Physicians' Diagnoses of Psychiatric Disorders for People with Chronic Fatigue Syndrome

2002 ◽  
Vol 32 (2) ◽  
pp. 109-124 ◽  
Author(s):  
Susan R. Torres-Harding ◽  
Leonard A. Jason ◽  
Victoria Cane ◽  
Adam Carrico ◽  
Renee R. Taylor
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Chronic Fatigue ◽  
Self Report ◽  
Control Group ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
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.

scholarly journals Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome

2005 ◽  
Vol 187 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Judith Prins ◽  
Gijs Bleijenberg ◽  
Eufride Klein Rouweler ◽  
Jos Van Der Meer
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Impact

SummaryPsychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.

scholarly journals The presence of co-morbid mental health problems in a cohort of adolescents with chronic fatigue syndrome

2017 ◽  
Vol 23 (3) ◽  
pp. 398-408 ◽  
Author(s):  
Maria Elizabeth Loades ◽  
Katharine A Rimes ◽  
Sheila Ali ◽  
Kate Lievesley ◽  
Trudie Chalder
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Chronic Fatigue Syndrome ◽  
Trait Anxiety ◽  
Chronic Fatigue ◽  
The State ◽  
Self Report ◽  
Psychiatric Interview ◽  
Depression Diagnosis ◽  
Fatigue Syndrome

Objective: To report on the prevalence of mental health disorders in adolescents with chronic fatigue syndrome (CFS) and to compare the diagnoses identified by a brief clinician-administered psychiatric interview with self-report screening questionnaires. Design: Cross-sectional study. Setting: Consecutive attenders to specialist CFS clinics in the United Kingdom. Patients: N = 52 adolescents, age 12–18 years with CFS. Measures: Self-report questionnaires and a brief structured psychiatric diagnostic interview, administered by a researcher. Results: On the psychiatric interview, 34.6% met a diagnosis of major depressive disorder and 28.8% had an anxiety disorder. Of these, 15% had co-morbid anxiety and depression. Those with a depression diagnosis reported significantly greater interference on the school and social adjustment scale. They also scored significantly higher on trait anxiety, but not on state anxiety. There were no differences between those who had an anxiety disorder and those who did not on fatigue, disability or depressive symptoms. Children’s Depression Inventory (CDI) score was associated with a depression diagnosis on the psychiatric interview. However, neither the state nor the trait subscale of the State-Trait Anxiety Inventory (STAI) was associated with an anxiety diagnosis. Conclusion: Clinicians should assess for the presence of anxiety and depressive disorders in adolescents with CFS using a validated psychiatric interview. Treatment should be flexible enough to accommodate fatigue, depression and anxiety. Transdiagnostic approaches may suit this purpose. Goals should include pleasurable activities particularly for those who are depressed.

scholarly journals The relationship between prior psychiatric disorder and chronic fatigue: evidence from a national birth cohort study

2007 ◽  
Vol 38 (7) ◽  
pp. 933-940 ◽  
Author(s):  
S. B. Harvey ◽  
M. Wadsworth ◽  
S. Wessely ◽  
M. Hotopf
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Dose Response ◽  
Psychiatric Illness ◽  
Chronic Fatigue ◽  
Self Report ◽  
Personality Factors ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Shared Risk

BackgroundIncreased rates of psychiatric disorder have previously been reported in those diagnosed with chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME), although the direction of causation in this relationship has not been established. We aimed to test the hypothesis that individuals with self-reported CFS/ME have increased levels of psychiatric disorder prior to the onset of their fatigue symptoms.MethodA total of 5362 participants were prospectively followed with various measures of personality, psychiatric disorder and fatigue levels collected over the first 43 years of their life. CFS/ME was identified through self-report during a semi-structured interview at age 53 years.ResultsThirty-four (1.1%) of the 3035 subjects assessed at age 53 years reported a diagnosis of CFS/ME. CFS/ME was more common among females, but there was no association between CFS/ME and either social class, social mobility or educational level. Those with psychiatric illness between the ages of 15 and 36 years were more likely to report CFS/ME later in life with an odds ratio (OR, adjusted for sex) of 2.65 [95% confidence interval (CI) 1.26–5.57, p=0.01]. Increased levels of psychiatric illness, in particular depression and anxiety, were present prior to the occurrence of fatigue symptoms. There was a dose–response relationship between the severity of psychiatric symptoms and the likelihood of later CFS/ME. Personality factors were not associated with a self-reported diagnosis of CFS/ME.ConclusionsThis temporal, dose–response relationship suggests that psychiatric disorders, or shared risk factors for psychiatric disorders, are likely to have an aetiological role in some cases of CFS/ME.

