The use of a symptom “self-report” inventory to evaluate the acceptability and efficacy of a walking program for patients suffering with chronic fatigue syndrome

Objective: To examine rates of psychiatric diagnoses given by patients' primary or regular physicians to persons with chronic fatigue syndrome (CFS), persons with psychiatrically explained fatigue, and a control group. Physicians' psychiatric diagnosis and participants' self-reported psychiatric diagnoses were compared to lifetime psychiatric diagnoses as measured by a structured psychiatric interview. Method: Participants were recruited as part of a community-based epidemiology study of chronic fatigue syndrome. Medical records of 23 persons with chronic fatigue syndrome, 25 persons with psychiatrically explained chronic fatigue, and 19 persons without chronic fatigue (controls) were examined to determine whether their physician had given a diagnosis of mood, anxiety, somatoform, or psychotic disorder. Lifetime psychiatric status was measured using the Structured Clinical Interview for the DSM-IV (SCID). Participants' self reports of specific psychiatric disorders were assessed as part of a detailed medical questionnaire. Results: Physicians' diagnosis of a psychiatric illness when at least one psychiatric disorder was present ranged from 40 percent in the psychiatrically explained group, 50 percent in the control group, and 64.3 percent in the CFS group. Participants in the psychiatrically explained group were more accurate than physicians in reporting the presence of a psychiatric disorder, and in accurately reporting the presence of a mood or anxiety disorder. Conclusions: The present investigation found underrecognition of psychiatric illness by physicians, with relatively little misdiagnosis of psychiatric illness. Physicians had particular difficulty assessing psychiatric disorder in those patients whose chronic fatigue was fully explained by a psychiatric disorder. Results emphasized the importance of using participant self report as a screening for psychiatric disorder.

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The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map?

Psychological Medicine ◽

10.1017/s003329171000139x ◽

2010 ◽

Vol 41 (5) ◽

pp. 1099-1107 ◽

Cited By ~ 40

Author(s):

R. Moss-Morris ◽

M. J. Spence ◽

R. Hou

Keyword(s):

Chronic Fatigue Syndrome ◽

Perceived Stress ◽

Chronic Fatigue ◽

Self Report ◽

Illness Beliefs ◽

Glandular Fever ◽

Fatigue Syndrome ◽

Behavioural Model ◽

Cognitive Behavioural ◽

New Onset

BackgroundThe cognitive behavioural model of chronic fatigue syndrome (CFS) suggests that the illness is caused through reciprocal interactions between physiology, cognition, emotion and behaviour. The purpose of this study was to investigate whether the psychological factors operationalized in this model could predict the onset of CFS following an acute episode of infectious mononucleosis commonly known as glandular fever (GF).MethodA total of 246 patients with GF were recruited into this prospective cohort study. Standardized self-report measures of perceived stress, perfectionism, somatization, mood, illness beliefs and behaviour were completed at the time of their acute illness. Follow-up questionnaires determined the incidence of new-onset chronic fatigue (CF) at 3 months and CFS at 6 months post-infection.ResultsOf the participants, 9.4% met the criteria for CF at 3 months and 7.8% met the criteria for CFS at 6 months. Logistic regression revealed that factors proposed to predispose people to CFS including anxiety, depression, somatization and perfectionism were associated with new-onset CFS. Negative illness beliefs including perceiving GF to be a serious, distressing condition, that will last a long time and is uncontrollable, and responding to symptoms in an all-or-nothing behavioural pattern were also significant predictors. All-or-nothing behaviour was the most significant predictor of CFS at 6 months. Perceived stress and consistently limiting activity at the time of GF were not significantly associated with CFS.ConclusionsThe findings from this study provide support for the cognitive behavioural model and a good basis for developing prevention and early intervention strategies for CFS.

