Seasonal symptom variation in patients with chronic fatigue: comparison with major mood disorders

The psychobiology of idiopathic fatigue has received renewed

interest in the medical literature in recent years. In order

to examine the relation between chronic, idiopathic fatigue

and specific subtypes of depressive illness, we characterized

the pattern and severity of seasonal symptom variation in 73

patients with chronic, idiopathic fatigue, compared to

patients with major depression (n = 55), atypical depression

(n = 35), and seasonal affective disorder (n = 16) Fifty of

the fatigued subjects also met the specific Centers for

Disease Control and Prevention case criteria for chronic

fatigue syndrome, though this definition was unable to

discriminate a distinct subgroup of patients, based on their

seasonality scores alone.

As a group, the fatigued subjects reported the lowest

levels of symptom seasonality of any of the study groups.

Further, even in those fatigued subjects with scores in the

range of those seen in patients with seasonal affective

disorder, seasonality was not reported to be a subjectively

distressing problem. These findings lend support to the idea

that although chronic fatigue shares some clinical features

with certain mood disorders, they are not the same illnesses.

These data are also consistent with the emerging view that

chronic fatigue represents a heterogeneously determined

clinical condition.

Zubieta JK, Engleberg NC, Yargic LI, Pande AC, Demitrack MA

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