This week’s journal contains two papers from multidisciplinary teams that shed light on syndromes of chronic fatigue and so move us towards resolving the often bitter controversy over myalgic encephalomyelitis. A large community survey by Pawlikowska and colleagues provides estimates of the prevalence of the symptom of fatigue,’ operationally defined chronic fatigue syndrome,2 and self declared (possibly self diagnosed) chronic fatigue syndrome in young and middle aged adults in south east England (p 763).1
They found that fatigue was common, occurred as a continuum, and was highly correlated with emotional distress. Most people attributed their fatigue to social or psychological factors. While 02% of the respondents reported that they had chronic fatigue syndrome, as many as 1% of respondents satisfied several of the criteria for the syndrome. As with many illnesses, the cases were found at the severe end of the continuum of fatigue, without any sharp cut off. Associations of self reported chronic fatigue syndrome with female sex and upper social class confirm what has been found in primary care and hospital studies 34 but are less typical in community surveys.’ 6 Previous studies have consistently identified a strong association between emotional morbidity and chronic fatigue syndrome,7 but this “is inevitable given the similarities of the criteria and the measures used to define them.”‘ Interestingly, the closer cases fulfil the definition of chronic fatigue syndrome the stronger the association with emotional morbidity.
Comment in:
Chronic fatigue syndrome. Prevalence study overlooked. [BMJ. 1994]
Chronic fatigue syndrome. …and study them separately. [BMJ. 1994]
Chronic fatigue syndrome. ME Association is honest about prognosis. [BMJ. 1994]
Comment on: Professional and popular views of chronic fatigue syndrome. [BMJ. 1994]
Source: Lawrie SM, Pelosi AJ. Chronic fatigue syndrome: prevalence and outcome. BMJ. 1994 Mar 19;308(6931):732-3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539646/
You can read the full article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539646/pdf/bmj00432-0006.pdf