Psychiatric diagnosis and chronic fatigue syndrome: Controversies and conflicts

Summary The overlap of symptoms in chronic fatigue syndrome (CFS) and psychiatric disorders such as depression can complicate diagnosis. Patients often complain that they are wrongly given a psychiatric label. We compared psychiatric diagnoses made by general practitioners and hospital doctors with diagnoses established according to research diagnostic criteria. 68 CFS patients referred to a hospital fatigue clinic were assessed, and psychiatric diagnoses were established by use of a standardized interview schedule designed to provide current and lifetime diagnoses. These were compared with psychiatric diagnoses previously given to patients. Of the 31 patients who had previously received a psychiatric diagnosis 21 (68%) had been misdiagnosed: in most cases there was no evidence of any past or current psychiatric disorder. Of the 37 patients who had not previously received a psychiatric diagnosis 13 (35%) had a treatable psychiatric disorder in addition to CFS. These findings highlight the difficulties of routine clinical evaluation of psychiatric disorder in CFS patients. We advise doctors to focus on subtle features that discriminate between disorders and to use a brief screening instrument such as the Hospital Anxiety and Depression Scale.

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Long- and short-term blood pressure andRR-interval variability and psychosomatic distress in chronic fatigue syndrome: authors’ reply 1

Clinical Science ◽

10.1042/cs19990155 ◽

1999 ◽

Vol 97 (3) ◽

pp. 319 ◽

Cited By ~ 1

Author(s):

D.A. DUPREZ ◽

M.L. DE BUYZERE ◽

B. DRIEGHE ◽

F. VANHAVERBEKE ◽

Y. TAES ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Short Term ◽

Fatigue Syndrome

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Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome

European Journal of Psychological Assessment ◽

10.1027/1015-5759/a000281 ◽

2017 ◽

Vol 33 (3) ◽

pp. 158-165

Author(s):

Natalia Calvo ◽

Naia Sáez-Francàs ◽

Sergi Valero ◽

Jesús Castro-Marrero ◽

José Alegre Martín ◽

...

Keyword(s):

Personality Disorder ◽

Chronic Fatigue Syndrome ◽

Personality Assessment ◽

Chronic Fatigue ◽

Specific Pattern ◽

Harm Avoidance ◽

Assessment Instrument ◽

Compulsive Disorder ◽

Fatigue Syndrome ◽

Self Transcendence

Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.

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