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A Comparison of the Characteristics of Chronic Fatigue Syndrome in Primary and Tertiary Care

Published online by Cambridge University Press:  02 January 2018

R. Euba ,
T. Chalder ,
A. Deale  and
S. Wessely
R. Euba*
Affiliation:
Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, and Institute of Psychiatry
T. Chalder
Affiliation:
Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, and Institute of Psychiatry
A. Deale
Affiliation:
Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, and Institute of Psychiatry
S. Wessely
Affiliation:
Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, and Institute of Psychiatry
*
Dr Simon Wessely, Department of Psychological Medicine, King's College School of Medicine and Dentistry, Denmark Hill, London SE5 9RS
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Abstract

Background

To evaluate the characteristics of Chronic Fatigue Syndrome (CFS) in primary and tertiary care.

Method

A comparison of subjects fulfilling criteria for CFS seen in primary care and in a hospital unit specialising in CFS. Subjects were 33 adults fulfilling criteria for CFS, identified as part of a prospective cohort study in primary care, compared to 79 adults fulfilling the same criteria referred for treatment to a specialist CFS clinic.

Results

Hospital cases were more likely to belong to upper socio-economic groups, and to have physical illness attributions. They had higher levels of fatigue and more somatic symptoms, and were more impaired functionally, but had less overt psychological morbidity. Women were over-represented in both primary care and hospital groups. Nearly half of those referred to a specialist clinic did not fulfil operational criteria for CFS.

Conclusion

The high rates of psychiatric morbidity and female excess that characterise CFS in specialist settings are not due to selection bias. On the other hand higher social class and physical illness attributions may be the result of selection bias and not intrinsic to CFS.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 1 , January 1996 , pp. 121 - 126
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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