Novakovic, Mina, Løhde, Linda, Brandt-Christensen, Anne Mette et al. · Ugeskrift for laeger · 2024 · DOI
This case report describes an older woman who was diagnosed with ME/CFS 30 years ago but was later found to actually have depression with severe fatigue as a main symptom. She received electroconvulsive therapy (ECT) for depression and regained the ability to walk after six years of immobility. The case highlights how depression and ME/CFS can look similar and sometimes get confused with one another.
This case is clinically relevant because it demonstrates that severe fatigue and immobility attributed to ME/CFS may occasionally have a psychiatric etiology responsive to ECT. It underscores the importance of thorough diagnostic evaluation in patients with ME/CFS-like presentations and the need for clinicians to consider overlapping depression, particularly atypical depression with prominent fatigue symptoms, in differential diagnosis.
This single case report does not prove that ECT is effective for ME/CFS or that patients with ME/CFS should be treated with ECT. It does not establish the frequency with which depression is misdiagnosed as ME/CFS. The case cannot determine whether other ME/CFS patients with depression might respond similarly, and causality between ECT and functional recovery cannot be definitively established from one case.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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