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Neuraesthenia revisited: ICD-10 & DSM-III-R psychiatric syndromes in chronic fatigue patients & comparison subjects

  [ 19 votes ]   [ Discuss This Article ]
www.ProHealth.com • October 5, 1995


BACKGROUND: Different definitions of chronic fatigue syndrome (CFS)
have different psychiatric exclusion criteria and this affects
the type and frequency of associated psychiatric morbidity
found. The operational criteria for neuraesthenia in ICD-10
vary in this and other respects from the Centers for Disease
Control and Prevention (CDC) criteria for CFS. Neuraesthenia
and associated psychiatric morbidity in CDC-defined CFS are
evaluated.

METHOD: CFS subjects and controls were interviewed
with the Schedule for the Clinical Assessment of
Neuropsychiatry (SCAN). The computerised scoring program for
SCAN (CATEGO5) facilitates the assignment of operational
definitions according to DSM-III-R and ICD-10. Subjects were
re-interviewed with SCAN an average of 11 months later. No
specific treatments or interventions were given during this
period.

RESULTS: The majority of subjects fulfilled ICD-10
operational criteria for neuraesthenia and had two and a half
times the rate of psychiatric morbidity as the healthy
comparison group according to the CATEGO5 Index of Definition
(ID). Approximately 80% of subjects fulfilled both DSM-III-R
and ICD-10 criteria for sleep disorders. There was a
significant fall in the number of subjects fulfilling criteria
for depression and anxiety disorders and a significant
increase in the number of subjects with no diagnosis for
DSM-III-R criteria over time. There were no significant
changes over time for any diagnosis according to ICD-10
criteria or for overall levels of psychopathology as reflected
in CATEGO5 ID levels.

CONCLUSIONS: The ICD-10 'neuraesthenia'
definition identifies almost all subjects with CDC-defined
CFS. Fifty percent of CFS subjects also had depressive or
anxiety disorders, some categories of which remit
spontaneously over time.

Farmer A, Jones I, Hillier J, Llewelyn M, Borysiewicz L, Smith A




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