sensitivity and the utility of Cognitive Behavior Therapy and Graded Exercise in patients with ME/CFS.

Where to Find the Guide

The downloadable PDF file of Dr. Stein’s Guidelines for Psychiatrists can be found on the University of Alberta website (

Dr. Stein was the first physician to respond to the Canadian National ME/FM Action Network's request for development of free profession-specific guides based on the Canadian Consensus Document for ME/CFS, a guide to best practice in diagnosis and treatment created by a panel of leading clinicians in 2003 (

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