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news of current publications and research efforts underway related to chronic
fatigue syndrome (CFS) — also called chronic fatigue and immune dysfunction
New standards for diagnosis?
CFS is diagnosed using
the U.S. Centers for Disease Control and Prevention (CDC) 1994 International
Case Definition, also known as the Fukuda definition. New community-based
research has confirmed many of the major criteria in the definition, and
suggests additional symptoms that may help with diagnosis.
The study looked at 32 people with CFS, 19 with melancholic depression
and 44 healthy controls. The subjects had all undergone physical and psychiatric
examinations to diagnose their conditions or exclude them from a diagnosis of
Several cardiopulmonary and neurological symptoms occurred with
significantly greater frequency in CFS patients than the control
groups—including shortness of breath (65.6% vs. 22.7%), chest pain (40.6% vs.
6.8%), dizziness after standing (46.9% vs. 9.1%), general dizziness (43.8% vs.
2.3%) and alcohol intolerance (43.8% vs. 6.8%).
While the study size was small, the authors suggest that more research
could prove the value of adding these symptoms to the case definition of CFS to
help refine and improve the diagnostic criteria.
al. “Symptom occurrence in persons with chronic fatigue syndrome.” Biological
Psychology. 2002; 59(1): 15-27.
CFS, anxiety link not genetic
Depression, anxiety and
other mood disorders are common comorbid conditions in patients with chronic
fatigue syndrome. New research on twins suggests that environmental factors, not
genetic ones, may lie behind this association.
One hundred twin pairs discordant for chronic fatigue were studied,
including 69 monozygotic and 31 dizygotic pairs. All test subjects were white
females. The subjects were asked to complete the General Health Questionnaire
(GHQ), a 28-item self-report that measures psychological and somatic distress on
a four-point scale.
Analysis of the questionnaires found that the twins who suffered from
chronic fatigue showed significantly higher measures for anxiety and somatic
preoccupation regardless of zygosity. Monozygotic twins with chronic fatigue
also were more likely to show symptoms of social dysfunction and
The authors say their data suggest no genetic basis for the link between
CFS and the comorbid psychological conditions, since the non-fatigued twins with
identical genes did not show similar levels of distress. The association may be
due to environmental factors, or could be due to overlapping definitions for CFS
and the other conditions.
Roy-Byrne P et al. “Chronic
fatigue and anxiety/depression: a twin study.” British Journal of
Psychiatry. Jan. 2002;