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Under proper supervision first-line treatments for chronic fatigue syndrome are effective and safe but research into second-line treatment is required.
In the paper by Smith and Wessely,1 problems are outlined in commissioning services in Scotland2 that accommodate the acrimonious debate between the views of those who consider myalgic encephalomyelitis (ME) to be a neurological condition versus an evidence-based medicine view that chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a condition of uncertain aetiology improved by graded exercise treatment (GET) and cognitive behaviour therapy (CBT).3 The debate threatens to hinder the development of safe, cost-effective and clinically effective services for patients with CFS/ME, and to stifle further research building on important discoveries on diagnosis, the limited effectiveness of current treatments and the validity of ‘objective’ outcome measures.
A wide range of diagnostic criteria …
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