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Subgrouping in Chronic Fatigue Syndrome Based on Actigraphy and Illness Severity

The Open Biology Journal ◽

10.2174/1874196700902010020 ◽

2009 ◽

Vol 2 (1) ◽

pp. 20-26 ◽

Cited By ~ 3

Author(s):

Mariya Zaturenskaya ◽

Leonard A. Jason ◽

Susan Torres-Harding ◽

Warren W. Tryon

Keyword(s):

Chronic Fatigue Syndrome ◽

Symptom Severity ◽

Chronic Fatigue ◽

Self Report ◽

Psychiatric Status ◽

Fatigue Syndrome ◽

Severe Group ◽

Report Symptom ◽

Symptom Group ◽

Anxiety Depression

Participants with chronic fatigue syndrome were categorized into subtypes based on actigraphy and illness selfreport symptom severity data. Each method identified two groups of patients, one with severe and one with less severe manifestations of the illness. For both subtypes, those in the more severe category had more physical functioning problems than those in the less severe categories. However, for the illness self-report symptom group, those in the more severe category had significantly more impairment in sleep, anxiety, depression, and pain, and more concurrent psychiatric status and Fibromyalgia than those in the less severe category. In contrast, those in the more severe actigraphy subtype group in comparison to the less severe group had more impairment in quality of life and cortisol readings. These findings suggest that CFS subtypes based on symptom severity and amount of activity identify different groups of patients with varying types of impairments.

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Assessment of Post-Exertional Malaise (PEM) in Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS): A Patient-Driven Survey

Diagnostics ◽

10.3390/diagnostics9010026 ◽

2019 ◽

Vol 9 (1) ◽

pp. 26 ◽

Cited By ~ 9

Author(s):

Carly Holtzman ◽

Shaun Bhatia ◽

Joseph Cotler ◽

Leonard Jason

Keyword(s):

Chronic Fatigue Syndrome ◽

Community Based Participatory Research ◽

Chronic Fatigue ◽

Research Process ◽

Myalgic Encephalomyelitis ◽

Self Report ◽

Overall Design ◽

Fatigue Syndrome ◽

Government Report ◽

Considerable Controversy

Considerable controversy has existed with efforts to assess post-exertional malaise (PEM), which is one of the defining features of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). While a number of self-report questionnaires have been developed to assess this symptom, none have been comprehensive, and a recent federal government report has recommended the development of a new PEM measure. The current study involved a community-based participatory research process in an effort to develop a comprehensive PEM instrument, with critical patient input shaping the item selection and overall design of the tool. A survey was ultimately developed and was subsequently completed by 1534 members of the patient community. The findings of this survey suggest that there are key domains of this symptom, including triggers, symptom onset, and duration, which have often not been comprehensively assessed in a previous PEM instrument. This study indicates that there are unique benefits that can be derived from patients collaborating with researchers in the measurement of key symptoms defining ME and CFS.

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Treatment Outcome and Metacognitive Change in CBT and GET for Chronic Fatigue Syndrome

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246581500017x ◽

2015 ◽

Vol 44 (4) ◽

pp. 397-409 ◽

Cited By ~ 11

Author(s):

Bruce A. Fernie ◽

Gabrielle Murphy ◽

Adrian Wells ◽

Ana V. Nikčević ◽

Marcantonio M. Spada

Keyword(s):

Clinical Practice ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Routine Clinical Practice ◽

Self Report ◽

Treatment Modalities ◽

Treatment Protocols ◽

Fatigue Syndrome ◽

Graded Exercise Therapy ◽

Fatigue Severity

Background: Studies have reported that Cognitive Behavioural Therapy (CBT) and Graded Exercise Therapy (GET) are effective treatments for Chronic Fatigue Syndrome (CFS). Method: One hundred and seventy-one patients undertook a course of either CBT (n = 116) or GET (n = 55) and were assessed on a variety of self-report measures at pre- and posttreatment and follow-up. Aims: In this paper we present analyses on treatment outcomes for CBT and GET in routine clinical practice and evaluate whether changes on subscales of the Metacognitions Questionnaire-30 (MCQ-30) predict fatigue severity independently of changes in other covariates, and across the two treatment modalities. Results: Both CBT and GET were equally effective at decreasing fatigue, anxiety, and depression, and at increasing physical functioning. Changes on the subscales of the MCQ-30 were also found to have a significant effect on fatigue severity independently of changes in other covariates and across treatment modalities. Conclusion: The findings from the current study suggest that CFS treatment protocols for CBT and GET, based on those from the PACE trial, achieve similar to poorer outcomes in routine clinical practice as in a RCT.

