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Chronic fatigue in a population sample: definitions and heterogeneity
Patrick F Sullivan1, Nancy L Pedersen, Andreas Jacks
1Department of Genetics, University of North Carolina at Chapel Hill, NC 27599-7264, USA. pfsulliv@med.unc.edu
Psychological Medicine
|September 20, 2005
Summary
This study questions the 1994 CDC criteria for chronic fatigue syndrome (CFS). Latent class analysis identified a CFS-like syndrome, suggesting a simpler definition is needed for fatigue research.
Area of Science:
- Medical research
- Epidemiology
- Psychiatry
Background:
- Diagnostic criteria for chronic fatigue syndrome (CFS) lack rigorous evaluation.
- Distinguishing CFS from general fatigue involves complex nosological decisions.
Purpose of the Study:
- To evaluate the definition and classification of CFS-like illness.
- To critically assess the 1994 Centers for Disease Control (CDC) criteria for CFS.
Main Methods:
- Analysis of telephone interview data from 31,406 twins in the Swedish Twin Registry (ages 42-64).
- Inclusion of 5,330 subjects with fatigue and no exclusionary conditions.
- Application of graphical methods, regression models, and latent class analysis.
Main Results:
- No empirical support for the CDC's requirement of four of eight cardinal CFS symptoms.
- The eight cardinal symptoms did not equally predict fatigue.
- Latent class analysis identified a distinct CFS-like syndrome.
- Heritability of symptom combinations was not significantly higher for CFS criteria.
Conclusions:
- Data support the existence of CFS-like illness, but current nosological approaches poorly capture population variation.
- A more parsimonious definition of chronic fatigue, excluding known causes, is proposed for future research.