Functional impairment in chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivity.
OBJECTIVE
To characterize patients diagnosed with multiple chemical sensitivity (MCS), chronic fatigue syndrome (CFS), or fibromyalgia (FM), to compare their level of function with Canadian population average values, and to assess factors associated with function.


METHODS
Chart review and abstraction of clinical information.


METHODS
The Environmental Health Clinic (EHC) at Women's College Hospital in Toronto, Ont, which is a provincial referral centre for patients with illnesses with suspected environmental links, especially MCS, CFS, and FM.


METHODS
A total of 128 consecutive patients diagnosed with 1 or more of MCS, CFS, or FM, seen between January 2005 and March 2006 at the EHC.


METHODS
Demographic and socioeconomic characteristics, comorbid diagnoses, duration of illness, health services usage, life stresses, helpful therapeutic strategies, and functional impairment measured by the Short Form-36, compared with Canadian population average values. Factors significantly associated with function in bivariate analyses were included in multiple linear and logistic regression models.


RESULTS
The patient population was predominantly female (86.7%), with a mean age of 44.6 years. Seventy-eight patients had discrete diagnoses of 1 of MCS, CFS, or FM, while the remainder had 2 or 3 overlapping diagnoses. Most (68.8%) had stopped work, and on average this had occurred 3 years after symptom onset. On every Short Form-36 subscale, patients had markedly lower functional scores than population average values, more so when they had 2 or 3 of these diagnoses. Having FM, younger age at onset, and lower socioeconomic status were most consistently associated with poor function.


CONCLUSIONS
Patients seen at the EHC demonstrated marked functional impairment, consistent with their reported difficulties working and caring for their homes and families during what should be their peak productive years. Early comprehensive assessment, medical management, and social and financial support might avoid the deterioration of function associated with prolonged illness. Education and information resources are required for health care professionals and the public, along with further etiologic and prognostic research.
Women's College Hospital, Family and Community Medicine, Toronto, ON M5S 1B2.
M Ruth
MR
Lavergne
Donald C
DC
Cole
Kathleen
K
Kerr
Lynn M
LM
Marshall
D000203:Activities of Daily Living; D000328:Adult; D002170:Canada; D016022:Case-Control Studies; D015673:Fatigue Syndrome, Chronic / Q000150:complications / Q000503:physiopathology; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000150:complications / Q000503:physiopathology; D011594:Psychometrics; D012016:Reference Values; D012917:Social Adjustment; D012959:Socioeconomic Factors