International Journal of Behavioral Medicine

, Volume 13, Issue 3, pp 244–251 | Cite as

Differential diagnosis of chronic fatigue syndrome and major depressive disorder

  • Caroline Hawk
  • Leonard A. Jason
  • Susan Torres-Harding
Article

Abstract

The goal of this study was to identify variables that successfully differentiated patients with chronic fatigue syndrome, major depressive disorder, and controls. Fifteen participants were recruited for each of these three groups, and discriminant function analyses were conducted. Using symptom occurrence and severity data from the Fukuda et al. (1994) definitional criteria, the best predictors were postexertional malaise, unrefreshing sleep, and impaired memory-concentration. Symptom occurrence variables only correctly classified 84.4% of cases, whereas 91.1% were correctly classified when using symptom severity ratings. Finally, when using percentage of time fatigue reported, postexertional malaise severity, unrefreshing sleep severity, confusion-disorientation severity, shortness of breath severity, and self-reproach to predict group membership, 100% were classified correctly.

Key words

chronic fatigue syndrome depression symptomatology diagnostic criteria 

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References

  1. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–100.CrossRefGoogle Scholar
  2. Carruthers, B. M., Jain, A. K., DeMeirleir, K. L., Peterson, D. L., Klimas, N. G., Lerner, A. M., et al. (2003). Myalgic encephalomyelitis/chronic fatigue syndrome: Clinical working case definition, diagnostic and treatments protocols. Journal of Chronic Fatigue Syndrome, 11, 7–115.CrossRefGoogle Scholar
  3. Friedberg, F., Dechene, L., McKenzie, M. J., II, & Fontanetta, R. (2000). Symptom patterns in long-duration chronic fatigue syndrome. Journal of Psychosomatic Research, 48(1), 59–68.PubMedCrossRefGoogle Scholar
  4. Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G., & Komaroff, A. (1994). The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953–959.PubMedGoogle Scholar
  5. Gerber, L., & Furst, G. (1992). Validation of the NIH Activity Record: A quantitative measure of life activities. Arthritis Care and Research, 5, 81–86.PubMedCrossRefGoogle Scholar
  6. Hartz, A., Kuhn, E. M., & Levine, P. H. (1998). Characteristics of fatigued persons associated with features of chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome, 4, 71–97.CrossRefGoogle Scholar
  7. Hawk, C., Jason, L. A., & Peña, J. (2006). ACTRE variables that differentiate chronic fatigue syndrome from depression. Manuscript submitted for publication.Google Scholar
  8. Holmes, G. P., Kaplan, J. E., Gantz, N. M., Komaroff, A. L., Schonberger, L. B., Strauss, S. S., et al. (1988). Chronic fatigue syndrome: A working case definition. Annals of Internal Medicine, 108, 387–389.PubMedGoogle Scholar
  9. Huber, S., Freidenberg, D., Paulson, G., Shuttleworth, E., & Christy, J. (1990). The pattern of depressive symptoms varies with progression of Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 53, 275–278.CrossRefGoogle Scholar
  10. Huber, S., Rammonhan, K., Bornstein, R., & Christy, J. (1993). Depressive symptoms are not influenced by severity of multiple sclerosis. Neuropsychology, Neuropsychiatry, and Behavioral Neurology, 6, 177–180.Google Scholar
  11. Jason, L. A., Fennell, P., & Taylor, R. R. (Eds.). (2003). Handbook of chronic fatigue syndrome. New York: Wiley.Google Scholar
  12. Jason, L. A., King, C. P., Taylor, R. R., & Kennedy, C. (2000). Defining chronic fatigue syndrome: Methodological challenges. Journal of Chronic Fatigue Syndrome, 7(3), 17–32.CrossRefGoogle Scholar
  13. Jason, L. A., Richman, J. A., Friedberg, F., Wagner, L., Taylor, R., & Jordan, K. M. (1997). Politics, science, and the emergence of a new disease: The case of chronic fatigue syndrome. American Psychologist, 52, 973–983.PubMedCrossRefGoogle Scholar
