BACKGROUND. This study examines the hypothesis that more recently
ill patients with chronic fatigue syndrome (CFS) might have
different characteristics from more chronic patients in
tertiary referral centres.
METHOD. Sixty-four patients who
fulfilled strict diagnostic criteria for CFS had detailed
medical, viral, immunological and psychiatric assessment.
Patients were advised to remain within their energy limits.
Patient and doctor monitored progress using a scoring system.
RESULTS. Using the Schedule for Affective Disorders and
Schizophrenia, patients were placed into four groups: group A
(no psychiatric disorder, 35 patients), group B (psychiatric
disorder before onset of CFS, 7 patients), group C (coincident
psychiatric disorder and CFS, 11 patients), and group D
(psychiatric disorder after onset of CFS, 11 patients). There
were no viral or immunological differences between the groups.
Patients in groups B, C and D had more severe illness than
those in group A (P < 0.05), but patients in group A had more
muscle pain (P < 0.05) than patients in group C. Counselling
resulted in 52 patients becoming better; nine remained the
same and three became worse.
CONCLUSIONS. A lower incidence of
psychiatric disorder may characterise patients who are more
recently ill, as may the type of associated emotional disorder
and better outcome.
Shanks MF, Ho-Yen DO