Six (or more) of the following symptoms have been present every day or nearly every day during the same 2-week period in the past month, and at least one of the symptoms is (A1) significant fatigue. |
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A1. Significant fatigue, diminished energy, or increased need to rest, disproportionate to any recent change in activity level |
A2. Complaints of generalized weakness or limb heaviness |
A3. Diminished concentration or attention |
A4. Decreased motivation or interest to engage in usual activities |
A5. Insomnia or hypersomnia |
A6. Experience of sleep as unrefreshing or nonrestorative |
A7. Perceived need to struggle to overcome inactivity |
A8. Marked emotional reactivity (eg, sadness, frustration, or irritability) to feeling fatigued |
A9. Difficulty completing daily tasks attributed to feeling fatigued |
A10. Perceived problems with short-term memory |
A11. Postexertional malaise lasting several hours |
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning |
C. There is evidence from the history, physical examination, or laboratory findings that the symptoms are a consequence of cancer or cancer therapy. |
D. The symptoms are not primarily a consequence of comorbid psychiatric disorders such as major depression, somatization disorder, somatoform disorder, or delirium. |