Daily Hassles Reported by Chronic Fatigue Syndrome and Fibromyalgia Patients in Tertiary Care: A Controlled Quantitative and Qualitative Study

Abstract

Background: This study aimed at providing insight in the frequency, emotional impact and nature of daily hassles, experienced by patients suffering from chronic fatigue syndrome (CFS) and/or fibromyalgia (FM), compared with patients with a chronic organic disease. Methods: One hundred and seventy-seven CFS/FM patients, 26 multiple sclerosis (MS) and 26 rheumatoid arthritis (RA) patients were investigated within 2–6 months after diagnosis. All patients completed a self-report questionnaire assessing daily hassles and associated distress, a visual analogue scale assessing fatigue and pain and a depression and anxiety questionnaire. Results: CFS/FM patients show a higher frequency of hassles, higher emotional impact and higher fatigue, pain, depression and anxiety levels compared with MS/RA patients. Three hassle themes dominate in the CFS/FM group: dissatisfaction with oneself, insecurity and a lack of social recognition. In contrast, hassles reported by MS/RA patients show a much larger diversity and are not focused on person-dependent problems. Conclusions: Patients recently diagnosed as suffering from CFS and/or FM are highly preoccupied and distressed by daily hassles that have a severe impact on their self-image, as well as their personal, social and professional functioning. An optimal therapeutic approach of CFS and FM should take account of this heavy psychosocial burden, which might refer to core themes of these patients’ illness experience.

Fibromyalgia: A Stress Disorder?

“…These etiological findings are clearly similar to those in CFS [83, 84]and in keeping with various psychosomatic studies [85, 86]but, nonetheless, conclusive proof of life stress predicting the onset or exacerbation of FM has not yet been established [87, 88]. …”

“…In many cases, psychosocial stress accompanied by lack of support seems to play a role as well, including critical life events [77, 79, 80, 81], psychotraumatic experiences [20]and daily hassles [82], particularly when the latter have high personal relevance and refer to core themes of the patient’s illness experience [83]. …”

Cognitive Behaviour Group Therapy for Chronic Fatigue Syndrome: A Non-Randomised Waiting List Controlled Study

“…Rest and relaxation are less emphasised and for passive CFS patients, the treatment protocol has been adapted [9]. Recently, lack of social support has been identified as an important determinant of CFS and a new perpetuating factor [31, 32]. Dealing with a lack of social support may also be a more prominent aspect of CBT for CFS.…”

Traumatic events, perceived stress and health in women with fibromyalgia and healthy controls

“…The diagnosis of FM is based on decreased pressure pain thresholds at a minimum of 11 of 18 specifi c 'tender points' as defi ned by American College of Rheumatology criteria (Wolfe stress? There is increasing evidence that the ongoing perception of stress may be related to health in women with FM (Murray, Murray, & Daniels, 2006;Van Houdenhove et al, 2002;Zautra, Hamilton, & Burke, 1999). In addition, women with FM may have experienced more traumatic events than healthy women or women with other rheumatological disorders (Van Houdenhove et al, 2001;Walker et al, 1997) These higher levels of traumatic events and perceptions of stress are important because they have consistently been linked to worse health and lower well-being.…”