  14. 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, 17, 323–337.CrossRefGoogle Scholar
  15. Jason, L. A., Taylor, R. R., Kennedy, C. L., Harding, S. T., Song, S., Johnson, D., et al. (2001). Subtypes of chronic fatigue syndrome: A review of findings. Journal of Chronic Fatigue Syndrome, 8, 1–21.CrossRefGoogle Scholar
  16. Jason, L. A., Taylor, R. R., Kennedy, C. L., Jordan, K., Huang, C., Torres-Harding, S., et al. (2002). A factor analysis of chronic fatigue symptoms in a community-based sample. Social Psychiatry and Psychiatric Epidemiology, 37, 183–189.PubMedCrossRefGoogle Scholar
  17. 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.CrossRefGoogle Scholar
  18. Johnson, S. K., De Luca, J., & Natelson, B. (1995). Depression in fatiguing illness: Comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. Journal of Affective Disorders, 39, 21–30.CrossRefGoogle Scholar
  19. Johnson, S. K., De Luca, J., & Natelson, B. H. (1996). Assessing somatization disorder in the Chronic Fatigue Syndrome. Psychosomatic Medicine, 58, 50–57.PubMedGoogle Scholar
  20. King, C., & Jason, L. A. (2005). Improving the diagnostic criteria and procedures for chronic fatigue syndrome. Biological Psychology, 68, 87–106.PubMedCrossRefGoogle Scholar
  21. Komaroff, A. L., Fagioli, L. R., Geiger, A. M., Doolittle, T. H., Lee, J., Kornish, R. J., et al. (1996). An examination of the working case definition of chronic fatigue syndrome. The American Journal of Medicine, 100, 56–64.PubMedCrossRefGoogle Scholar
  22. Linder, R., Dinser, R., Wagner, M., Krueger, G. R., & Hoffmann, A. (2002). Generation of classification criteria for chronic fatigue syndrome using an artificial neural network and traditional criteria set. In Vivo, 16(1), 37–43.PubMedGoogle Scholar
  23. Lloyd, A. R., Hickie, I., Boughton, C. R., Spencer, O., & Wakefield, D. (1990). Prevalence of chronic fatigue syndrome in an Australian population. Medical Journal of Australia, 153, 522–528.PubMedGoogle Scholar
  24. 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.PubMedGoogle Scholar
  25. Nisenbaum, R., Reyes, M., Unger, E. R., & Reeves, W. C. (2004). Factor analysis of symptoms among subjects with unexplained chronic fatigue: What can we learn about chronic fatigue syndrome? Journal of Psychosomatic Research, 56(2), 171–178.PubMedCrossRefGoogle Scholar
  26. Ray, C., Weir, W. R. C., Phillips, S., & Cullen, S. (1992). Development of a measure of symptoms in chronic fatigue syndrome: The profile of fatigue-related symptoms (PFRS). Psychology and Health, 7, 27–43.CrossRefGoogle Scholar
  27. Rowe, P. C., & Calkins, H. (1998). Neurally mediated hypotension and chronic fatigue syndrome. The American Journal of Medicine, 105(3A), 15S-21S.PubMedCrossRefGoogle Scholar
  28. Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1995). Structured clinical interview for the DSM-IV: Non-Patient Edition (SCID: NP, Version 2.0). Washington, DC: American Psychiatric Press.Google Scholar
  29. Stouten, B. (2005). Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Services Research 2005, 5:37 doi:10.1186/1472–6963–5–37.Google Scholar
  30. Taylor, R. R., Jason, L. A., & Schoeny, M. E. (2001). Evaluating latent variable models of functional somatic distress in a community-based sample. Journal of Mental Health, 10, 335–349.CrossRefGoogle Scholar
  31. Wasser, T. E. (1991, August). Statistical correction of Hollinghead’s four factor index of social status. Paper presented at the American Psychological Association, San Francisco, CA.Google Scholar

Copyright information

© International Society of Behavioral Medicine 2006

Authors and Affiliations

  • Caroline Hawk
    • 1
  • Leonard A. Jason
    • 2
  • Susan Torres-Harding
    • 2
  1. 1.Hines VA HospitalHinesUSA
  2. 2.DePaul UniversityChicagoUSA

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