It is a debilitating condition that GAP 1-13 can lead to severe impairment of function in every aspect of patients' lives, including physical, psychological, cognitive, social and occupational. Some patients are able to maintain, with difficulty, some or all of their premorbid level of functioning whereas others may be severely restricted in their activities. Relationships and social functioning are often adversely affected with consequent negative effects on self-esteem and mental wellbeing. The most severely affected patients may be housebound or even bedbound. As such, CFS presents a considerable burden on the individual, their carers and society.
Assessment
Fatigue is a common symptom in the population, and there are no diagnostic tests available for CFS. CFS is therefore a diagnosis of exclusion, and the list of potential differential diagnoses is wide (Table 1), from fatigue associated with ongoing exertion on the one hand, to that associated with medical illness on the other. For seed coat reason a thorough and comprehensive assessment including physical examination should be carried out. As CFS patients may find long appointments difficult, consideration should be given to rest breaks during the assessment.
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Such low level of genetic differentiation
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