Chronic Fatigue Syndrome - Welfare.ie

In association withmonths.A number of Authorities have commented that this time limit is not clinicallyappropriate, and that the six month time barrier should be considered as the endpoint by which the diagnosis should have been confirmed (Department of Health,2003; Turnbull et al, 2007). NICE guidance recommends that referral to specialistsin Chronic Fatigue Syndrome should be made immediately in people with severesymptoms, within three months for individuals who present with moderatesymptoms, and within six months for individuals with mild symptoms.These referral limits differ for paediatric and adolescent cases.4.3 Physical ExaminationA physical examination should be performed, but it should be noted that this may notreveal any abnormalities.4.4 Mental State ExaminationA thorough mental state examination should be performed to identify changes inmood, intellectual function, memory, and personality. Any symptoms of depressionor anxiety should be identified.The examination should aim to identify any psychiatric or neurological disorder thatmay account for the chronic fatigue. Referral for further psychological orneurological evaluation may be required.4.5 InvestigationsWhere symptoms suggest CFS/ME, the following tests should usually be done:Urinalysis for protein, blood and glucoseFull blood countUrea and electrolytesLiver functionThyroid functionErythrocyte sedimentation rate or plasma viscosityC-reactive proteinRandom blood glucoseSerum creatinineBearingPoint, Atos Healthcare & DSPEBM Chronic Fatigue SyndromePage 13CopyrightVersion:5.0 FINAL