Subgroups of chronic fatigue syndrome based on psychiatric disorder onset and current psychiatric status
Molly M. Brown, Carly Kaplan, Leonard A. Jason, Christopher B. Keys
DOI: 10.4236/health.2010.22015   PDF    HTML     6,268 Downloads   10,745 Views   Citations


Few studies have examined the effects of psy-chiatric disorders occurring over a long dura-tion among patients with chronic fatigue syn-drome (CFS). The role of premorbid and current psychiatric disorders in impairment was ex-plored with a sample of 113 participants with CFS. Subgroups were created based on past and current psychiatric status including those whose psychiatric history was premorbid and current, postmorbid and current, past but not current, and those with no lifetime diagnosis. Results from a one-way MANOVA revealed that patients with a premorbid and current psychiat-ric disorder reported significantly higher pain severity, more somatic symptoms, poorer sleep quality, and poorer quality of life than those with no psychiatric history. Levels of fatigue and physical functioning among patients with CFS were unrelated to the four subgroups in this study. Although those with a premorbid and current psychiatric disorder were differentiated from those with no psychiatric history on some markers of impairment, the sample as a whole had severe fatigue-related impairment, which is the cardinal symptom of CFS. Implications for research are discussed.

Share and Cite:

Brown, M. , Kaplan, C. , Jason, L. and Keys, C. (2010) Subgroups of chronic fatigue syndrome based on psychiatric disorder onset and current psychiatric status. Health, 2, 90-96. doi: 10.4236/health.2010.22015.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Johnson, S.K., DeLuca, J. and Natelson, B. (1996) Per-sonality dimensions in the chronic fatigue syndrome: A comparison with multiple sclerosis and depression. Journal of Psychosomatic Research, 30, 9-0.
[2] Wessely, S., Chalder, T., Hirsch, S., Wallace, P. and Wright, D. (1996) Psychological symptoms, somatic symptoms, and psychiatric disorder in chronic fatigue and chronic fatigue syndrome: A prospective study in the primary care setting. American Journal of Psychiatry, 153, 1050-1059
[3] Buchwald, D., Pearlman, T., Kith, P., Katon, W. and Schmaling, K. (1997) Screening for psychiatric disorders in chronic fatigue and chronic fatigue syndrome. Journal of Psychosomatic Research, 42, 87-94.
[4] Jason, L.A., Taylor, R.R., Kennedy, C.L., Song, S., John-son, D. and Torres, S. (2001) Chronic fatigue syndrome: Comorbidity with fibromyalgia and psychiatric illness. Medicine and Psychiatry, 4, 29-34.
[5] Morriss, R. K., Wearden, A. J. and Battersby, L. (1997). The relation of sleep difficulties to fatigue, mood and disability in chronic fatigue syndrome. Journal of Psy-chosomatic Research, 42, 597-605.
[6] Claypoole, K.H., Noonan, C., Mahurin, R.K., Goldberg, J., Erickson, T. and Buchwald, D. (2007) A twin study of cognitive function in chronic fatigue syndrome: The ef-fects of sudden illness onset. Neuropsychology, 21, 507-513.
[7] Grafman, J., Schwartz, V., Dale, J.K., Scheffers, M., Houser, C. and Straus, S.E. (1993). Analysis of neuro-psychological functioning in patients with chronic fa-tigue syndrome. Journal of Neurology, Neurosurgery, and Psychiatry, 56, 684-689.
[8] Joyce, J., Blumenthal, S. and Wessely, S. (1996) Memory, attention and executive function in chronic fatigue syn-drome. Journal of Neurology, Neurosurgery, and Psy-chiatry, 60, 495-503.
[9] Ciccone, D.S., Busichio, K., Vickroy, M. and Natelson, B.H. (2003) Psychiatric morbidity in the chronic fatigue syndrome: Are patients with personality disorder more physically impaired? Journal of Psychosomatic Research, 54, 445-452
[10] Komaroff, A.L., Fagioli, L.R., Doolittle, T.H., Gandek, B., Gleit, M.A., Guerriero, R.T., et al. (1996) Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups. The American Journal of Medicine, 101, 281-290.
[11] Morriss, R.K., Ahmed, M., Wearden, A.J., Mullis, R., Strickland, P., Appleby, L., et al. (1999) The role of de-pression in pain, psychological syndromes and medically unexplained symptoms associated with chronic fatigue syndrome. Journal of Affective Disorders, 55, 143-148.
[12] Harvey, S.B., Wadsworth, M., Wessely, S. and Hotopf, M. (2007) The relationship between prior psychiatric disor-der and chronic fatigue: Evidence from a national birth cohort study. Psychological Medicine, doi: 10.1017/ S0033291707001900.
