OUTCOME AND PROGNOSIS OF PATIENTS WITH CHRONIC FATIGUE VS CHRONIC FATIGUE SYNDROME

Background: There are few data on the natural history and prognosis of persons with chronic fatigue (CF) or CF syndrome (CFS). Therefore, we compared functional outcomes in patients with each condition and test ed the validity of various prognostic indicators. Methods: Four hundre d forty-five (89%) of 498 consecutive referral patients were surveyed an average of 1.5; years after an initial evaluation. Data from the in itial evaluation were used to predict outcomes. Results: Sixty-four pe rcent of all patients reported improvement, but only 2% reported compl ete resolution of symptoms. Patients initially diagnosed as having CFS reported greater symptom severity and lower level of functioning at f ollow-up than did patients with CF. Major depression predicted unemplo yment in the CF group. Older age, longer duration of illness, and a li fetime history of dysthymia predicted less improvement in the CF group . Current dysthymia predicted less improvement for the CFS group. Conc lusions: The case definition of CFS according to the Centers for Disea se Control and Prevention identifies chronically fatigued patients wit h poorer prognosis. In a tertiary care setting, recovery from CF or CF S is rare, but improvement is common. Prognostic indicators vary for t he two groups, but the coexistence of dysthymia suggests poorer outcom es generally.