Tag: tertiary care

Comparing symptoms of chronic fatigue syndrome in a community-based versus tertiary care sample

Abstract:

Chronic Fatigue Syndrome (CFS) is a debilitating condition characterized by six or more months of prolonged or relapsing, unexplained fatigue of new or definite onset and at least four of eight associated somatic and cognitive symptoms. Almost all studies of samples with patients with CFS have relied on referrals from physicians or health facilities.

Underserved minorities, who not only tend to manifest higher levels of chronic illness, but are also less likely to seek and receive adequate medical care, have not been adequately represented in these studies. The present study compared two groups of individuals with CFS, one from a community-based sample and another from a tertiary-based sample. Findings indicate that patients with CFS from tertiary care settings have a higher frequency of symptoms than those in the general population who have CFS.

 

Source: Jason LA, Plioplys AV, Torres-Harding S, Corradi K. Comparing symptoms of chronic fatigue syndrome in a community-based versus tertiary care sample. J Health Psychol. 2003 Jul;8(4):459-64. http://www.ncbi.nlm.nih.gov/pubmed/19127712

 

Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care

Abstract:

OBJECTIVE: To evaluate the attributions of patients with chronic fatigue syndrome (CFS) and fibromyalgia (FM) consulting at a university fatigue and pain clinic.

METHODS: Consecutive attenders (n = 192) who met the CFS criteria (n = 95) or FM criteria (n = 56) or who had medically unexplained chronic pain and/or fatigue without meeting both criteria (CPF) (n = 41) were evaluated. All subjects completed an extended form of the Cause of Illness Inventory. Descriptive statistics, frequency analyses, chi-square tests, one-way analysis of variance, and sequential Fisher least significant difference tests were performed.

RESULTS: In total, 48 patients reported physical causes only and 10 patients psychosocial causes only; the majority (70%) mentioned both types of causes. With regard to the contents, “a chemical imbalance in my body” (61%), “a virus” (51%), “stress” (61%), and “emotional confusion” (40%) were reported most frequently. The diagnostic label did not have a significant influence on number and type of attributions. Small to moderate effect sizes were registered concerning the association of specific attributions and diagnosis, sex, duration of the symptoms, contact with a self-help group, and premorbid depression.

CONCLUSION: The majority of patients with CFS, FM, and CPF reported a great diversity of attributions open to a preferably personalized cognitive behavioral approach. Special attention should be paid to patients with symptoms existing for more than one year and those who had previous contacts with a self-help group. They particularly show external, stable, and global attributions that may compromise feelings of self-efficacy in dealing with the illness.

 

Source: Neerinckx E, Van Houdenhove B, Lysens R, Vertommen H, Onghena P. Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care. J Rheumatol. 2000 Apr;27(4):1051-5. http://www.ncbi.nlm.nih.gov/pubmed/10782836

 

A comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care

Abstract:

BACKGROUND: To evaluated the characteristics of Chronic Fatigue Syndrome (CFS) in primary and tertiary care.

METHOD: A comparison of subjects fulfilling criteria for CFS, identified as part of a prospective cohort study in primary care, compared to 79 adults fulfilling the same criteria referred for treatment to a specialist CFS clinic.

RESULTS: Hospital cases were more likely to belong to upper socio-economic groups, and to have physical illness attributions. They had higher levels of fatigue and more somatic symptoms, and were more impaired functionally, but had less overt psychological morbidity. Women were over-represented in both primary care and hospital groups. Nearly half of those referred to a specialist clinic did not fulfil operational criteria for CFS.

CONCLUSION:The high rates of psychiatric morbidity and female excess that characterise CFS in specialist settings are not due to selection bias. On the other hand higher social class and physical illness attributions may be the result of selection bias and not intrinsic to CFS.

 

Source: Euba R, Chalder T, Deale A, Wessely S. A comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care. Br J Psychiatry. 1996 Jan;168(1):121-6. http://www.ncbi.nlm.nih.gov/pubmed/8770441