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Post-Lyme syndrome & Chronic Fatigue Syndrome (CFS). Neuropsychiatric similarities & differences

  [ 57 votes ]   [ Discuss This Article ]
By Gaudino EA, Coyle PK, Krupp LB • • November 5, 1997

BACKGROUND: Patients with chronic fatigue syndrome (CFS) and
post-Lyme syndrome (PLS) share many features, including
symptoms of severe fatigue and cognitive difficulty.

OBJECTIVE: To examine the neuropsychiatric differences in
these disorders to enhance understanding of how mood, fatigue,
and cognitive performance interrelate in chronic illness.

METHODS: Twenty-five patients with CFS, 38 patients with PLS,
and 56 healthy controls participated in the study. Patients
with CFS met 1994 criteria for CFS and lacked histories
suggestive of Lyme disease. Patients with PLS were
seropositive for Lyme disease, had met the Centers for Disease
Control and Prevention criteria, or had histories strongly
suggestive of Lyme disease and were experiencing severe
fatigue that continued 6 months or more following completion
of antibiotic treatment for Lyme disease. All subjects
completed self-report measures of somatic symptoms and mood
disturbance and underwent neuropsychological testing. All
patients also underwent a structured psychiatric interview.

RESULTS: Patients with CFS and PLS were similar in several
somatic symptoms and in psychiatric profile. Patients with CFS
reported more flulike symptoms than patients with PLS.
Patients with PLS but not patients with CFS performed
significantly worse than controls on tests of attention,
verbal memory, verbal fluency, and motor speed. Patients with
PLS without a premorbid history of psychiatric illness did
relatively worse on cognitive tests than patients with PLS
with premorbid psychiatric illness compared with healthy

CONCLUSIONS: Despite symptom overlap, patients with
PLS show greater cognitive deficits than patients with CFS
compared with healthy controls. This is particularly apparent
among patients with PLS who lack premorbid psychiatric

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