[13] Tiersky, L.A., Matheis, R.J., DeLuca, J., Lange, G. and Natelson, B.H. (2003) Functional status, neuropsy-chological functioning, and mood in chronic fatigue syn-drome (CFS). Journal of Nervous and Mental Disease, 191, 324-331.
[14] Kavanagh, D.J. and Wilson, P.H. (1989) Prediction of outcome with group cognitive therapy for depression. Behaviour Research and Therapy, 27, 333-343.
[15] Jason, L.A., Torres-Harding, S., Friedberg, F., Corradi, K., Njoku, M.G., Donalek, J., et al. (2007). Non-phar-macologic interventions for CFS: A randomized trial. Journal of Clinical Psychology in Medical Settings, 14, 275-296.
[16] Fukuda, K., Straus, S.E., Hickie, I., Sharpe, M.C., Dob-bins, J.G. and Komaroff, A. (1994) The Chronic Fatigue Syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953-959.
[17] Hawk, C., Jason, L.A. and Torres-Harding, S. (2007) Reliability of a chronic fatigue syndrome questionnaire. Journal of Chronic Fatigue Syndrome, 13, 41-66.
[18] Jason, L.A., Ropacki, J.A., Santoro, N.B., Richman, J.A., Heatherly, W., Taylor, R., et al. (1997). A screening scale for chronic fatigue syndrome: Reliability and validity. Journal of Chronic Fatigue Syndrome, 3, 39-59.
[19] Jason, L.A., Corradi, K. and Torres-Harding, S. (2007) Toward an empirical case definition of CFS. Journal of Social Service Research 34, 43-54.
[20] Spitzer, R.L., Williams, J.B.W., Gibbon, M. and First, M.B. (1995) Structured Clinical Interview for the DSM-IV—Non-Patient Edition (SCID—NP, Version 2.0). Washington, DC: American Psychiatric Press.
[21] Friedberg, F. and Jason, L.A. (1998) Understanding chronic fatigue syndrome: An empirical guide to assess-ment and treatment. Washington, D.C.: American Psy-chological Association.
[22] Taylor, R.R. and Jason, L.A. (1998) Comparing the DIS with the SCID: Chronic fatigue syndrome and psychiatric comorbidity. Psychology and Health, 13, 1087-1104.
[23] Ware, J.E. and Sherbourne, C.D. (1992) The MOS 36-item short-form health survey. Medical Care, 30, 473-483.
[24] McHorney, C.A., Ware, J.E. and Raczek, A.E. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247-263.
[25] McHorney, C.A., Ware, J.E., Lu, A.W. and Sherbourne, C.D. (1994) The MOS 36-item Short-Form Health Sur-vey (SF-36): III. Tests of data quality, scaling assump-tions, and reliability across diverse patient groups. Medical Care, 32, 40-66.
[26] Krupp, L.B., LaRocca, N.G., Muir-Nash, J. and Steinberg, A.D. (1989) The Fatigue Severity Scale: Application to patients with multiple sclerosis and systemic Lupus ery-thematosus. Archives of Neurology, 46, 1121-1123.
[27] Pepper, C.M., Krupp, L.B., Friedberg, F., Doscher, C. and Coyle, P.K. (1993) A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis and major depression. The Journal of Neuro-psychiatry and Clinical Neurosciences, 5, 200-205.
[28] Taylor, R.R., Jason, L.A. and Torres, S. (2000) Fatigue rating scales: an empirical comparison. Psychological Medicine, 30, 849–856.
[29] Cleeland, C.S. and Ryan, K.M. (1994) Pain assessment: The global use of the Brief Pain Inventory. Annals Academy of Medicine Singapore, 23, 129-138.
[30] Keller, S., Bann, C.M., Dodd, S.L., Schein, J., Mendoza, T.R. and Cleeland, C.S. (2004) Validity of the Brief Pain Inventory for use in documenting the outcomes of pa-tients with noncancer pain. The Clinical Journal of Pain, 20, 309-18.
[31] Buysse, D.J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatric Research, 28, 193-213.
[32] Burckhardt, C.S. and Anderson, K.L. (2003) The Quality of Life Scale (QOLS): Reliability, validity, and utiliza-tion. Health and Quality of Life Outcomes, 1, 60-63.
[33] Huberty, C.J. and Morris, J.D. (1989) Multivariate ana- lysis versus multiple univariate analyses. Psycho-l ogical Bulletin, 105, 302-308.
[34] Natelson, B.H., Johnson, S.K., DeLuca, J., Sisto, S., Ellis, S.P., Hill, N., et al. (1995). Reducing heterogeneity in chronic fatigue syndrome: A comparison with depression and multiple sclerosis. Clinical Infectious Diseases, 21, 1204-1210.
[35] Kessler, R.C., Berglund, P., Demler, O., Jin, R. and Wal-ters, E.E. (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co-morbidity Survey Replication. Archives of General Psy-chiatry, 62, 593-602.
[36] Bell, D.S. (1997). Illness onset characteristics in children with chronic fatigue syndrome and idiopathic chronic fa-tigue. Journal of Chronic Fatigue Syndrome, 3, 43-51.
[37] Salit, I.E. (1997). Precipitating factors for the chronic fatigue syndrome. Journal of Psychiatric Research, 31, 59-65.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.