Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case-control study

Background. The role of stress in the onset of chronic fatigue syndrome is unclear. Our objectives in this study were first, to determine the relation between the onset of chronic fatigue syndrome and stressful life events and difficulties. Secondly, we examined the role of a particular type of problem, dilemmas, in the onset of chronic fatigue syndrome. Method. We used a case–control design with 64 consecutive referrals from an Infectious Diseases/Liaison Psychiatry Fatigue clinic and 64 age- and sex-matched controls from a general practice population control group in Leeds. We had two main outcome measures; the odds ratios of the risk of developing chronic fatigue syndrome after experiencing a severe life event, severe difficulties or both in the year and 3 months preceding onset; and the proportion of subjects in each group who experienced a dilemma prior to onset. Results. Patients with chronic fatigue syndrome were more likely to experience severe events and difficulties in the 3 months (OR=9, 95% CI 3·2 to 25·1) and year (OR=4·3, 95% CI 1·8 to 10·2) prior to onset of their illness than population controls. In the 3 months prior to onset 19 of the 64 patients (30%) experienced a dilemma compared to none of the controls. Conclusions. Chronic fatigue syndrome is associated with stressful events and difficulties prior to onset. Those events and difficulties characterized as being dilemmas seem to be particularly important

Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study

Objective The aims of this study were to examine (i) base line pressure pain thresholds in patients with chronic fatigue syndrome and those with chronic low back pain compared with healthy subjects, (ii) the change in mean pain threshold in response to exercise, and (iii) associations with exercise induced increase in nitric oxide Participants Twenty six patients with chronic fatigue syndrome suffering of chronic pain, 21 patients with chronic low back pain and 31 healthy subjects Methods Participants underwent a submaximal aerobic exercise protocol on a bicycle ergometer, preceded and followed by venous blood sampling (nitric oxide) and algometry (hand arm calf low back) Results Patients with chronic fatigue syndrome presented overall lower pain thresholds compared with healthy sub jects and patients with chronic low back pain (p<0 05) No significant differences were found between healthy subjects and patients with chronic low back pain After submaximal aerobic exercise, mean pain thresholds decreased in patients with chronic fatigue syndrome and increased in the others (p<0 01) At baseline nitric oxide levels were significantly higher in the chronic low back pain group After controlling for body mass index no significant differences were seen be tween the groups at baseline or in response to exercise Nitric oxide was not related to pain thresholds in either group Conclusion The results suggest hyperalgesia and abnormal central pain processing during submaximal aerobic exercise in chronic fatigue syndrome, but not in chronic low back pain Nitric oxide appeared to be unrelated to pain processin

Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population

BACKGROUND: Scant research has adequately addressed the impact of chronic fatigue syndrome on patients' daily activities and quality of life. Enumerating specific problems related to quality of life in chronic fatigue syndrome patients can help us to better understand and manage this illness. This study addresses issues of functional status in persons with chronic fatigue syndrome and other fatiguing illnesses in a population based sample, which can be generalized to all persons with chronic fatigue. METHODS: We conducted a random telephone survey in Wichita, Kansas to identify persons with chronic fatigue syndrome and other fatiguing illnesses. Respondents reporting severe fatigue of at least 1 month's duration and randomly selected non-fatigued respondents were asked to participate in a detailed telephone interview. Participants were asked about symptoms, medical and psychiatric illnesses, and about physical, social, and recreational functioning. Those meeting the 1994 chronic fatigue syndrome case definition, as determined on the basis of their telephone responses, were invited for clinical evaluation to confirm a diagnosis of chronic fatigue syndrome. For this analysis, we evaluated unemployment due to fatigue, number of hours per week spent on work, chores, and other activities (currently and prior to the onset of fatigue), and energy level. RESULTS: There was no difference between persons with chronic fatigue syndrome and persons with a chronic fatigue syndrome-like illness that could be explained by a medical or psychiatric condition for any of the outcomes we measured except for unemployment due to fatigue (15% vs. 40%, P < .01). Persons with chronic fatigue syndrome and other fatiguing illnesses had substantially less energy and spent less time on hobbies, schooling, or volunteer work than did non-fatigued controls (P < .01). CONCLUSIONS: Persons with chronic fatigue syndrome are as impaired as persons whose fatigue could be explained by a medical or psychiatric condition, and they have less energy than non-fatigued controls

