Are chronic fatigue and chronic fatigue syndrome valid clinical entities across countries and health-care settings?
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Publication year
2009Author(s)
Source
Australian and New Zealand Journal of Psychiatry, 43, 1, (2009), pp. 25-35ISSN
Publication type
Article / Letter to editor
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Organization
Internal Medicine
Medical Psychology
Oral and Maxillofacial Surgery
Journal title
Australian and New Zealand Journal of Psychiatry
Volume
vol. 43
Issue
iss. 1
Page start
p. 25
Page end
p. 35
Subject
NCEBP 8: Psychological determinants of chronic illness; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 2: Age-related aspects of cancer; ONCOL 4: Quality of CareAbstract
OBJECTIVE: The validity of the diagnosis of chronic fatigue syndrome and related chronic fatigue states remains controversial, particularly in psychiatry. This project utilized international epidemiological and clinical research data to test construct validity across diagnostic categories, health-care settings and countries. Relevant demographic, symptom and diagnostic data were obtained from 33 studies in 21 countries. The subjects had fatigue lasting 1-6 months (prolonged fatigue), or >6 months (chronic fatigue), or met diagnostic criteria for chronic fatigue syndrome. METHOD: Common symptom domains were derived by factor analytic techniques. Mean scores on each symptom factor were compared across diagnostic categories, health-care settings and countries. RESULTS: Data were obtained on 37,724 subjects (n = 20,845 female, 57%), including from population-based studies (n = 15,749, 42%), studies in primary care (n = 19 472, 52%), and secondary or specialist tertiary referral clinics (n = 2503, 7%). The sample included 2013 subjects with chronic fatigue, and 1958 with chronic fatigue syndrome. A five-factor model of the key symptom domains was preferred ('musculoskeletal pain/fatigue', 'neurocognitive difficulties', 'inflammation', 'sleep disturbance/fatigue' and 'mood disturbance') and was comparable across subject groups and settings. Although the core symptom profiles were similar, some differences in symptoms were observed across diagnostic categories, health-care settings and between countries. CONCLUSIONS: The construct validity of chronic fatigue and chronic fatigue syndrome is supported by an empirically derived factor structure from existing international datasets.
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- Academic publications [238441]
- Electronic publications [122537]
- Faculty of Medical Sciences [90373]
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