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General practitioners' beliefs, attitudes and reported actions towards chronic fatigue syndrome.

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By Steven ID, McGrath B, Qureshi F, Wong C, Chern I, Pearn-Rowe B • • January 1, 2000

SUMMARY: For those with chronic fatigue syndrome (CFS), the patient-physician relationship has a profound impact on initial diagnosis and course of treatment. In the following study, researchers report on the "beliefs, attitudes and reported actions" of 2,090 physicians in Australia when it comes to treating CFS. The survey yielded an impressive 77% response rate. The doctors who addressed CFS in their patients reported the following six symptoms that they felt were critical in this diagnosis:

Failure to recover energy after rest
Reduced exercise tolerance
Prostration for several days after exercise
Generalised myalgia
Poor concentration
In response to the symptoms of CFS, the doctors most often recommended counseling. Other statistics produced by the study highlight the difficulty CFS sufferers may face in obtaining a diagnosis; 31% doctors did not believe CFS is a distinct syndrome – most of these same doctors felt that depression was causing their patients' fatigue.

While the researchers note the diversity of opinion regarding CFS, it can be suggested that the salience of the study for CFS patients is to be advised that some physicians may still be reluctant to make a diagnosis of CFS. Persistence in seeking a diagnosis that resonates with your health experience is valid and necessary. One other hand, this same data may also serve as a source of relief to those who have found already support in their patient-doctor relationship, from a physician who believes in the applicability of a CFS diagnosis.

OBJECTIVE: To undertake a survey of Australian general practitioners (GPs) to explore their beliefs, attitudes and reported actions with respect to chronic fatigue syndrome (CFS).

METHOD: A random sample of 2090 Australian GPs, stratified by state, was surveyed in May-August 1995.

RESULTS: A 77% response rate was obtained. For the majority of practitioners who pursue a diagnosis of CFS, six symptoms were considered to be of significance: chronic unremitting fatigue for over 6 months; failure to recover energy after rest; reduced exercise tolerance; prostration for several days after exercise; generalised myalgia and poor concentration. Individual counseling was the most frequently used treatment. Thirty-one percent of practitioners reported that they did not believe that CFS is a distinct syndrome. Of these, 70% reported that the most likely cause of chronic fatigue was depression.

CONCLUSION: There is considerable diversity of opinion between practitioners about CFS. The diversity extends from questioning whether the syndrome even exists to different strategies for diagnosis and management.

Source: Steven ID, McGrath B, Qureshi F, Wong C, Chern I, Pearn-Rowe B, Royal Australian College of General Practitioners, South Australia, Aust Fam Physician 2000 Jan;29(1):80-5.

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