BACKGROUND: To evaluate the characteristics of Chronic Fatigue
Syndrome (CFS) in primary and tertiary care.
comparison of subjects fulfilling criteria for CFS, identified
as part of a prospective cohort study in primary care,
compared to 79 adults fulfilling the same criteria referred
for treatment to a specialist CFS clinic.
cases were more likely to belong to upper socio-economic
groups, and to have physical illness attributions. They had
higher levels of fatigue and more somatic symptoms, and were
more impaired functionally, but had less overt psychological
morbidity. Women were over-represented in both primary care
and hospital groups. Nearly half of those referred to a
specialist clinic did not fulfil operational criteria for CFS.
CONCLUSION: The high rates of psychiatric morbidity and female
excess that characterise CFS in specialist settings are not
due to selection bias. On the other hand higher social class
and physical illness attributions may be the result of
selection bias and not intrinsic to CFS.
Euga R, Chalder T, Deale A, Wessely S