Outcome & prognosis of patients with chronic fatigue CF vs Chronic Fatigue Syndrome (CFS)

BACKGROUND: There are few data on the natural history and prognosis
of persons with chronic fatigue (CF) or CF syndrome (CFS).
Therefore, we compared functional outcomes in patients with
each condition and tested the validity of various prognostic
indicators.

METHODS: Four hundred forty-five (89%) of 498
consecutive referral patients [to the UW CF clinic] were
surveyed an average of 1.5 years after an initial evaluation.
Data from the initial evaluation were used to predict
outcomes.

RESULTS: Sixty-four percent of all patients reported
improvement, but only 2% reported complete resolution of
symptoms. Patients initially diagnosed as having CFS reported
greater symptom severity and lower level of functioning at
follow-up than did patients with CF. Major depression
predicted unemployment in the CF group. Older age, longer
duration of illness, and a lifetime history of dysthymia
predicted less improvement in the CF group. Current dysthymia
predicted less improvement for the CFS group.

CONCLUSIONS: The
case definition of CFS according to the Centers for Disease
Control and Prevention identifies chronically fatigued
patients with poorer prognosis. In a tertiary care setting,
recovery from CF or CFS is rare, but improvement is common.
Prognostic indicators vary for the two groups, but the
coexistence of dysthymia suggests poorer outcomes generally.

Bombardier CH, Buchwald D

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