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Vol. 41, No. 6, 2008
Issue release date: October 2008
Psychopathology 2008;41:339–345

Functional Incapacity and Physical and Psychological Symptoms: How They Interconnect in Chronic Fatigue Syndrome

Priebe S. · Fakhoury W.K.H. · Henningsen P.
aUnit for Social and Community Psychiatry, Barts’ and the London School of Medicine, Queen Mary University of London, London, UK; bDepartment of Psychosomatic Medicine, University of Munich, Munich, Germany

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Background: It has been argued that perceived functional incapacity might be a primary characteristic of chronic fatigue syndrome (CFS) and could be explained by physical symptoms. If so, it could be expected to be closely associated with physical, but not psychological symptoms. The study tests this hypothesis. Sampling and Methods: The sample consisted of 73 patients, with a diagnosis of CFS according to the Oxford criteria, randomly selected from clinics in the Departments of Immunology and Psychiatry at St. Bartholomew’s Hospital, London. The degree of fatigue experienced by patients was assessed using the Chalder Fatigue Questionnaire and a visual analogue scale. Self-rated instruments were used to measure physical and social functioning, quality of life, and physical and psychological symptoms. Results: Principal-component analysis of all scale scores revealed 2 distinct components, explaining 53% of the total variance. One component was characterized by psychological symptoms and generic quality of life indicators, whilst the other component was made up of physical symptoms, social and physical functioning and indicators of fatigue. Conclusions: The findings suggest that perceived functional incapacity is a primary characteristic of CFS, which is manifested and/or explained by physical symptoms.

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  1. Sharpe MC, Archard LE, Banatvala J: A report – chronic fatigue syndrome. J R Soc Med 2001;84:118–121.
  2. Reeves WC, Lloyd A, Vernon SD, Klimas N, Jason LA, Bleijenberg G, Evengard B, White PD, Nisenbaum R, Unger ER: Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Serv Res 2003;3:25.
  3. Henningsen P, Priebe S: Modern disorders of vitality: the struggle for legitimate incapacity. J Psychosom Res 1999;46:209–214.
  4. Lehman AM, Lehman DR, Hemphill KJ, Mandel DR, Cooper LM: Illness experience, depression and anxiety in chronic fatigue syndrome. J Psychosom Res 2002;52:461–465.
  5. Lee S, Yu H, Wing Y, Chan C, Lee AM, Lee DTS, Chen C, Lin K, Weiss MG: Psychiatric morbidity and illness experience of primary care patients with chronic fatigue in Hong Kong. Am J Psychiatry 2000;157:380–384.
  6. Andersen MM, Permin H, Albrecht F: Illness and disability in Danish chronic fatigue syndrome patients at diagnosis and 5-year follow-up. J Psychosom Res 2004;56:217–229.
  7. Joyce J, Hotopf M, Wessely S: The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review. Q J Med 1997;90:223–233.
  8. Moss-Morris R, Petrie KJ: Discriminating between chronic fatigue and depression: a cognitive analysis. Psychol Med 2001;21;469–479.
  9. Metzger FA, Denney DR: Perception of cognitive performance in patients with chronic fatigue syndrome. Ann Behav Med 2002;24:106–112.
  10. Hardt J, Buchwald D, Wilks D, Sharpe M, Nix WA, Egle UT: Health-related quality of life in patients with chronic fatigue syndrome: an international study. J Psychosom Res 2001;51:431–434.
  11. White PD, Pinching AJ, Rakib A, Castle M, Hedge B, Priebe S: A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry. J R Soc Med 2002;95:440–444.
  12. Rakib A, White PD, Pinching A, Hedge B, Newbery N, Fakhoury WK, Priebe S: Subjective quality of life among patients with chronic fatigue syndrome. Qual Life Res 2005;14:11–29.
  13. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessley S, Wright D, Wallace EP: Development of a fatigue scale. J Psychosom Res 1993;37:147–153.
  14. White PD, Grover SA, Kangro HO: The validity and reliability of the fatigue syndrome that follows glandular fever. Psychol Med 1995;45:7–12.
  15. Peveler RC, Fairburn GC: Measurement of neurotic symptoms by self-report questionnaire: validity of the SCL-90R. Psychol Med 1990;20:873–879.
  16. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA: Self Evaluation Questionnaire: STAI Form. Palo Alto, Consulting Psychologists Press, 1968.
  17. Lucock MP, Morley S: The health anxiety questionnaire. Br J Health Psychol 1996;1:137–150.
  18. Wittenborn JR, Buhler R: Somatic discomfort among depressed women. Arch Gen Psychiatry 1979;36:465–471.
  19. Beck AT, Weismann A, Lester D, Trexler L: The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974;42:861–862.
  20. Ware JJ, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–483.
  21. Priebe S, Huxley P, Knight S, Evans S: Application and results of the Manchester Short Assessment of Quality of Life (MANSA). Int J Soc Psychiatry 1999;45:7–12.
  22. Priebe S: Research in quality of life in mental health care: aims and strategies; in Priebe S, Oliver JPJ, Kaiser W (eds): Quality of Life and Mental Health Care. Petersfield, Wrightson Biomedical Publishing, 1999, pp 139–154.
  23. Jason LA, Taylor RR, Kennedy CL, Jordan K, Huang CF, Torres-Harding S, Song S, Johnson D: A factor analysis of chronic fatigue symptoms in community-based sample. Soc Psychiatry Psychiatr Epidemiol 2002;37:183–189.
  24. Nisenbaum R, Meyes M, Unger ER, Reeves WC: Factor analysis of symptoms among subjects with unexplained chronic fatigue: what can we learn about chronic fatigue symptoms? J Psychosom Res 2004;56:171–178.
  25. Prins JB, Bos E, Huibers MJ, Servaes P, Van der Werf SP, Van der Meer JW, Bleijenberg G: Social support and the persistence of complaints in chronic fatigue syndrome. Psychother Psychosom 2004;73:174–178.

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