Abstract
Despite the existence of 2 different case definitions for chronic fatigue syndrome, little data exist to evaluate how each performs. We evaluated the symptom patterns of patients fulfilling either the more demanding 1988 or the less demanding 1994 case definitions of Chronic Fatigue Syndrome over an 11-year period from 1991 to 2001. Factor analysis identified 3 factors: muscular–skeletal, viral, and sleep:memory symptom factors accounting for significant variation in the data. Further discriminant analysis showed that the first 2 factors and a self-reported measure of decrease in activity alone gave 91% accuracy in the placement of patients into their respective case definitions. This analysis did indicate that both case definitions were capturing the same broad group of patients. However, the patients in the 1994 group do not endorse infectious-type symptoms as often or to the same degree of severity as those in the 1988 group. This may mean that infection as a cause of CFS is more likely in patients fulfilling the earlier, more demanding case definition.
Similar content being viewed by others
REFERENCES
Bates, D.W., Buchwald, D., Lee, J., Kith, P., Doolittle, T. H., Umali, P., et al. (1994). A comparison of case definitions of chronic fatigue syndrome. Clinical Infectious Diseases, 18(Suppl. 1), S11–S15.
De Becker, P., McGregor, N., & De Meirleir, K. (2001). A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome. Journal of Internal Medicine, 250, 234–240.
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Komaroff, A., and the International Study Group. (1994). The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953–959.
Holmes, G. P., Kaplan, J. E., Gantz, N. M., Komaroff, A. L., Schonberger, L. B., Straus, S. E., et al. (1988). Chronic fatigue syndrome: A working case definition. Annals of Internal Medicine, 108, 387–389.
Jason, L. A., & Taylor, R. R. (2002). Applying cluster analysis to define a typology of chronic fatigue syndrome in a medically-evaluated, random community sample. Psychology and Health, 1, 1–15.
Jason, L. A., Torres-Harding, S. R., Taylor, R. R., & Carrico, A.W. (2001). A comparison of the 1988 and 1994 diagnostic criteria for chronic fatigue syndrome. Journal of Clinical Psychology in Medical Settings, 8, 337–343.
Katon, W. J., Buchwald, D. S., Simon, G. E., Russo, J. E., & Meas, P. H. (1991). Psychiatric illness in patients with chronic fatigue and rheumatoid arthritis. Journal of General Internal Medicine, 6277–285.
Komaroff, A. L., Fagioli, L. R., Geiger, A. M., Doolittle, T. H., Lee, J., Kornish, J., et al. (1996). An examination of the working case definition of chronic fatigue syndrome. American Journal of Medicine, 100, 56–64.
Marcus, S., Robins, L. N., & Bucholz, K. (1990). Quick diagnostic interview schedule 3R version 1. St. Louis, MO: Washington University School of Medicine.
Nisenbaum, R., Reyes, M., Mawle, A. C., & Reeves, W. C. (1998). Factor analysis of unexplained severe fatigue and interrelated symptoms–Overlap with criteria for chronic fatigue syndrome. American Journal of Epidemiology, 148, 72–77.
Wessely, S., Chalder, T., Hirsch, S., Wallace, P., & Wright, D. (1997). The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: A prospective primary care study. American Journal of Public Health, 87, 1449–1455.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brimacombe, M., Helmer, D. & Natelson, B.H. Clinical Differences Exist Between Patients Fulfilling the 1988 and 1994 Case Definitions of Chronic Fatigue Syndrome. Journal of Clinical Psychology in Medical Settings 9, 309–314 (2002). https://doi.org/10.1023/A:1020739002058
Issue Date:
DOI: https://doi.org/10.1023/A:1020739002058