top of page
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

Screen Shot 2018-08-12 at 1.24.09 AM.png
Screen Shot 2018-08-12 at 1.24.02 AM.png
Screen Shot 2018-08-12 at 1.23.57 AM.png
Screen Shot 2018-08-12 at 1.23.52 AM.png
crossref
doi
open access

Published: 22 April 2019

Measurements of Recovery and Predictors of Outcome in an Untreated Chronic Fatigue Syndrome Sample

Marie Thomas, Andrew P. Smith

Bath Spa University, Cardiff University, UK

journal of social and political sciences
pdf download

Download Full-Text Pdf

doi

10.31014/aior.1994.02.02.33

Pages: 167-178

Keywords: Chronic Fatigue Syndrome, Improvement, Predictors of outcome, Recovery

Abstract

The current study examined a large cohort of untreated Chronic Fatigue Syndrome patients at initial assessment and at specific time points over a three-year period. Methods used in previous studies to assess patient health, were validated and used to assess recovery and improvement. Possible predictors of outcome would then be identified by assessing improvements in health status at specific follow-up points. The illness was also assessed in terms of recovery and improvement by using health related and psychosocial measures together with the aetiology of the illness. These were further used to investigate possible mechanisms influencing or predicting recovery or improvement. Two-hundred and twenty-six patients completed wide ranging questionnaires at initial assessment and again six and eighteen months and three years later. A current state of health score was used to measure recovery over time and analyses conducted to investigate the relationship between this and other health related measures. Regression analyses were conducted to assess predictors of improvement and recovery. Spontaneous recovery rates in the untreated patient at three-year follow-up were low (6%). The data suggested, however, that illness length, symptom severity and health status have an important role in recovery. Although there was no evidence to suggest an association between illness onset type and subsequent recovery or psychopathology scores at initial assessment and recovery, regression analyses did indicate that levels of anxiety, cognitive difficulties and social support at initial assessment predict a positive outcome. The state of health measure was validated as a method of accurately assessed the health status of patients and was used as an indicator of improvement and recovery within this group. Spontaneous recovery in the patient group was associated with several factors measured at initial assessment. However, further studies are necessary to more fully identify the factors which affect recovery or improvement and to investigate the exact nature of the mechanisms involved. The present study shows that spontaneous recovery of CFS patients is rare. Treatment or management is essential, and the efficacy of different approaches must be assessed.

References

  1. Afari N, Buchwald D. Chronic fatigue syndrome: a review.  American Journal of Psychiatry 2003; 160: 221-36.

  2. Andersen MM, Permin IH, Albrecht F.  Illness and disability in Danish chronic fatigue syndrome patients at diagnosis and 5-year follow up.  Journal of Psychosomatic Research 2004; 56: 217-29.

  3. Bates D, Schmitt W, Lee J, et al.  Prevalence of fatigue and chronic fatigue syndrome in primary care practice.  Archives of International Medicine 1993; 153: 2759-2765.

  4. Cairns R, Hotopf M.  A systematic review describing the prognosis of Chronic Fatigue Syndrome.  Occupational Medicine 2005; 55: 20-31.

  5. Cathebras PJ, Robbins JM, Kirmayer LJ, Hayton BC. Fatigue in primary care: prevalence, psychiatric co-morbidity, illness behaviour and outcome.  Journal of General International Medicine 1992; 7: 276-286.

  6. Chen M. The epidemiology of self-perceived fatigue among adults.  Preventative Medicine 1986; 15: 74-81.

  7. David A, Pelosi A, McDonald E, et al. Tired, weak or in need of rest: a profile of fatigue among general practice attenders.  British Medical Journal 1990; 301: 1199-1202.

  8. Dowsett EG, Ramsay AM, McCartney RA, Bell EJ.  ME – a persistent enteroviral infection?  Postgraduate Medical Journal 1990; 66: 526-530.

  9. Fleming JS, Watts WA.  The dimensionality of self esteem: Some results from a college sample.  Journal of Personality and Social Psychology 1980; 39: 921-929.

  10. Fukuda K, Dobbins JG, Wilson LJ, Dunn RA, et al.  An epidemiologic study of fatigue with relevance to the Chronic Fatigue Syndrome.  Journal of Psychiatric Research 1997; 31: 19-29.

  11. Fukuda K, Straus S, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. International Chronic Fatigue Syndrome Study Group. The Chronic Fatigue Syndrome: a comprehensive approach to its definition and study.  Annals of Internal Medicine 1994; 121: 953-959.

  12. Henderson S, Bryne DG, Duncan-Jones P.  Neurosis and the Social Environment.  Sydney. Australia.  Academic Press 1981.

  13. Hinds, McClusky,  A retrospective study of CFS.  Proceedings from the Royal College of Physicians (Edinburgh) 1993; 23: 10-14.

  14. Ho-Yen DO, McNamara I.  General Practitioners’ experience of CFS.  British Journal of General Practice 1991; 41: 324-334.

  15. Kroenke K, Wood DR, Mangelsdorff AD, et al.  Chronic fatigue in primary care: prevalence, patient characteristics and outcome.  Journal of the American Medical Association 1988; 260: 929-34.

  16. McDonald E, David AS, Pelosi AJ, Mann AH. Chronic fatigue in primary care attenders.  Psychological Medicine 1993; 23:987-98.

  17. Nisenbaum R, Jones AB, Jones JF, Reeves WC.  Longitudinal analysis of symptoms reported by patients with CFS.  Annals of Epidemiology 2000; 10: 458.

  18. Pawlikowska T, Chalder T, Hirsch SR, Wallace P, et al. Population based study of fatigue and psychological distress.  British Medical Journal 1994; 308: 763-766.

  19. Price RK, North CS, Wessely S, Fraser VJ.  Estimating the prevalence of CFS and associated symptoms in the community.  Public Health Report 1992; 107: 514-522.

  20. Radloff LS.  The CES-D scale: a self-rep