Longitudinal study of outcome of Chronic Fatigue Syndrome (CFS)

OBJECTIVE–To examine the predictors of long term outcome for

patients with the chronic fatigue syndrome.

DESIGN–Cohort study.

SUBJECTS–139 subjects previously enrolled in two

treatment trials; 103 (74%) were reassessed a mean of 3.2

years after start of the trials.

SETTING–University hospital

referral centre.

MAIN OUTCOME MEASURES–Age at onset, duration

of illness, psychological and immunological status at initial

assessment. Ongoing symptom severity, levels of disability,

and immunological function at follow up.

RESULTS–65 subjects

had improved but only six reported no current symptoms. An

alternative medical diagnosis had been made in two and

psychiatric illness diagnosed in 20. The assignment of a

primary psychiatric diagnosis at follow up and the strength of

the belief that a physical disease process explained all

symptoms at entry to the trials both predicted poor outcome.

Age at onset of illness, duration of illness, neuroticism,

premorbid psychiatric diagnoses, and cell mediated immune

function did not predict outcome.

CONCLUSION–Though most

patients with the chronic fatigue syndrome improve, a

substantial proportion remain functionally impaired.

Psychological factors such as illness attitudes and coping

style seem more important predictors of long term outcome than

immunological or demographic variables.

Wilson A, Hickie I, Lloyd A, Hadzi-Pavlovic D, Boughton C, Dwyer J,

Wakefield D

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