Clinical and psycho-functional features of rehabilitants with chronic fatigue syndrome

In the last hundred years, the problem of "diseases of civilization" arose before mankind. So, in the last quarter of the last century, there were descriptions of a new disease of the civilization of the chronic fatigue syndrome. Purpose: to review the literature to identify the clinical and psycho-functional characteristics of rehabilitants with chronic fatigue syndrome. Methods of research: analysis of scientific literature, synthesis and generalization. Results: Primary symptoms and additional, basic clinical manifestations of the chronic fatigue syndrome are singled out. The features of the immune status disorder, the parameters of cellular and humoral immunity in patients with chronic fatigue syndrome are considered. Based on the analysis of the literature, the features of the psychological status of patients with chronic fatigue syndrome are examined and the prevalence of signs of socio-psychological disadaptation is presented; hypochondriacal, depressive, paranoid and other types of personality profiles. Conclusions: Patients with chronic fatigue syndrome have a number of characteristics that can affect the effectiveness of rehabilitation activities

Modern view on chronic fatigue syndrome and approaches to physical rehabilitation

Chronic fatigue syndrome is a disease with insufficiently studied hitherto etiology and pathogenesis. Purpose: based on the analysis of literature to form a modern understanding of the syndrome of chronic fatigue and approaches to physical rehabilitation. Methods of the research: analysis of scientific literature, synthesis and generalization. Results: A perspective on the evaluation of the pathogenesis of the disease and the development of new treatments is the view on chronic fatigue syndrome as a pronounced disadapted syndrome, against which the effects of viral infection and immune system disorders are manifested. In the study of predisposing to the development of chronic fatigue syndrome factors, along with high stress, social and economic instability, pollution of the environment, very important are the low standard of living, poor quality and expensive (not available) medical assistance. For patients with chronic fatigue syndrome, compulsory daily walks, therapeutic gymnastics courses, massage, hydrotherapy and autogenous training are recommended. Essential role belongs to complex sanatorium treatment (sparing-training regime of motor activity, diet, internal use of drinking mineral water, mineral baths) and physiotherapy methods. Conclusions: The provision of medical care for patients with chronic fatigue syndrome should begin with early detection of the symptom complex and further readaptation and rehabilitation. The main principle of treatment and rehabilitation of chronic fatigue syndrome is its complexity

Reduced responsiveness is an essential feature of chronic fatigue syndrome: A fMRI study

BACKGROUND: Although the neural mechanism of chronic fatigue syndrome has been investigated by a number of researchers, it remains poorly understood. METHODS: Using functional magnetic resonance imaging, we studied brain responsiveness in 6 male chronic fatigue syndrome patients and in 7 age-matched male healthy volunteers. Responsiveness of auditory cortices to transient, short-lived, noise reduction was measured while subjects performed a fatigue-inducing continual visual search task. RESULTS: Responsiveness of the task-dependent brain regions was decreased after the fatigue-inducing task in the normal and chronic fatigue syndrome subjects and the decrement of the responsiveness was equivalent between the 2 groups. In contrast, during the fatigue-inducing period, although responsiveness of auditory cortices remained constant in the normal subjects, it was attenuated in the chronic fatigue syndrome patients. In addition, the rate of this attenuation was positively correlated with the subjective sensation of fatigue as measured using a fatigue visual analogue scale, immediately before the magnetic resonance imaging session. CONCLUSION: Chronic fatigue syndrome may be characterised by attenuation of the responsiveness to stimuli not directly related to the fatigue-inducing task

