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Psych Congress  

Case Study: Patient Focused Treatment of Chronic Fatigue/ME in Collaborative Mental Health Care

Dawn Van Ruler, NP

There is a general recognition that chronic fatigue syndrome (CFS) is under-recognized (Griffith & Arrouf, 2008) and thus undertreated. CFS is often misdiagnosed as depression (Griffith & Aarrouf, 2008). There are also few treatments with proven significance in relieving symptoms (Kreijkamp-Kaspers, Benu, Marshall, Staines, & Van Driel, 2011) and prognosis remains poor (Brown,2004). CFS sufferers frequently access the internet to search for treatment alternatives. Kisley found that 42% of the recommendations CFS sufferers accessed on the internet were not concordant (Kisley, 2002). Lack of effective medication treatments leads to frequent use of prescribed or over-the-counter medication (Boneva, Lin, Maloney, Jones, & Reeves, 2009). Aims of this study are: to identify barriers to care of CFS including lack of consensus on the definition and lack of collaboration in the care environment, to increase awareness of need for mental health professionals to have knowledge about chronic fatigue identification and treatment, and to highlight lack of research basis to study effective medication or supplements for treatment of symptoms of fibromyalgia. Methods: Will be a phenomenological descriptive case study approach engaging an individual that suffers from chronic fatique/myalgic encephalomyelitis (ME). Case study findings will describe a patient focused view of the experience of living with CFS/ME. The working hypothesis is that from a patient perspective there is insufficient consideration of physical symptoms and evaluation for chronic fatigue such as thyroid status testing and ebstein-bar titre status at initial evaluation stage when seeking care for depression. This focus on mental health aspects may avoid delay of diagnosis and lead to ineffective or only partially effective treatment outcomes of depression in these individuals. Patient perspective also suggests implementation of treatment with possible efficacy and minimal side effects would produce the best benefit-to-harm ratio in patients with CFS and depressive symptoms. This type of intervention would require communication and collaboration regarding the treatment plan between primary and mental health care providers to maximize benefits and limit harm for patients.

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