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Incidence of myalgic encephalomyelitis/chronic fatigue syndrome in a large prospective cohort of U.S. nurses

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By Natalia Palacios et al.

Abstract
 

Background: The incidence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), the rates of both under-diagnosis and over-diagnosis, and the nature of the onset of the condition have not been assessed in large studies of health professionals.
 
Purpose: To determine the cumulative incidence of ME/CFS in a large population of health professionals, to examine the nature of the onset of the illness, and to estimate the frequency of both over-diagnosis and under-diagnosis of ME/CFS.
 
Methods: We sent an email questionnaire to participants in the Nurses’ Health Study II (NHS II), a large prospective cohort of female nurses. Forty-two thousand three hundred and ninety-four women completed the questionnaire, which included the 1994 Centers for Disease Control and Prevention (CDC) criteria for ME/CFS.
 
Results: One-hundred and two women (240 per 100,000 surveyed) developed an illness that met criteria for ME/CFS between 1989 and 2009. The onset of ME/CFS was gradual in 40.6%, sudden (following flu-like illness or other precipitating events) in 18.8%, followed emotional or physical trauma in 32.3%, and was uncertain in the rest. Under-diagnosis was common: only 15 (15%) of the women who met criteria for ME/CFS reported having been diagnosed. Over-diagnosis also was common: four times as many subjects had been diagnosed with ME/CFS by community doctors as actually met criteria. The distribution of symptoms was not different in comparing cases with a sudden onset to those with a gradual onset.
 
Conclusions: In this large cohort of female nurses, we found a low cumulative incidence of ME/CFS. Over-diagnosis and under-diagnosis were high, even in this medically sophisticated population.

Source: Natalia Palacios, Kathryn C. Fitzgerald, Anthony L. Komaroff, and Alberto Ascherio. Incidence of myalgic encephalomyelitis/chronic fatigue syndrome in a large prospective cohort of U.S. nurses. Fatigue: Biomedicine, Health & Behavior Vol. 0 , Iss. 0,0

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2 thoughts on “Incidence of myalgic encephalomyelitis/chronic fatigue syndrome in a large prospective cohort of U.S. nurses”

  1. dfwmom says:

    So, what percentage of nurses who did NOT develop CFS, experience physical or emotional trauma during that period?

    In fact, how many people have NOT experienced physical or emotional trauma of some sort over a ten year period? Ask yourself that about your own life. And, what, exactly, is “trauma”? The word “trauma” is a very vague and unscientific term that tempts the researcher into scientific bias. Criteria for this kind of research need to be specific and measurable. So, exactly how many grams of trauma are we talking about, and of what specific type? I know you can’t answer that, and that’s my concern.

    We need to try to keep CFS research precise, so that we can get some reliable results. Vague, fuzzy terms like “trauma” cloud the water, and prevent true understanding. Let’s drill down a bit more. Was it an infectious illness lasting more than a week and causing a fever over 102? Was it a broken bone? Was it the death of a family member? If we propose to link “trauma” to CFS, then we need a lot more specifics than this broad and slippery term.

    Meanwhile, suggestions that CFS is caused by “trauma” feed right into the medical community’s decades long agenda of trying to classify CFS as a psychological illness, that can be resolved with a bit of counselling and some exercise (exercise that can be fatal in patients whose bodies cannot recover from the effects of it). This medical myth has led to horrific situations, such as the brutal, callous and inhumane treatment that Karina Hansen has been, and is still being, subjected to by Denmark’s medical community. Let’s be crystal clear. If “emotional” trauma is triggering onset of CFS, in only some of the patients, then emotional stress is depressing the immune system providing an opportunity for CFS to take hold, but that continues to leave the question of “Why?”. Emotional stress can only ever be a trigger, never a cause, of a physical illness. The important question is “Why?”. “Why didn’t the body cope with or recover from the physical or mental insult”?

    We need to be very careful and very specific when we ask these questions, so that we can get ourselves out of the muddle we’ve been in for years with this disease and start getting some traction. And, we need to stop rearranging the deck chairs with questions about “emotional trauma” and start looking at the engines, where the real action is occurring.

    To start with, there needs to be less PSYCHOLOGICAL research on this disease and more MEDICAL research on this disease.

    1. Deadinbed1 says:

      mine came on OVERNIGHT, was it the dream I had? come on people, figure it out, OVERNIGHT? as far as I know, I was sleeping!

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