Psychiatric correlates in chronic fatigue syndrome

Area of Science:

• Psychiatry
• Epidemiology
• Internal Medicine

Background:

• Chronic Fatigue Syndrome (CFS) is a complex illness with poorly understood psychiatric comorbidities.
• Previous research has not fully elucidated the relationship between psychiatric disorders and CFS, including their onset and prevalence.

Purpose of the Study:

• To investigate the psychiatric correlates of CFS using data from the CDC's Surveillance Study.
• To determine the onset, rates, and predominant type of psychiatric disorders in CFS patients.
• To assess the association between depression and CFS symptomatology and evaluate the specificity of the CDC case definition.

Main Methods:

• Utilized the Diagnostic Interview Schedule for DSM-III-R and Beck Depression Inventory on 565 subjects with fatiguing illnesses.
• Calculated prevalence of syndromal psychiatric disorders and compared CFS symptoms by depression status.
• Contrasted syndromal and self-reported depression and compared outcomes between CFS and non-CFS groups.

Main Results:

• High rates of current psychiatric disorders were observed in CFS subjects compared to the general community.
• Depression was the predominant psychiatric disorder, with many disorders emerging concurrently with the fatiguing illness.
• Weak agreement was found between syndromal and self-reported depression measures; no specific psychiatric features distinguished CFS cases.

Conclusions:

• Psychiatric disorders are associated with fatiguing illnesses like CFS, with onset often concurrent with the illness.
• Prior psychiatric disorders can be risk factors, but new-onset disorders are common.
• The Beck Depression Inventory is not recommended for measuring psychiatric morbidity in CFS; the CDC case definition lacks psychiatric specificity.