definition of chronic fatigue syndrome.
Journal: BMC Med. 2009 Oct 12;7(1):57. [Epub ahead of print]
Authors: Jones JF, Lin JM, Maloney EM, Boneva RS, Nater UM, Unger ER,
Reeves WC.
NLM Citation: PMID: 19818157
ABSTRACT:
BACKGROUND: The diagnosis of chronic fatigue syndrome (CFS) in
research studies requires the exclusion of subjects with medical and
psychiatric conditions that could confound the analysis and
interpretation of results. This study compares illness parameters
between individuals with CFS who have and those who do not have
exclusionary conditions.
METHODS: We used a population-based telephone survey of randomly
selected individuals, followed by a clinical evaluation in the
metropolitan, urban, and rural counties of Georgia, USA. The medical
and psychiatric histories of the subjects were examined and they
underwent physical and psychiatric examinations and laboratory
screening. We also employed the multidimensional fatigue inventory
(MFI), the medical outcomes survey short form-36 (SF-36) and the US
Centres for Disease Control and Prevention symptom inventory (SI).
RESULTS: Twenty-nine percent (1,609) of the 5623 subjects who
completed the detailed telephone interview reported exclusionary
diagnoses and we diagnosed an exclusionary condition in 36% of 781
clinically evaluated subjects. Both medical and psychiatric
exclusionary conditions were more common in women, blacks and
participants from rural areas. Subjects with and without exclusions
had similar levels of fatigue and impairment as measured by the MFI
and SF-36; those with CFS-like illness (not meeting the formal CFS
definition) were more likely to have an exclusionary diagnosis. After
adjusting for demographics, body mass index, fatigue subscales, SF-36
subscales and CFS symptoms, CFS-like illness did not remain
significantly associated with having an exclusionary diagnosis.
CONCLUSIONS: Medical and psychiatric illnesses associated with
fatigue are common among the unwell. Those who fulfill CFS-like
criteria need to be evaluated for potentially treatable conditions.
Those with exclusionary conditions are equally impaired as those
without exclusions. See the related commentary by Harvey and Wessely:
http://www.biomedcentral.com/1741-7015/7/58.
[Note: This is an Open Access article, the full text
of which is available for free in PDF at:
http://www.biomedcentral.com/content/pdf/1741-7015-7-57.pdf ]
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