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BACKGROUND: Chronic fatigue syndrome (CFS) is a condition that may be associated with substantial disability. The Medical Outcomes Study Short-Form General Health Survey (SF-36) is an instrument that has been widely used in outpatient populations to determine functional status. Our objectives were to describe the usefulness of the SF-36 in CFS patients and to determine if subscale scores could distinguish patients with CFS from subjects with unexplained chronic fatigue (CF), major depression (MD), or acute infectious mononucleosis (AIM), and from healthy control subjects (HC). An additional goal was to ascertain if subscale scores correlated with the signs and symptoms of CFS or the presence of psychiatric disorders and fibromyalgia. DESIGN: Prospectively collected case series. SETTING: Patients with CFS and CF were seen in a university-based referral clinic and had undergone a complete medical and psychiatric evaluation. Other study subjects were recruited from the community to participate in research studies. PARTICIPANTS: The study included 185 patients with CFS, 246 with CF, 111 with AIM, and a with MD. There were 99 HC subjects. MEASURES: The SF-36 and a structured psychiatric interview were used. The SF-36 contains 8 subscales. physical, emotional, social, and role functioning, body pain, mental health, vitality, and general health - and a structured psychiatric interview. RESULTS: Performance characteristics (internal reliability coefficients, convergent validity) of the SF-36 were excellent. A strikingly consistent pattern was found for the physical functioning, role functioning, social functioning, general health, and body pain subscales, with the lowest scores in CFS patients, intermediate scores in AIM patients, and the highest scores in the HC subjects. The CFS patients had significantly lower scores than patients with CF alone on the physical functioning (P [less than or equal to] 0.01), role functioning (P [less than or equal to] 0.01), and body pain (P [less than or equal to] 0.001). subscales. The emotional functioning and mental health scores were worst among those with MD. The presence of fibromyalgia, being unemployed, and increasing fatigue severity all were associated with additional functional limitations across multiple functional domains, with increasing fatigue appearing to have the greatest effect. CONCLUSIONS: The SF-36 is useful in assessing functional status in patients with fatiguing illnesses. Patients with CFS and CF have marked impairment of their functional status. The severity and pattern of impairment as documented by the SF-36 distinguishes patients with CFS and CF from those with MD and AIM, and from HC, but does not discriminate between CF and CFS. Am J Med. 1996;171:364-370.

Chronic fatigue syndrome (CFS) may occur in nearly 7% of the general population. Patients with CFS experience unexplained long-term debilitating fatigue. Additional symptoms include muscle pain, sleep disturbances, sore throat, low-grade fever, and depression. Researchers surveyed 4,000 people with a mail-in questionnaire to determine the prevalence of CFS in the general population. They identified 202 people (6.6%) who met the major criteria for CFS. Only 3 of the 74 people consenting to further study met all of the criteria for CFS. Statistics indicate that CFS may occur in the general population with a frequency of 98 to 267 cases per 100,000 people. All 3 patients with CFS continued to experience symptoms of this syndrome after one year. Twenty-five percent of the 71 patients who reported only chronic fatigue had no symptoms after one year.

Abstract: Objective: To determine whether there are differences between men and women patients who have chronic fatigue syndrome (CFS) and, if so, to ascertain whether a gender-related pattern exists. Design: A descriptive study of demographic, clinical, and psychosocial measures, the results of which were prospectively collected for patients who had CFS. Setting: A university-based referral clinic devoted to the evaluation and management of chronic fatigue. Patients: 348 CFS patients who had undergone complete medical evaluations. Measures: Clinical variables included symptoms, physical examination findings, and laboratory results. Psychosocial assessment consisted of a structured psychiatric interview, the Medical Outcomes Study Shortform General Health Survey to assess functional status, the General Health Questionnaire to ascertain psychological distress, the Multidimensional Health Locus of Control, and measures of attribution, social support, and coping. Main results: Overall, few gender-related differences were identified. Women had a higher frequency of tender or enlarged lymph nodes (60% versus 33%, p≤0.01) and fibromyalgia (36% versus 12%, p≤0.001) and lower scores on the physical functioning subscale of the Medical Outcomes Study Short-form General Health Survey (37.6 versus 52.2, p<0.01); men more often had pharyngeal inflammation (42% versus 22%, p≤0.001) and reported a higher lifetime prevalence of alcoholism (20% versus 9%, p≤0.01). Conclusions: In general, demographic, clinical, and psychosocial factors do not distinguish men from women CFS patients.

Chronic fatigue syndrome (CPS) is often preceded by a viral illness and has recurrent “flulike” symptoms. We compared demographic, clinical, and laboratory features (markers of inflammation and viral infection) among 717 patients with chronic fatigue (CF) with and without a self-reported postinfectious onset to identify associated clinical and biologic findings and to examine the subset of patients with CFS. Only subjective fever, chills, sore throat, lymphadenopathy, poorer functional status, and attribution of illness to a physical condition were significantly associated with a postinfectious onset. The features of patients with CPS were virtually identical to those of the broader category of patients with CF. We conclude that a postinfectious onset was not associated with a pattern of abnormalities across multiple psychosocial and biologic parameters.