scholarly journals Diagnosis of psychiatric disorder in clinical evaluation of chronic fatigue syndrome

2000 ◽  
Vol 93 (6) ◽  
pp. 310-312 ◽  
Author(s):  
Alicia Deale ◽  
Simon Wessely
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorder ◽  
Clinical Evaluation ◽  
Psychiatric Diagnosis ◽  
Depression Scale ◽  
Chronic Fatigue ◽  
Psychiatric Diagnoses ◽  
Fatigue Syndrome ◽  
Standardized Interview ◽  
Brief Screening

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.

scholarly journals Structural brain changes versus self-report: machine-learning classification of chronic fatigue syndrome patients

2018 ◽  
Vol 236 (8) ◽  
pp. 2245-2253 ◽  
Author(s):  
Landrew S. Sevel ◽  
Jeff Boissoneault ◽  
Janelle E. Letzen ◽  
Michael E. Robinson ◽  
Roland Staud
Keyword(s):  
Machine Learning ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Self Report ◽  
Machine Learning Classification ◽  
Fatigue Syndrome ◽  
Brain Changes ◽  
Structural Brain

scholarly journals Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case–control study

2003 ◽  
Vol 33 (7) ◽  
pp. 1185-1192 ◽  
Author(s):  
SIMON HATCHER ◽  
ALLAN HOUSE
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Life Events ◽  
Stressful Life Events ◽  
Chronic Fatigue ◽  
Case Control ◽  
Stressful Events ◽  
Control Group ◽  
Liaison Psychiatry ◽  
Fatigue Syndrome

Background. The role of stress in the onset of chronic fatigue syndrome is unclear. Our objectives in this study were first, to determine the relation between the onset of chronic fatigue syndrome and stressful life events and difficulties. Secondly, we examined the role of a particular type of problem, dilemmas, in the onset of chronic fatigue syndrome.Method. We used a case–control design with 64 consecutive referrals from an Infectious Diseases/Liaison Psychiatry Fatigue clinic and 64 age- and sex-matched controls from a general practice population control group in Leeds. We had two main outcome measures; the odds ratios of the risk of developing chronic fatigue syndrome after experiencing a severe life event, severe difficulties or both in the year and 3 months preceding onset; and the proportion of subjects in each group who experienced a dilemma prior to onset.Results. Patients with chronic fatigue syndrome were more likely to experience severe events and difficulties in the 3 months (OR=9, 95% CI 3·2 to 25·1) and year (OR=4·3, 95% CI 1·8 to 10·2) prior to onset of their illness than population controls. In the 3 months prior to onset 19 of the 64 patients (30%) experienced a dilemma compared to none of the controls.Conclusions. Chronic fatigue syndrome is associated with stressful events and difficulties prior to onset. Those events and difficulties characterized as being dilemmas seem to be particularly important.

scholarly journals Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group

1995 ◽  
Vol 237 (5) ◽  
pp. 499-506 ◽  
Author(s):  
CAROLINE M. A. SWANINK ◽  
JAN H. M. M. VERCOULEN ◽  
GIJS BLEIJENBERG ◽  
JAN F. M. FENNIS ◽  
JOEP M. D. GALAMA ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Laboratory Study ◽  
Matched Control ◽  
Chronic Fatigue ◽  
Control Group ◽  
Matched Control Group ◽  
Fatigue Syndrome
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