Abstract
OBJECTIVE: To examine the effect of the presence or absence of psychiatric disease on cognitive functioning in chronic fatigue syndrome. METHODS: Thirty six patients with chronic fatigue syndrome and 31 healthy controls who did not exercise regularly were studied. Subgroups within the chronic fatigue syndrome sample were formed based on the presence or absence of comorbid axis I psychiatric disorders. Patients with psychiatric disorders preceding the onset chronic fatigue syndrome were excluded. Subjects were administered a battery of standardised neuropsychological tests as well as a structured psychiatric interview. RESULTS: Patients with chronic fatigue syndrome without psychiatric comorbidity were impaired relative to controls and patients with chronic fatigue syndrome with concurrent psychiatric disease on tests of memory, attention, and information processing. CONCLUSION: Impaired cognition in chronic fatigue syndrome cannot be explained solely by the presence of a psychiatric condition.
Full text
PDF![151](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b7/486726/3f28a9626ef7/jnnpsyc00002-0043.png)
![152](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b7/486726/eb457fa906b1/jnnpsyc00002-0044.png)
![153](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b7/486726/23cb2f57d6c0/jnnpsyc00002-0045.png)
![154](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b7/486726/4b6a7b765bc6/jnnpsyc00002-0046.png)
![155](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51b7/486726/d1461e9409f0/jnnpsyc00002-0047.png)
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- 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]
- 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]
- Bornstein R. A., Pace P., Rosenberger P., Nasrallah H. A., Para M. F., Whitacre C. C., Fass R. J. Depression and neuropsychological performance in asymptomatic HIV infection. Am J Psychiatry. 1993 Jun;150(6):922–927. doi: 10.1176/ajp.150.6.922. [DOI] [PubMed] [Google Scholar]
- Buchwald D., Cheney P. R., Peterson D. L., Henry B., Wormsley S. B., Geiger A., Ablashi D. V., Salahuddin S. Z., Saxinger C., Biddle R. A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection. Ann Intern Med. 1992 Jan 15;116(2):103–113. doi: 10.7326/0003-4819-116-2-103. [DOI] [PubMed] [Google Scholar]
- Cope H., Pernet A., Kendall B., David A. Cognitive functioning and magnetic resonance imaging in chronic fatigue. Br J Psychiatry. 1995 Jul;167(1):86–94. doi: 10.1192/bjp.167.1.86. [DOI] [PubMed] [Google Scholar]
- Davidoff G. N., Roth E. J., Richards J. S. Cognitive deficits in spinal cord injury: epidemiology and outcome. Arch Phys Med Rehabil. 1992 Mar;73(3):275–284. [PubMed] [Google Scholar]
- 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]
- 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]
- 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]
- Golinkoff M., Sweeney J. A. Cognitive impairments in depression. J Affect Disord. 1989 Sep-Oct;17(2):105–112. doi: 10.1016/0165-0327(89)90032-3. [DOI] [PubMed] [Google Scholar]
- Grafman J., Johnson R., Jr, Scheffers M. Cognitive and mood-state changes in patients with chronic fatigue syndrome. Rev Infect Dis. 1991 Jan-Feb;13 (Suppl 1):S45–S52. doi: 10.1093/clinids/13.supplement_1.s45. [DOI] [PubMed] [Google Scholar]
- Grafman J., Schwartz V., Dale J. K., Scheffers M., Houser C., Straus S. E. Analysis of neuropsychological functioning in patients with chronic fatigue syndrome. J Neurol Neurosurg Psychiatry. 1993 Jun;56(6):684–689. doi: 10.1136/jnnp.56.6.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Grossman I., Kaufman A. S., Mednitsky S., Scharff L., Dennis B. Neurocognitive abilities for a clinically depressed sample versus a matched control group of normal individuals. Psychiatry Res. 1994 Mar;51(3):231–244. doi: 10.1016/0165-1781(94)90011-6. [DOI] [PubMed] [Google Scholar]
- 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]
