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De Lorenzo F et al. Lung
function test findings in patients with chronic fatigue syndrome
(CFS). Australian and New Zealand Journal of Medicine, 1996,
26, 4, 563-564.
Lung function was assessed in 33
patients with CFS (CDC criteria '88) and 23 healthy controls.
Compared to the controls, patients with
CFS showed a significant reduction on all lung function measures
(p<.01). The reasons for the abnormalities are unclear.
Chalder, T et al. Chronic
fatigue in the community: 'a question of attribution'.
Psychological Medicine, 1996, 26, 4, 791-800.
Thirty eight patients who attributed
their chronic fatigue to 'ME' were compared to 38 patients who
attributed their fatigue to social variables and 40 who believed
their fatigue to be due to psychological factors. All three groups
were followed up eighteen months later.
At the start of the trial, there were a
number of differences between the groups. For instance, the ME
patients were more physically and mentally fatigued than the others
(p<.05) and they had significantly lower GHQ scores (measure of
emotional distress) than the psychological group.
At Time 2, the ME group had the lowest
scores for anxiety and depression; they had the lowest GHQ scores and
the lowest proportion of GHQ psychiatric 'cases' (28% compared with
70% in the psychological group and 53% in the social group). There
were also differences in coping styles with the ME group being more
likely to reduce their activity than the others. Finally, many
patients attributed their fatigue to a number of causes, not just
infection. The ME patients cited reasons such as workstress and
emotional upset, although 13% referred to continuing infection and
25% cited a previous infection.
The authors note that the ME group were
less psychologically dis-tressed than the other two groups, although
they reported greater fatigue and disability. The rate of psychiatric
disorder was lower than that found in studies of fatigue among
hospital attenders or in primary care.
Vercoulen, JMHH et al. The
measurement of fatigue in patients with multiple sclerosis: a
multidimensional comparison with patients with chronic fatigue
syndrome and healthy subjects. Archives of Neurology, 1996,
53, 642-649.
Fifty patients with clinically definite MS were compared with 51 patients with CFS (own criteria) and 53 healthy subjects.
Patients with MS and CFS had significantly higher subjective fatigue severity scores than healthy subjects and they were significantly less active. Subjective fatigue severity was related to impairment in daily life, low sense of control over symptoms, and strong focusing on bodily sensations.
Sixteen per cent of CFS patients had
scores suggesting current depression compared to 17% of the MS
group.
Buchwald D et al. Functional
status in patients with chronic fatigue syndrome, other fatiguing
illnesses, and healthy individuals. American Journal of
Medicine, 1996, 101, 364-370.
In this study, 185 patients with CFS
(modified '88 criteria) were compared to 246 people with chronic
fatigue (CF), 111 individuals with acute infectious mononucleosis, 25
patients with major depression and 99 healthy controls.
The patients with CFS were more
impaired than the CF group on three of the eight MOS scales measuring
disability (physical functioning, body pain and role functioning).
Overall, the CFS group showed greater impairment than previously
observed for any medical or psychiatric disorder. The disability of
CFS correlated with a number of symptoms (not just fatigue).
Komaroff, AL et al. Health
status in patients with chronic fatigue syndrome and in general
population and disease comparison groups. American Journal of
Medicine, 1996, 101, 3, 281-290
The functional status of 223 patients
with CFS (CDC criteria '94) was compared with that of a general
population controls group (n=2474) and disease comparison groups with
hypertension (n=2089), congestive heart failure (n=216), type II
diabetes mellitus (n=163), acute myocardial infarction (n=107),
multiple sclerosis (n=25) and depression (n=502). Measures included
the MOS Short-Form 36 assessing disability.
The scores showed that patients with
CFS were more impaired than the general population controls on all
eight MOS scales. As before, their disability exceeded that of the
disease comparison groups.
The scores of the CFS patients also
differed significantly from the depressed group. Certain key symptoms
of CFS, including post-exertional malaise, fevers and muscle weakness
correlated with the functional impairment scores but depression did
not. Thus "most of the symptoms of CFS are unlikely to represent
expression of an underlying primary depressive disorder".
The patients with CFS who were or had
been depressed reported slightly more impairment on most scales
compared to the patients with CFS who were not and had never been
depressed.
The researchers conclude that their CFS
patients were signifcantly more impaired than the disease comparison
groups and that the pattern and degree of impairment was different
from that seen in people with major depression.
Copyright EM. Goudsmit 1997.
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