Longitudinal Assessment of Neuropsychological Functioning, Psychiatric Status, Functional Disability and Employment Status in Chronic Fatigue Syndrome

Abstract

The longitudinal course of subjective and objective neuropsychological functioning, psychological functioning, disability level, and employment status in chronic fatigue syndrome (CFS) was examined. The relations among several key outcomes at follow-up, as well as the baseline characteristics that predict change (e.g., improvement), were also evaluated. The study sample consisted of 35 individuals who met the 1988 and 1994 CFS case definition criteria of the Centers for Disease Control (CDC) at intake. Participants were evaluated a mean of 41.9 (SEM = 1.7) months following their initial visit (range = 24-63 months). Results indicated that objective and subjective attention abilities, mood, level of fatigue, and disability improve over time in individuals with CFS. Moreover, improvements in these areas were found to be interrelated at follow-up. Finally, psychiatric status, age, and between-test duration were significant predictors of outcome. Overall, the prognosis for CFS appears to be poor, as the majority of participants remained functionally impaired over time and were unemployed at follow-up, despite the noted improvements.

Neuropsychological Impairment in Female Patients with Chronic Fatigue Syndrome: A Preliminary Study

“…In clinical practice, most patients report a progressive worsening in their cognitive functioning over time which would appear to indicate that cognitive impairment is directly associated with CFS. However, empirical research does not confirm this hypothesis (Cope, Pernet, Kendall, & David, 1995;Tiersky, et al, 2001). In a recent study carried out by our team, we also conclude that there is no progressive cognitive dysfunction in patients with CFS (Santamarina-Perez, .…”

“…Since depressive symptoms and anxiety are frequently observed in patients with CFS (Harvey, Wessely, Kuh, & Hotopf, 2009), the possibility that these may contribute to impaired cognitive performance must be considered. Some studies have found a relationship between cognitive deficits and depression and anxiety in CFS (Michiels & Cluydts, 2001;Tiersky et al, 2001). However, the majority of neuropsychological studies that have examined this relationship conclude that cognitive dysfunction in CFS is not a function of depression or anxiety (Busichio, et al, 2004;Short, et al, 2002).…”

Length of Illness Does Not Predict Cognitive Dysfunction in Chronic Fatigue Syndrome

“…In the present study, there is not any practice effect, because it is a cross-sectional study, with only one examination. Tiersky et al (2001), included measures of attention (PASAT, forward and backward digit) and memory (CVLT and ROCFT), but this study didn´t incorporate other cognitive tests in which patients' performance is impaired such as Stroop reaction time, AVLT and motor Functioning (Cockshell & Mathias, 2010). So, to study how the length of the illness affects cognitive impairment in CFS patients, we should include a neuropsychological battery with measures that have been shown to be altered in these patients.…”

T. Egeland og medarbeidere svarer:

“…Kvinner er generelt alvorligere rammet enn menn (63) . Høy alder, flere kroniske sykdommer, og psykiatriske tilleggsdiagnoser er risikofaktorer for et alvorligere sykdomsforløp (64,65) . Pågående uheldig stress vil vaere forbundet med lengre sykdomsforløp (66) .…”

“…Prognosen er bedre for barn og unge enn for voksne uansett alvorlighetsgrad (65,67) . En meta-analyse av forløpsstudier, viste at 54-94 % av barna med CFS/ME ble friske i løpet av oppfølgingsperioden (64) .…”