Longitudinal study of outcome of chronic fatigue syndrome.
OBJECTIVE
To examine the predictors of long term outcome for patients with the chronic fatigue syndrome.


METHODS
Cohort study.


METHODS
139 subjects previously enrolled in two treatment trials; 103 (74%) were reassessed a mean of 3.2 years after start of the trials.


METHODS
University hospital referral centre.


METHODS
Age at onset, duration of illness, psychological and immunological status at initial assessment. Ongoing symptom severity, levels of disability, and immunological function at follow up.


RESULTS
65 subjects had improved but only six reported no current symptoms. An alternative medical diagnosis had been made in two and psychiatric illness diagnosed in 20. The assignment of a primary psychiatric diagnosis at follow up and the strength of the belief that a physical disease process explained all symptoms at entry to the trials both predicted poor outcome. Age at onset of illness, duration of illness, neuroticism, premorbid psychiatric diagnoses, and cell mediated immune function did not predict outcome.


CONCLUSIONS
Though most patients with the chronic fatigue syndrome improve, a substantial proportion remain functionally impaired. Psychological factors such as illness attitudes and coping style seem more important predictors of long term outcome than immunological or demographic variables.
Wilson
A
A
Department of Psychiatry, Prince Henry Hospital, Little Bay, NSW, Australia.
Hickie
I
I
Lloyd
A
A
Hadzi-Pavlovic
D
D
Boughton
C
C
Dwyer
J
J
Wakefield
D
D
D000223:Adaptation, Psychological; D000328:Adult; D017668:Age of Onset; D000368:Aged; D015331:Cohort Studies; D006233:Persons with Disabilities; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology* / Q000276:immunology / Q000523:psychology; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007136:Immunoglobulins / Q000627:therapeutic use; D017567:Karnofsky Performance Status; D008137:Longitudinal Studies; D008231:Lymphopenia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome
D007136:Immunoglobulins