RogerBlack
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https://www.ncbi.nlm.nih.gov/pubmed/27845196
Crawley et al.
Unfortunately, questionnaire based from a general purpose survey, so at best would be an interesting screen to use before contacting the patients and following them up to see if they have CFS. This was not done, nor were the questions specific to CFS. At best perhaps an upper bound on those who have fatigue and some other symptoms.
The prevalence of 2.6% seems rather high, though the case definition is a hell of a lot better than '6 months medically unexplained fatigue'.
As an exclusion 'the adolescent felt better after resting' seems to partially capture PEM and non-restorative sleep.
The lack of support they find for the central sensitisation hypothesis is interesting - as I understand it this is one of the keystones of BPS.
(everything is felt more than it should, so fear/avoidance kick in)
Crawley et al.
Unfortunately, questionnaire based from a general purpose survey, so at best would be an interesting screen to use before contacting the patients and following them up to see if they have CFS. This was not done, nor were the questions specific to CFS. At best perhaps an upper bound on those who have fatigue and some other symptoms.
We identified 3214 adolescents with complete data for all outcomes and covariates. There were 82 (2.6%) individuals classified as CFS and 145 (4.5%) as CWP. A classification of CFS resulted in an increased likelihood of having CWP (OR: 3.87; 95% CI: 2.05 - 7.31). Females were approximately twice as likely to have CFS or CWP, with multinomial regression revealing a greater sex-effect for CWP compared to CFS. Those with exclusive CFS were more likely to report higher levels of pain and greater effect of pain compared to those without CFS, though associations attenuated to the null after adjustment for covariates, which did not occur in those with exclusive CWP. Multinomial regression revealed that relative to having neither CFS nor CWP, a one-unit increase in the depression and anxiety scales increased the risk of having exclusive CFS and, to a greater extent, the risk of having co-morbid CFS and CWP, but not exclusive CWP, which was
Participants were classified as CFS if they indicated that they had been getting tired or had been lacking in energy during the past month and then responded ‘yes’ to >2 of the following 4 items: 1) felt tired or lacking in energy for 4 days or more in the past 7 days, 2) felt tired or lacking in energy for more than 3 hours in total on any day in the past 7 days, 3) felt so tired or lacking in energy that they had to push themselves to get things done on 1 or more occasion in the past 7 days, and 4) felt tired or lacking in energy when doing things they enjoy in the past 7 days. Participants were classified as not chronically fatigued if: the tiredness or lack of energy had lasted for <6 months, the adolescent thought it was due to exercise or medication, the adolescent felt better after resting, if daily activities were not impaired, or if exercise did not make them feel exhausted the following day. The CIS-R also provided data on 9 of the 12 associated symptoms of CFS listed in NICE guidelines,39 namely: muscle or joint pain, headaches, painful glands, sore throat, problems with memory or concentration (cognitive dysfunction), dizziness, nausea, and insomnia (as part of the ‘difficulty sleeping’ symptom in the NICE guideline). Adolescents without any of these accompanying symptoms were reclassified as non-CFS. Because data on only 9 of the 12 symptoms included in the NICE guideline could be collected using the CIS-R, the estimates of CFS at 17 years are likely to be conservative (ie, an adolescent may have been classified as non-CFS because of the lack of 1 of the 9 symptoms, but he/she may have had 1 of the other 3 symptoms for which data were uncollected). Of those identified as having CFS, 16.5% had a single symptom, 29.13% had 2, 25.54% had 3, 10.68% had 4, 8.74% had 5, 5.83% had 6, 2.91% had 7, and .97% had 8. Adolescents were classified as non-CFS if they reported having had problems with alcohol or drugs (crack, solvents, heroin, or cocaine) during the previous year, or a diagnosis of anorexia nervosa.
The prevalence of 2.6% seems rather high, though the case definition is a hell of a lot better than '6 months medically unexplained fatigue'.
As an exclusion 'the adolescent felt better after resting' seems to partially capture PEM and non-restorative sleep.
The lack of support they find for the central sensitisation hypothesis is interesting - as I understand it this is one of the keystones of BPS.
(everything is felt more than it should, so fear/avoidance kick in)
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