The role of depression in pain, psychophysiological syndromes & medically unexplained symptoms associated with Chronic Fatigue Syndrome (CFS)

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BACKGROUND: The association between depression and pain,

function, medically unexplained symptoms and

psychophysiological syndromes such as irritable bowel syndrome

has not been explored before in chronic fatigue syndrome.

METHODS: Cross-sectional controlled study of the current

prevalence of psychophysiological syndromes, pain, function

and lifetime prevalence of medically unexplained symptoms in

77 out-patients with chronic fatigue syndrome (CFS) without

DSM-III-R depression, 42 CFS out-patients with DSM-III-R

depression and 26 out-patient with primary DSM-III-R

depression.

RESULTS: Both CFS groups differed significantly

from the primary depression group but not each other in the

prevalence of tension headaches (P < 0.001), reporting of

widespread bodily pain (P < 0.001) and the number of lifetime

medically unexplained symptoms (P < 0.001). The three groups

did not significantly differ in the prevalence of irritable

bowel syndrome or fibromyalgia. CFS patients with depression

were more impaired in social function than other CFS patients.

CONCLUSION: Depression is not associated with the reporting of

pain, psychophysiological syndromes and medically unexplained

symptoms in CFS patients. Depression is associated with

decreased social function in CFS patients.

LIMITATIONS: Study

depended on recall of symptoms, not confirmed by medical

records and current investigations. Patients with depression

were taking antidepressants.

CLINICAL RELEVANCE: Treating

depression in chronic fatigue syndrome is unlikely to diminish

reporting of pain and medically unexplained symptoms but may

improve social function.

Morriss RK, Ahmed M, Wearden AJ, Mullis R, Strickland P, Appleby L,

Campbell IT, Pearson D