Dr Per Julin writes about the differences between ME and stress-induced fatigue/burnout ("utmattningssyndrom", literally "exhaustion syndrome", which is a separate diagnosis in Sweden), in the latest issue of the medical journal Medicinsk Tidskrift:
Nyfiken på Trötthet
https://ki.se/forskning/nyfiken-pa-trotthet
Google Translate:
Curious About Fatigue
[...]ME/CFS, formerly called chronic fatigue syndrome, is a disease that in many ways resembles burnout syndrome. This poses a certain risk of uncertain diagnostics, says Per Julin, chief physician at the neurological rehabilitation clinic Stora Sköndal and researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
- There have been several rounds of diagnostic criteria for ME/CFS and some of those who have been diagnosed with older variants, where fatigue was the main criterion, may in fact have had stress-induced fatigue syndrome, burnout. This gives uncertainty about older studies, where it is unclear what diagnosis the included patients actually had. But research becomes better and safer as the right people are included in the studies, says Per Julin.
There are several clear differences between the illnesses. For example, the ME/CFS disease often occurs after an acute infection, such as glandular fever, tick borne infection or influenza.
Another difference is that people with ME/CFS get worse by any kind of exertion. Physical and mental activity can cause flu-like symptoms, some even cause fever. This symptom, called post-exertional malaise, PEM, is central to the disease. This means that all activity can be exhausting, even such as the patient previously experienced as recovering, such as pleasant socializing or a walk. It also means that people with ME/CFS cannot use physical activity as part of their treatment in the same way as patients with stress-induced fatigue syndrome burnout.
- Actually, the typical patient is fairly easy to diagnose. The sad thing is that they are often the most misunderstood, says Per Julin.
He collaborates with researchers at Karolinska Institutet and Uppsala, among others, in search of biomarkers and treatments relevant to ME/CFS. And from a research perspective, Per Julin is hopeful for the future.
- Current research increasingly points to autoimmune mechanisms, inflammation of the nervous system and impact on the cells' energy production capacity. In recent years there have been many new drugs in the fields of cancer and immunology, aimed at specific mechanisms of action in the immune system. I think that if we only get a little further in biomarker research around ME/CFS, so that we can better dial in the mechanisms that are affected, then I think the step may be short for more drug or treatment trials,” says Per Julin.
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. A family member was registered to attend and received a mail about the seminar unfortunately being postponed, a new date will be announced, likely in the autumn.
