Sub-typing CFS patients on the basis of ‘minor’ symptoms
Section snippets
Subjects
We collected data from 176 women who met the 1994 case definition of CFS (Fukuda et al., 1994). Patients came to our tertiary University-based Chronic Fatigue Syndrome/Fibromyalgia Center via newspaper advertisement, media reports, physician referral or information provided on a University website.
Procedure
All prospective subjects completed a paper and pencil screen for CFS. Individuals screening positive for CFS were asked to sign informed consent; if they agreed, they then received a psychiatric
Sampling and demographics
Of the 176 women enrolled, 161 (91.4%) provided complete data; only they are considered in the following. With a mean age of 39.7 year (S.D. = 8.8), 146 (90.7%) were white, and all but 26 (83.9%) had at least 1 year of college; 67.1% of the sample reported a gradual onset of symptoms; 56.3% met criteria for FM; 12.9% met criteria only for current MDD, 14.3% met criteria only for a current anxiety disorder and 12.9% met criteria for both current MDD and current anxiety disorder; 22.4% reported
Discussion
Because CFS is defined by clinical criteria, similar symptoms may result from different causes. To address this issue of heterogeneity, Fukuda et al. (1994) recommended using stratification strategies to identify patient subtypes with different etiological or pathophysiological mechanisms. Toward this end, we categorized patients on the basis of their scores on a principal components analysis of severity ratings of the minor symptoms from the 1988 case definition of CFS. Groups derived from
Acknowledgement
This study was supported by NIH grant AI-32247.
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Chronic Fatigue Syndrome
2017, Principles and Practice of Pediatric Infectious DiseasesChronic fatigue syndrome (CFS) symptom-based phenotypes in two clinical cohorts of adult patients in the UK and The Netherlands
2016, Journal of Psychosomatic ResearchCitation Excerpt :Heterogeneity in the symptom profile of CFS can be confusing for clinicians, fuelling debate over diagnostic criteria, and posing an obstacle to biomedical research that aims to find biomarkers of CFS [26]. Several studies have investigated heterogeneity (phenotypes) in adult [21,22,25,48,49,55,57] and paediatric [33] CFS patients. Despite between-study variation in the factors analysed and the methods used, these studies have demonstrated some consistency in classifying CFS phenotypes, including: a ‘polysymptomatic’ phenotype; a ‘sore throat/painful lymph node’ phenotype; phenotypes classified according to the presence/absence of musculoskeletal pain; and a dose-response effect in the number of symptoms and the overall severity of CFS.
Section 12: Poorly Understood Conditions
2013, Women and HealthChronic Fatigue Syndrome
2012, Principles and Practice of Pediatric Infectious Diseases, Fourth EditionConditions associated with fibromyalgia
2010, Fibromyalgia SyndromeAssociation of peripheral inflammatory markers with chronic fatigue in a population-based sample
2009, Brain, Behavior, and ImmunityCitation Excerpt :Mawle et al., 1997) A variety of factors may contribute to these discrepancies. CFS is likely a heterogenous condition composed of more etiologically consistent subtypes (Aslakson et al., 2006; Janal et al., 2006; King and Jason, 2005; Nisenbaum et al., 2004; Wilson et al., 2001), only some of which may be associated with innate immune pathway activation, and clinical studies likely suffer from recruitment bias with respect to the subtypes. This is particularly likely because published studies of immune system function have evaluated patients identified through tertiary referral centers rather than through a population-based approach, so it is also possible that conflicting results reflect differences in systematic biases in the types of patients referred to each center (Wessely et al., 1997).