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Causal attributions for somatic sensations in patients with chronic fatigue syndrome and their partners

Psychological Medicine ◽

10.1017/s0033291799003001 ◽

2001 ◽

Vol 31 (1) ◽

pp. 97-105 ◽

Cited By ~ 36

Author(s):

J. A. BUTLER ◽

T. CHALDER ◽

S. WESSELY

Keyword(s):

Chronic Fatigue Syndrome ◽

Causal Attributions ◽

Chronic Fatigue ◽

Cross Sectional Study ◽

Self Report ◽

Cross Sectional ◽

Vulnerability Factor ◽

Fracture Clinic ◽

Fatigue Syndrome ◽

Cognitive Behavioural

Background. Patients with chronic fatigue syndrome (CFS) often make somatic attributions for their illness which has been associated with poor outcome. A tendency to make somatic attributions in general may be a vulnerability factor for the development of CFS.Methods. This cross-sectional study based on self-report questionnaire data aimed to investigate the type of attributions for symptoms made by patients with CFS and to compare this to attributions made by their partners. It was hypothesized that patients with CFS would make more somatic attributions for their own symptoms than control subjects and that partners of patients with CFS would make more somatic attributions for their ill relative's symptoms but would be similar to controls regarding their own symptoms. Fifty patients with CFS were compared to 50 controls from a fracture clinic in the same hospital and 46 relatives living with the patients with CFS. A modified Symptom Interpretation Questionnaire was used to assess causal attributions.Results. CFS patients were more likely to make somatic attributions for their symptoms. The relatives of patients with CFS made significantly more somatic attributions for symptoms in their ill relative. However, they were like the fracture clinic controls in terms of making predominantly normalizing attributions for their own symptoms.Conclusions. The data support modification of existing cognitive behavioural treatments for CFS to investigate whether addressing partners' attributions for patients' symptoms improves recovery in the patient. Furthermore, a tendency to make somatic attributions for symptoms may be a vulnerability factor for the development of CFS.

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Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study

Psychological Medicine ◽

10.1017/s0033291720001774 ◽

2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Rei Monden ◽

Judith G. M. Rosmalen ◽

Klaas J. Wardenaar ◽

Francis Creed

Keyword(s):

Irritable Bowel Syndrome ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Population Based ◽

Current Approach ◽

Self Report ◽

Fatigue Syndrome ◽

Starting Point ◽

Irritable Bowel

Abstract Background It has been claimed that functional somatic syndromes share a common etiology. This prospective population-based study assessed whether the same variables predict new onsets of irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS) and fibromyalgia (FM). Methods The study included 152 180 adults in the Dutch Lifelines study who reported the presence/absence of relevant syndromes at baseline and follow-up. They were screened at baseline for physical and psychological disorders, socio-demographic, psycho-social and behavioral variables. At follow-up (mean 2.4 years) new onsets of each syndrome were identified by self-report. We performed separate analyses for the three syndromes including participants free of the relevant syndrome or its key symptom at baseline. LASSO logistic regressions were applied to identify which of the 102 baseline variables predicted new onsets of each syndrome. Results There were 1595 (1.2%), 296 (0.2%) and 692 (0.5%) new onsets of IBS, CFS, and FM, respectively. LASSO logistic regression selected 26, 7 and 19 predictors for IBS, CFS and FM, respectively. Four predictors were shared by all three syndromes, four predicted IBS and FM and two predicted IBS and CFS but 28 predictors were specific to a single syndrome. CFS was more distinct from IBS and FM, which predicted each other. Conclusions Syndrome-specific predictors were more common than shared ones and these predictors might form a better starting point to unravel the heterogeneous etiologies of these syndromes than the current approach based on symptom patterns. The close relationship between IBS and FM is striking and requires further research.

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