Chronic fatigue in primary care attenders

1993 ◽  
Vol 23 (4) ◽  
pp. 987-998 ◽  
Author(s):  
Elizabeth McDonald ◽  
Anthony S. David ◽  
Anthony J. Pelosi ◽  
Anthony H. Mann
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Psychological Factors ◽  
Primary Care Physicians ◽  
Psychiatric Morbidity ◽  
Chronic Fatigue ◽  
Interview Schedule ◽  
Physical Evaluation ◽  
Fatigue Syndrome ◽  
Persistent Fatigue

SynopsisFrom 686 patients attending primary care physicians, 77 were identified by a screening procedure as having chronic fatigue. Of these, 65 were given a comprehensive psychological, social and physical evaluation. Seventeen cases (26%) met criteria for the chronic fatigue syndrome. Forty-seven (72%) received an ICD-9 diagnosis of whom 23 had neurotic depression, with a further 5 meeting criteria for neurasthenia. Forty-nine were ‘cases’ as defined by the revised Clinical Interview Schedule (CIS-R), and 42 if the fatigue item was excluded. Psychiatric morbidity was more related to levels of social stresses than was severity of fatigue. The main difference between these subjects and those examined in hospital settings is that the former are less liable to attribute their symptoms to wholly physical causes, including viruses, as opposed to social or psychological factors. Identification and management of persistent fatigue in primary care may prevent the secondary disabilities seen in patients with chronic fatigue syndromes.

scholarly journals Chronic Fatigue Syndrome in Childhood Revisited: Not Common, But Not Unknown- Case Study and Literature Review

2021 ◽  
Author(s):  
Alison Leong ◽  
Rajeev Ramachandran ◽  
Sajini Mary Varughese ◽  
Lee Gan Goh
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Literature Review ◽  
Chronic Fatigue ◽  
Diagnosis And Treatment ◽  
Fatigue Syndrome ◽  
Persistent Fatigue ◽  
Unknown Case

Abstract Lethargy is a common non-specific complaint to primary care and has a broad range of differentials. Chronic fatigue syndrome (CFS) should be considered when there is persistent fatigue affecting function and post- exertional malaise six months or longer and initial workup is not suggestive of other organic causes; it is a debilitating condition that would benefit from diagnosis and treatment. We present an adolescent with CFS, the disease timeline, its impact and outcome.

A Comparison of the Characteristics of Chronic Fatigue Syndrome in Primary and Tertiary Care

1996 ◽  
Vol 168 (1) ◽  
pp. 121-126 ◽  
Author(s):  
R. Euba ◽  
T. Chalder ◽  
A. Deale ◽  
S. Wessely
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Selection Bias ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Chronic Fatigue ◽  
Physical Illness ◽  
Hospital Unit ◽  
Fatigue Syndrome ◽  
Operational Criteria

BackgroundTo evaluate the characteristics of Chronic Fatigue Syndrome (CFS) in primary and tertiary care.MethodA comparison of subjects fulfilling criteria for CFS seen in primary care and in a hospital unit specialising in CFS. Subjects were 33 adults fulfilling criteria for CFS, identified as part of a prospective cohort study in primary care, compared to 79 adults fulfilling the same criteria referred for treatment to a specialist CFS clinic.ResultsHospital cases were more likely to belong to upper socio-economic groups, and to have physical illness attributions. They had higher levels of fatigue and more somatic symptoms, and were more impaired functionally, but had less overt psychological morbidity. Women were over-represented in both primary care and hospital groups. Nearly half of those referred to a specialist clinic did not fulfil operational criteria for CFS.ConclusionThe high rates of psychiatric morbidity and female excess that characterise CFS in specialist settings are not due to selection bias. On the other hand higher social class and physical illness attributions may be the result of selection bias and not intrinsic to CFS.

scholarly journals Chronic fatigue syndrome Role of psychological factors overemphasised

BMJ ◽  
1994 ◽  
Vol 308 (6939) ◽  
pp. 1297-1301 ◽  
Author(s):  
C Blatch ◽  
T Blatt ◽  
A Wilson ◽  
I Hickie ◽  
A Lloyd ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychological Factors ◽  
Chronic Fatigue ◽  
Fatigue Syndrome

Screening for Psychiatric Morbidity in Subjects Presenting with Chronic Fatigue Syndrome

1996 ◽  
Vol 168 (3) ◽  
pp. 354-358 ◽  
Author(s):  
Anne Farmer ◽  
Helen Chubb ◽  
Irene Jones ◽  
Janis Hillier ◽  
Andy Smith ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Serial Correlation ◽  
General Health Questionnaire ◽  
Psychiatric Morbidity ◽  
Correlation Coefficients ◽  
Chronic Fatigue ◽  
Healthy Controls ◽  
Operating Characteristics ◽  
Fatigue Syndrome ◽  
Icd 10

BackgroundThere is a need for a valid self-rating questionnaire to screen for psychiatric morbidity in patients with chronic fatigue syndrome (CFS). This study had the aim of assessing the utility and validity of two commonly used measures.MethodScores obtained on the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) were compared with various diagnostic and severity ratings obtained via a validating clinical interview, the Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) in 95 consecutively referred subjects at a medical out-patient clinic who fulfilled standard criteria for CFS, and 48 healthy controls. Outcome measures were validating coefficients and receiver operating characteristics (ROC) for different thresholds and scoring on GHQ and BDI and index of definition (ID) as measured by SCAN; and Pearson and point by serial correlation coefficients for different diagnostic groups derived via SCAN and defined according to ICD–10 and DSM–III–R.ResultsGHQ and BDI perform poorly as screeners of psychiatric morbidity in CFS subjects when compared with various SCAN derived ratings although results for controls are comparable with other studies.ConclusionsNeither the GHQ nor BDI alone can be recommended as screeners for psychiatric morbidity in CFS subjects.

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