A comparison of the characteristics of Chronic Fatigue Syndrome (CFS) in primary & tertiary care

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.

RESULTS: Hospital

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

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