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Distinguishing patients with chronic fatigue from those with CFS (2003)

WillowJ

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Guys, King's College and St. Thomas School of Medicine, London, Department of General Practice:

Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care.
Darbishire L, Ridsdale L, Seed PT.

Method: One hundred and forty-one patients who presented to their GP with unexplained fatigue lasting six months or more as a main symptom were recruited, and the Centers for Disease Control (CDC) case definition was applied to classify CFS.

Results: Approximately two-thirds (69%) of patients had chronic fatigue and not CFS. The duration of fatigue (32 months) and perceived control over fatigue were similar between groups; however, fatigue, functioning, associated symptoms, and psychological distress were more severe in the patients in the CFS group, who also consulted their GP significantly more frequently, were twice as likely to be depressed, and more than twice as likely to be unemployed. About half (CFS = 50%; chronic fatigue = 55%) in each group attributed their fatigue to mainly psychological causes.

Conclusions: In primary care, CFS is a more severe illness than chronic fatigue, but non-CFS chronic fatigue is associated with significant fatigue and is reported at least twice as often. That half of patients, irrespective of CFS status, attribute their fatigue to psychological causes, more than is observed in secondary care, indicates an openness to the psychological therapies provided in that setting. More evidence on the natural history of chronic fatigue and CFS in primary care is required, as are trials of complex interventions. The results may help determine the usefulness of differentiating between chronic fatigue and CFS.

Abstract:
http://www.ncbi.nlm.nih.gov/pubmed/12939888

Free full:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314617/pdf/12939888.pdf
 

WillowJ

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GPs included patients:
• aged 16 to 75 years;​
• complaining of fatigue as a main or important problem lasting for six months or more;
• with no recent change to any drug regimen; and
• with normal full blood count, erythrocyte sedimentation rate, and thyroid function tests, within the previous six months.

GPs excluded patients:
• with psychotic illness, organic brain syndrome, or substance dependency;​
• with concurrent physical problems that (in the doctor’s judgement) could have caused fatigue symptoms;
• who were currently seeing a psychiatrist, counsellor, community psychiatric nurse, or physiotherapist, or
• who were unable to read English.

To this population, they applied the Fukuda criteria to separate CF from CFS.