- Ichise M., Salit I. E., Abbey S. E., Chung D. G., Gray B., Kirsh J. C., Freedman M. Assessment of regional cerebral perfusion by 99Tcm-HMPAO SPECT in chronic fatigue syndrome. Nucl Med Commun. 1992 Oct;13(10):767–772. [PubMed] [Google Scholar]
- 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]
- Johnson S. K., DeLuca J., Natelson B. H. Personality dimensions in the chronic fatigue syndrome: a comparison with multiple sclerosis and depression. J Psychiatr Res. 1996 Jan-Feb;30(1):9–20. doi: 10.1016/0022-3956(95)00040-2. [DOI] [PubMed] [Google Scholar]
- Katon W., Russo J. Chronic fatigue syndrome criteria. A critique of the requirement for multiple physical complaints. Arch Intern Med. 1992 Aug;152(8):1604–1609. doi: 10.1001/archinte.152.8.1604. [DOI] [PubMed] [Google Scholar]
- Krupp L. B., LaRocca N. G., Muir-Nash J., Steinberg A. D. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989 Oct;46(10):1121–1123. doi: 10.1001/archneur.1989.00520460115022. [DOI] [PubMed] [Google Scholar]
- Krupp L. B., Sliwinski M., Masur D. M., Friedberg F., Coyle P. K. Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis. Arch Neurol. 1994 Jul;51(7):705–710. doi: 10.1001/archneur.1994.00540190089021. [DOI] [PubMed] [Google Scholar]
- 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]
- Manu P., Matthews D. A., Lane T. J. The mental health of patients with a chief complaint of chronic fatigue. A prospective evaluation and follow-up. Arch Intern Med. 1988 Oct;148(10):2213–2217. [PubMed] [Google Scholar]
- McDonald E., Cope H., David A. Cognitive impairment in patients with chronic fatigue: a preliminary study. J Neurol Neurosurg Psychiatry. 1993 Jul;56(7):812–815. doi: 10.1136/jnnp.56.7.812. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller L. S., Faustman W. O., Moses J. A., Jr, Csernansky J. G. Evaluating cognitive impairment in depression with the Luria-Nebraska Neuropsychological Battery: severity correlates and comparisons with nonpsychiatric controls. Psychiatry Res. 1991 Jun;37(3):219–227. doi: 10.1016/0165-1781(91)90058-w. [DOI] [PubMed] [Google Scholar]
- Natelson B. H., Cohen J. M., Brassloff I., Lee H. J. A controlled study of brain magnetic resonance imaging in patients with the chronic fatigue syndrome. J Neurol Sci. 1993 Dec 15;120(2):213–217. doi: 10.1016/0022-510x(93)90276-5. [DOI] [PubMed] [Google Scholar]
- 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]
- Pepper C. M., Krupp L. B., Friedberg F., Doscher C., Coyle P. K. A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis, and major depression. J Neuropsychiatry Clin Neurosci. 1993 Spring;5(2):200–205. doi: 10.1176/jnp.5.2.200. [DOI] [PubMed] [Google Scholar]
- 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]
- Ray C., Phillips L., Weir W. R. Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention. Br J Clin Psychol. 1993 Sep;32(Pt 3):357–364. doi: 10.1111/j.2044-8260.1993.tb01068.x. [DOI] [PubMed] [Google Scholar]
- Sandman C. A., Barron J. L., Nackoul K., Goldstein J., Fidler F. Memory deficits associated with chronic fatigue immune dysfunction syndrome. 1993 Apr 15-May 1Biol Psychiatry. 33(8-9):618–623. doi: 10.1016/0006-3223(93)90100-r. [DOI] [PubMed] [Google Scholar]
- 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]
- Schwartz R. B., Garada B. M., Komaroff A. L., Tice H. M., Gleit M., Jolesz F. A., Holman B. L. Detection of intracranial abnormalities in patients with chronic fatigue syndrome: comparison of MR imaging and SPECT. AJR Am J Roentgenol. 1994 Apr;162(4):935–941. doi: 10.2214/ajr.162.4.8141020. [DOI] [PubMed] [Google Scholar]
- Smith A. P., Behan P. O., Bell W., Millar K., Bakheit M. Behavioural problems associated with the chronic fatigue syndrome. Br J Psychol. 1993 Aug;84(Pt 3):411–423. doi: 10.1111/j.2044-8295.1993.tb02492.x. [DOI] [PubMed] [Google Scholar]
- Tancer M. E., Brown T. M., Evans D. L., Ekstrom D., Haggerty J. J., Jr, Pedersen C., Golden R. N. Impaired effortful cognition in depression. Psychiatry Res. 1990 Feb;31(2):161–168. doi: 10.1016/0165-1781(90)90118-o. [DOI] [PubMed] [Google Scholar]