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Symptom Patterns in Long-Duration Chronic Fatigue Syndrome.

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By Friedberg F, Dechene L, McKenzie MJ 2nd, Fontanetta R • • April 26, 2000

SUMMARY: Is there a pattern to the symptoms experienced by people who have been ill with chronic fatigue syndrome for as long as ten years? That's one of the issues these researchers set out to quantify using a self-reporting method in which CFS and healthy volunteers answered 574 questions in a survey mailed out to them.

A majority of those who filled out the questionnaire (258 people) had what the researchers considered long-duration CFS – in this case the median number was 18 years. Short duration CFS, about 3 years, accounted for 28 of those surveyed, and 79 healthy controls were included. Their findings indicate that those with long-duration CFS score higher in terms of severity of symptoms -- which they believe to be significantly related to increased problems with cognition. In contrast, a characteristic of those with short-duration CFS, who had not yet hit a 4-7 year mark, was a highly likelihood of using denial as a coping strategy. As might be expected, CFS patients of whatever length of illness experienced other disorders concurrent to CFS, as compared to the healthy subjects. And in terms of self-evaluation, many of those with CFS saw the disease culprit as viral or stress-related.

In looking at this data, researchers confirmed cognitive problems were greater for those with long-duration CFS, and comorbid diseases greater for all those with CFS. It is this last point that they feel supports the hypothesis that hypersensitivity and viruses play a role in the pathogenesis of CFS.

OBJECTIVE: Our objective was to evaluate symptom patterns in patients with chronic fatigue syndrome (CFS) who were ill for 10 or more years.

METHODS: This cross-sectional self-report study compared patient groups with long-duration (median = 18 years; n = 258) and short-duration (median = 3 years; n = 28) CFS to a group of healthy significant others (n = 79) on symptomatic, neurocognitive, and psychological variables. Data were gathered from a 574-item postal questionnaire.

RESULTS: A principal-components analysis of CFS symptom data yielded a three-factor solution: cognitive problems; flu-like symptoms; and neurologic symptoms. Compared with the short-duration CFS group, the long-duration group had significantly higher CFS symptom severity scores (p < 0.04), largely attributable to increased cognitive difficulties. A subgroup comparison of subjects ill for < 3 years versus those ill 4-7 years suggested that denial coping strategies were more likely in those participants with the shorter illness duration. Significant differences between both CFS groups and healthy controls were found in a number of comorbid disorders. Participants with CFS most often endorsed immune/viral abnormalities and persistent stress as important perceived causes of their illness.

CONCLUSION: Participants with long-duration CFS reported a large number of specific cognitive difficulties that were greater in severity than those reported by participants with short-duration CFS. The pattern of comorbid disorders in the CFS groups was consistent with hypersensitivity and viral reactivation hypotheses.

Source: Friedberg F, Dechene L, McKenzie MJ 2nd, Fontanetta R, J Psychosom Res 2000 Jan; 48(1):59-68, Department of Mathematics, Fitchburg State College, MA, USA, PubMed.

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