The psychological impact of dependency in adults withchronic fatigue syndrome/myalgic encephalomyelitis: A qualitative exploration

Chronic fatigue syndrome/myalgic encephalomyelitis can limit functional capacity, producing various degrees of disability and psychological distress. Semi-structured interviews explored the experiences of adults with chronic fatigue syndrome/myalgic encephalomyelitis being physically dependent on other people for help in daily life, and whether physical dependency affects their psychological well-being. Thematic analysis generated six themes: loss of independence and self-identity, an invisible illness, anxieties of today and the future, catch-22, internalised anger, and acceptance of the condition. The findings provide insight into the psychological impact of dependency. Implications for intervention include better education relating to chronic fatigue syndrome/myalgic encephalomyelitis for family members, carers, and friends; ways to communicate their needs to others who may not understand chronic fatigue syndrome/myalgic encephalomyelitis; and awareness that acceptance of the condition could improve psychological well-being

Chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is defined by a profound, debilitating fatigue, lasting for at least 6 months and resulting in a substantial reduction of occupational, personal, social and educational status. CFS is a relatively poorly recognized clinical entity, although everyday experience shows that there are many patients with CFS symptoms. The incidence and prevalence of CFS remain unknown in most countries; however, the working population is most affected with predominantly female patients in generative period. Although, CFS was first mentioned four centuries ago, mysterious aethiopathogensis of CFS still intrigues scientists as hundreds of studies are still published every year on the subject. About 80 different aetiological CFS factors are mentioned, which can be classified into five basic groups: genetics, immunology, infectious diseases, endocrinology and neuropsychiatry-psychology. Even today the condition is passed established based on the diagnosis by exclusion of organic and psychiatric disorders, which demands u multidisciplinary approach. As the syndrome is often misdiagnosed and mistreated, self-medication is not uncommon in CFS patients’. In addition, such patients usually suffer for years tolerating severe fatigue. Thus, at the moment there are three priorities regarding CFS; understanding pathogenesis, development of diagnostic tests and creating efficient treatment program

Chronic fatigue syndrome

Objective. To acknowledge the dinical syndrome chronic fatigue syndrome (CFS) and outline the diagnostic criteria and reasonable management.Outcomes. Attempt at containment of treatment cost and improvement of the quality of care of patients with CFS.Evidence. Delphi-type commentary from 20 expert clinicians and appropriate organisations. Limited literature survey.Values. To clarify the reasonable management of CFS amid conflicting clinical opinion on a condition qf concern to patients, funders and doctors, An adaptation:of an existing guideline was sent to organisations and individuals for comment. Comments received were included in this guideline where possible.Benefits, harms and costs. To acknowledge a clinical syndrome with a reasonable approach to management considering the cost implications. No cost analysis was done.Recommendations. To recommend the following: (I) diagnostic criteria for CFS; (il) potential differential diagnoses and possible investigations; and (iil) management protocol.Validation. The draft guidelines were subjected to external review by individual doctors who are acknowledged CFS treaters, doctor groups and the patient support group. There were major disputes about the content, with the responses falling into two groups: thosewho do not believe CFS is a distinguishable illness, and those who do.Developer and funding. The Committee for Science and Education, Medical Association of South Africa, Endorsements. Medical Association of South Africa and national health care organisations (see list at the end of the document)

Prevalence of xenotropic murine leukaemia virus-related virus in patients with chronic fatigue syndrome in the Netherlands: retrospective analysis of samples from an established cohort

Objective The presence of the retrovirus xenotropic murine leukaemia virus-related virus (XMRV) has been reported in peripheral blood mononuclear cells of patients with chronic fatigue syndrome. Considering the potentially great medical and social relevance of such a discovery, we investigated whether this finding could be confirmed in an independent European cohort of patients with chronic fatigue syndrome