Category: Prevalence

The frequency of the chronic fatigue syndrome in patients with symptoms of persistent fatigue

Abstract:

STUDY OBJECTIVE: To determine the frequency of the chronic fatigue syndrome among patients with symptoms of fatigue.

DESIGN: Prospective, cohort study.

SETTING: Referral clinic, based in a primary care general internal medicine faculty practice of a university medical center.

PATIENTS: Consecutive sample of 135 patients (53 men, 82 women) with 6 months or more of debilitating fatigue.

INTERVENTIONS: All patients had a complete history taken, had a physical examination and a comprehensive battery of blood tests, and were given the Diagnostic Interview Schedule of the National Institute of Mental Health, a highly-structured 260-item instrument designed to enable accurate psychiatric diagnoses. Other diagnostic studies (for example, sleep studies and electroencephalography) were ordered if necessary for individual patients.

MEASUREMENTS AND MAIN RESULTS: Six of the one hundred thirty-five patients met criteria for chronic fatigue syndrome (95% CI, 0 to 10). Ninety-one (67%) patients (CI, 56 to 78) had clinically active psychiatric disorders and 4 (3%) patients (CI, 0 to 8) had medical disorders that were considered a major cause of their fatigue. Thirty-four (25%) patients (CI, 14 to 36) had insufficient symptoms or objective findings of the chronic fatigue syndrome.

CONCLUSION: The chronic fatigue syndrome is rare among patients with symptoms of persistent fatigue. Most of these patients have psychiatric disorders.

 

Source: Manu P, Lane TJ, Matthews DA. The frequency of the chronic fatigue syndrome in patients with symptoms of persistent fatigue. Ann Intern Med. 1988 Oct 1;109(7):554-6. http://www.ncbi.nlm.nih.gov/pubmed/3421564

 

Frequency of ‘chronic active Epstein-Barr virus infection’ in a general medical practice

Abstract:

Twenty-one percent of 500 unselected patients, aged 17 to 50 years, seeking primary care for any reason were found to be suffering from a chronic fatigue syndrome consistent with “chronic active Epstein-Barr virus (EBV) infection,” They had been experiencing “severe” fatigue, usually cyclic, for a median of 16 months (range, six to 458 months), associated with sore throat, myalgias, or headaches; 45% of the patients were periodically bedridden; and 25% to 73% reported recurrent cervical adenopathy, paresthesias, arthralgias, and difficulty in concentrating or sleeping.

The patients had no recognized chronic “physical” illness and were not receiving psychiatric care. While antibody titers to several EBV-specific antigens were higher in patients than in age- and sex-matched controls subjects, the differences generally were not statistically significant.

A chronic fatigue syndrome consistent with the chronic active EBV infection syndrome was prevalent in our primary care practice. However, our data offer no evidence that EBV is causally related to the syndrome. Indeed, we feel that among unselected patients seen in a general medical practice currently available EBV serologic test results must be interpreted with great caution.

 

Source: Buchwald D, Sullivan JL, Komaroff AL. Frequency of ‘chronic active Epstein-Barr virus infection’ in a general medical practice. JAMA. 1987 May 1;257(17):2303-7. http://www.ncbi.nlm.nih.gov/pubmed/3033338