Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 Apr;64(4):431–434. doi: 10.1136/jnnp.64.4.431

Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome

C Christodoulou 1, J DeLuca 1, G Lange 1, S Johnson 1, S A Sisto 1, L Korn 1, B Natelson 1
PMCID: PMC2170049  PMID: 9576531

Abstract

OBJECTIVES—To examine the relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome, and determine whether the relation is independent of psychiatric factors.
METHODS—The subjects were 53 patients with chronic fatigue syndrome and 32 healthy controls who did not exercise regularly. Subjects were administered a structured psychiatric interview and completed questionnaires focusing on depression and functional disability. They also completed a battery of standardised neuropsychological tasks focusing on the cognitive domains that patients with chronic fatigue syndrome experience as particularly difficult: memory (verbal and visual), and attention/concentration. A test score was defined as failing when it was ⩾2 SD below the mean of the healthy controls after controlling for demographic factors.
RESULTS—Those patients with chronic fatigue syndrome with higher numbers of failing neuropsychological test scores reported significantly more days of general inactivity in the past month than those with fewer failing scores. This result remained significant even after partialling out the contribution of the presence of a comorbid axis I psychiatric episode and the overall level of depressive symptomology. Patients with failing verbal memory scores were particularly functionally disabled compared with those with passing scores.
CONCLUSION—A relation was found between cognitive impairment and functional disability which could not be explained entirely on the basis of psychiatric factors.



Full Text

The Full Text of this article is available as a PDF (90.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbey S. E., Garfinkel P. E. Chronic fatigue syndrome and depression: cause, effect, or covariate. Rev Infect Dis. 1991 Jan-Feb;13 (Suppl 1):S73–S83. doi: 10.1093/clinids/13.supplement_1.s73. [DOI] [PubMed] [Google Scholar]
  2. Amato M. P., Ponziani G., Pracucci G., Bracco L., Siracusa G., Amaducci L. Cognitive impairment in early-onset multiple sclerosis. Pattern, predictors, and impact on everyday life in a 4-year follow-up. Arch Neurol. 1995 Feb;52(2):168–172. doi: 10.1001/archneur.1995.00540260072019. [DOI] [PubMed] [Google Scholar]
  3. DeLuca J., Johnson S. K., Beldowicz D., Natelson B. H. Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression. J Neurol Neurosurg Psychiatry. 1995 Jan;58(1):38–43. doi: 10.1136/jnnp.58.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DeLuca J., Johnson S. K., Natelson B. H. Information processing efficiency in chronic fatigue syndrome and multiple sclerosis. Arch Neurol. 1993 Mar;50(3):301–304. doi: 10.1001/archneur.1993.00540030065016. [DOI] [PubMed] [Google Scholar]
  5. Fitz A. G., Teri L. Depression, cognition, and functional ability in patients with Alzheimer's disease. J Am Geriatr Soc. 1994 Feb;42(2):186–191. doi: 10.1111/j.1532-5415.1994.tb04950.x. [DOI] [PubMed] [Google Scholar]
  6. Fukuda K., Straus S. E., Hickie I., Sharpe M. C., Dobbins J. G., Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994 Dec 15;121(12):953–959. doi: 10.7326/0003-4819-121-12-199412150-00009. [DOI] [PubMed] [Google Scholar]
  7. Holmes G. P., Kaplan J. E., Gantz N. M., Komaroff A. L., Schonberger L. B., Straus S. E., Jones J. F., Dubois R. E., Cunningham-Rundles C., Pahwa S. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988 Mar;108(3):387–389. doi: 10.7326/0003-4819-108-3-387. [DOI] [PubMed] [Google Scholar]
  8. Jette A. M., Davies A. R., Cleary P. D., Calkins D. R., Rubenstein L. V., Fink A., Kosecoff J., Young R. T., Brook R. H., Delbanco T. L. The Functional Status Questionnaire: reliability and validity when used in primary care. J Gen Intern Med. 1986 May-Jun;1(3):143–149. doi: 10.1007/BF02602324. [DOI] [PubMed] [Google Scholar]
  9. Johnson S. K., DeLuca J., Natelson B. H. Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. J Affect Disord. 1996 Jun 20;39(1):21–30. doi: 10.1016/0165-0327(96)00015-8. [DOI] [PubMed] [Google Scholar]
  10. Joyce E., Blumenthal S., Wessely S. Memory, attention, and executive function in chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1996 May;60(5):495–503. doi: 10.1136/jnnp.60.5.495. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lloyd A. R., Hickie I., Boughton C. R., Spencer O., Wakefield D. Prevalence of chronic fatigue syndrome in an Australian population. Med J Aust. 1990 Nov 5;153(9):522–528. doi: 10.5694/j.1326-5377.1990.tb126191.x. [DOI] [PubMed] [Google Scholar]
  12. Manu P., Lane T. J., Matthews D. A. Chronic fatigue syndromes in clinical practice. Psychother Psychosom. 1992;58(2):60–68. doi: 10.1159/000288612. [DOI] [PubMed] [Google Scholar]
  13. Michiels V., Cluydts R., Fischler B., Hoffmann G., Le Bon O., De Meirleir K. Cognitive functioning in patients with chronic fatigue syndrome. J Clin Exp Neuropsychol. 1996 Oct;18(5):666–677. doi: 10.1080/01688639608408290. [DOI] [PubMed] [Google Scholar]
  14. Moss-Morris R., Petrie K. J., Large R. G., Kydd R. R. Neuropsychological deficits in chronic fatigue syndrome: artifact or reality? J Neurol Neurosurg Psychiatry. 1996 May;60(5):474–477. doi: 10.1136/jnnp.60.5.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Natelson B. H., Johnson S. K., DeLuca J., Sisto S., Ellis S. P., Hill N., Bergen M. T. Reducing heterogeneity in chronic fatigue syndrome: a comparison with depression and multiple sclerosis. Clin Infect Dis. 1995 Nov;21(5):1204–1210. doi: 10.1093/clinids/21.5.1204. [DOI] [PubMed] [Google Scholar]
  16. Rao S. M., Leo G. J., Bernardin L., Unverzagt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology. 1991 May;41(5):685–691. doi: 10.1212/wnl.41.5.685. [DOI] [PubMed] [Google Scholar]
  17. Rao S. M., Leo G. J., Ellington L., Nauertz T., Bernardin L., Unverzagt F. Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology. 1991 May;41(5):692–696. doi: 10.1212/wnl.41.5.692. [DOI] [PubMed] [Google Scholar]
  18. Schluederberg A., Straus S. E., Peterson P., Blumenthal S., Komaroff A. L., Spring S. B., Landay A., Buchwald D. NIH conference. Chronic fatigue syndrome research. Definition and medical outcome assessment. Ann Intern Med. 1992 Aug 15;117(4):325–331. doi: 10.7326/0003-4819-117-4-325. [DOI] [PubMed] [Google Scholar]
  19. Tatemichi T. K., Desmond D. W., Stern Y., Paik M., Sano M., Bagiella E. Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatry. 1994 Feb;57(2):202–207. doi: 10.1136/jnnp.57.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES