What can wage development before and after a G93.3 diagnosis tell us about prognoses for myalgic encephalomyelitis?

Highlights:

•The article used public register data to assess the prognosis of G93.3 patients.
•Patient wages started declining around 3 years before the G93.3 diagnosis.
•Dependency on public transfers had started to increase 7 years before diagnosis.
•Less than 6% maintained an income of at least median wages after diagnosis.
•Very few moved from no or very low wage incomes to median wages.

Abstract:

Prognoses for persons affected by myalgic encephalomyelitis (ME) are rarely studied systematically. Existing studies are often based on smaller samples with unclear inclusion and subjective outcome criteria, and few look at wages as indicators of illness trajectories. This article considers how ME affects the wages and dependency on public transfers of people affected over time, especially in the period when the welfare authorities investigate eligibility for disability pension.
We matched Norwegian population register data on 8485 working-age individuals diagnosed with G93.3 (postviral fatigue syndrome) from 2009 to 2018 with wage and transfer data and compared male and female cases to control groups. The G93.3 population’s wages fell sharply from around 3 years before diagnosis to 1 year after and stabilized at a low level. Public transfers started increasing several years before diagnosis and stabilized at a high level after.
Few of those making no or very low income around the time of the diagnosis resumed earning moderate wages, and only exceptional cases returned to wages corresponding to median wages.
Source: Anne Kielland, Jing Liu. What can wage development before and after a G93.3 diagnosis tell us about prognoses for myalgic encephalomyelitis? Social Sciences & Humanities Open. Volume 11, 2025, 101206. https://www.sciencedirect.com/science/article/pii/S2590291124004030 (Full text)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021-2022

Abstract:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem illness characterized by activity-limiting fatigue, worsening of symptoms after activity, and other symptoms (1). It affects all age, sex, and racial and ethnic groups and costs the U.S. economy about $18-$51 billion annually (2-5). This report describes the percentage of adults who had ME/CFS at the time of interview by selected demographic and geographic characteristics based on data from the 2021-2022 National Health Interview Survey (NHIS).

Source: Vahratian A, Lin JS, Bertolli J, Unger ER. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021-2022. NCHS Data Brief. 2023 Dec;(488):1-8. PMID: 38085820. https://www.cdc.gov/nchs//data/databriefs/db488.pdf (Full text)

The epidemiology of chronic fatigue in San Francisco

Abstract:

Despite considerable research on chronic fatigue syndrome (CFS) and conditions associated with unexplained chronic fatigue (CF), little is known about their prevalence and demographic distribution in the population. The present study describes the epidemiology and characteristics of self-reported CF and related conditions in a diverse urban community.

The study used a cross-sectional telephone screening survey of households in San Francisco, followed by interviews with fatigued and nonfatigued residents. Respondents who appeared to meet case definition criteria for CFS, based on self-reported fatigue characteristics, symptoms, and medical history, were classified as CFS-like cases. Subjects who reported idiopathic chronic fatigue (ICF) that did not meet CFS criteria were classified as ICF-like cases.

Screening interviews were completed for 8,004 households, providing fatigue and demographic information for 16,970 residents. Unexplained CF was extremely rare among household residents <18 years of age, but was reported by 2% of adult respondents. A total of 33 adults (0.2% of the study population) were classified as CFS-like cases and 259 (1.8%) as ICF-like cases. Neither condition clustered within households.

CFS- and ICF-like illnesses were most prevalent among women and persons with annual household incomes below $40,000, and least prevalent among Asians. The prevalence of CFS-like illness was elevated among African Americans, Native Americans, and persons engaged in clerical occupations. Although CFS-like cases were more severely ill than those with ICF-like illness, a similar symptom pattern was observed in both groups.

In conclusion, conditions associated with unexplained CF occur in all sociodemographic groups but appear to be most prevalent among women, persons with lower income, and some racial minorities.

 

Source: Steele L, Dobbins JG, Fukuda K, Reyes M, Randall B, Koppelman M, Reeves WC. The epidemiology of chronic fatigue in San Francisco. Am J Med. 1998 Sep 28;105(3A):83S-90S. http://www.ncbi.nlm.nih.gov/pubmed/9790487