Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 May;60(5):489–494. doi: 10.1136/jnnp.60.5.489

Prognosis in chronic fatigue syndrome: a prospective study on the natural course.

J H Vercoulen 1, C M Swanink 1, J F Fennis 1, J M Galama 1, J W van der Meer 1, G Bleijenberg 1
PMCID: PMC486359  PMID: 8778251

Abstract

OBJECTIVE--To determine spontaneous improvement after a follow up interval of 18 months in patients with chronic fatigue syndrome and to identify factors that predict improvement. METHODS--A longitudinal study was used. Of 298 initially assessed self referred patients fulfilling criteria for chronic fatigue syndrome, 246 patients completed self report questionnaires at follow up (response rate 83%). A multidimensional assessment method was used, measuring behavioural, emotional, cognitive, and social functioning. Comparison data from 53 healthy subjects matched for age, sex, and educational level were available. RESULTS--Three per cent of patients reported complete recovery and 17% reported improvement. At follow up, there were considerable problems at work and consumption of medication was high. Subjective improvement was confirmed by dimensional change: at follow up recovered patients had similar scores to healthy subjects and improved patients showed significant improvement on four out of seven outcome measures and had higher scores than healthy subjects in all dimensions. Sociodemographic variables or treatment by specialists and alternative practitioners did not predict improvement. Predictors of improvement were: subjective sense of control over symptoms, less fatigue, shorter duration of complaints, and a relative absence of physical attributions. CONCLUSION--The improvement rate in patients with a relatively long duration of complaints is small. Psychological factors are related to improvement, especially cognitive factors.

Full text

PDF
489

Selected References

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

  1. BECK A. T., WARD C. H., MENDELSON M., MOCK J., ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004. [DOI] [PubMed] [Google Scholar]
  2. Bonner D., Ron M., Chalder T., Butler S., Wessely S. Chronic fatigue syndrome: a follow up study. J Neurol Neurosurg Psychiatry. 1994 May;57(5):617–621. doi: 10.1136/jnnp.57.5.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Butler S., Chalder T., Ron M., Wessely S. Cognitive behaviour therapy in chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1991 Feb;54(2):153–158. doi: 10.1136/jnnp.54.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clark M. R., Katon W., Russo J., Kith P., Sintay M., Buchwald D. Chronic fatigue: risk factors for symptom persistence in a 2 1/2-year follow-up study. Am J Med. 1995 Feb;98(2):187–195. doi: 10.1016/S0002-9343(99)80403-3. [DOI] [PubMed] [Google Scholar]
  5. Friedberg F., Krupp L. B. A comparison of cognitive behavioral treatment for chronic fatigue syndrome and primary depression. Clin Infect Dis. 1994 Jan;18 (Suppl 1):S105–S110. doi: 10.1093/clinids/18.supplement_1.s105. [DOI] [PubMed] [Google Scholar]
  6. Lloyd A. R., Hickie I., Brockman A., Hickie C., Wilson A., Dwyer J., Wakefield D. Immunologic and psychologic therapy for patients with chronic fatigue syndrome: a double-blind, placebo-controlled trial. Am J Med. 1993 Feb;94(2):197–203. doi: 10.1016/0002-9343(93)90183-p. [DOI] [PubMed] [Google Scholar]
  7. Powell R., Dolan R., Wessely S. Attributions and self-esteem in depression and chronic fatigue syndromes. J Psychosom Res. 1990;34(6):665–673. doi: 10.1016/0022-3999(90)90111-g. [DOI] [PubMed] [Google Scholar]
  8. Sharpe M. C., Archard L. C., Banatvala J. E., Borysiewicz L. K., Clare A. W., David A., Edwards R. H., Hawton K. E., Lambert H. P., Lane R. J. A report--chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991 Feb;84(2):118–121. doi: 10.1177/014107689108400224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Sharpe M., Hawton K., Seagroatt V., Pasvol G. Follow up of patients presenting with fatigue to an infectious diseases clinic. BMJ. 1992 Jul 18;305(6846):147–152. doi: 10.1136/bmj.305.6846.147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Vercoulen J. H., Swanink C. M., Fennis J. F., Galama J. M., van der Meer J. W., Bleijenberg G. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res. 1994 Jul;38(5):383–392. doi: 10.1016/0022-3999(94)90099-x. [DOI] [PubMed] [Google Scholar]
  11. Wallston K. A., Wallston B. S., DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr. 1978 Spring;6(2):160–170. doi: 10.1177/109019817800600107. [DOI] [PubMed] [Google Scholar]
  12. Wessely S., Powell R. Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders. J Neurol Neurosurg Psychiatry. 1989 Aug;52(8):940–948. doi: 10.1136/jnnp.52.8.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Wilson A., Hickie I., Lloyd A., Hadzi-Pavlovic D., Boughton C., Dwyer J., Wakefield D. Longitudinal study of outcome of chronic fatigue syndrome. BMJ. 1994 Mar 19;308(6931):756–759. doi: 10.1136/bmj.308.6931.756. [DOI] [PMC free article] [PubMed] [Google Scholar]

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

RESOURCES