A. Farmer et al., NEURAESTHENIA REVISITED - ICD-10 AND DSM-III-R PSYCHIATRIC SYNDROMES IN CHRONIC FATIGUE PATIENTS AND COMPARISON SUBJECTS, British Journal of Psychiatry, 167, 1995, pp. 503-506
Background. Different definitions of chronic fatigue syndrome (CFS) ha
ve different psychiatric exclusion criteria and this affects the type
and frequency of associated psychiatric morbidity found. The operation
al criteria for neuraesthenia in ICD-10 vary in this and other respect
s from the Centers for Disease Control and Prevention (CDC) criteria f
or CFS. Neuraesthenia and associated psychiatric morbidity in CDC-defi
ned CFS are evaluated. Method. CFS subjects and controls were intervie
wed with the Schedule for the Clinical Assessment of Neuropsychiatry (
SCAN). The computerised scoring program for SCAN (CATEGO5) facilitates
the assignment of operational definitions according to DSM-III-R and
ICD-10. Subjects were re-interviewed with SCAN an average of 11 months
later. No specific treatments or interventions were given during this
period. Results. The majority of subjects fulfilled ICD-10 operationa
l criteria for neuraesthenia and had two and a half times the rate of
psychiatric morbidity as the healthy comparison group according to the
CATEGO5 Index of Definition (ID). Approximately 80% of subjects fulfi
lled both DSM-III-R and ICD-10 criteria for sleep disorders. There was
a significant fall in the number of subjects fulfilling criteria for
depression and anxiety disorders and a significant increase in the num
ber of subjects with no diagnosis for DSM-III-R criteria over time. Th
ere were no significant changes over time for any diagnosis according
to ICD-10 criteria or for overall levels of psychopathology as reflect
ed in CATEGO5 ID levels. Conclusions. The ICD-10 'neuraesthenia' defin
ition identifies almost all subjects with CDC-defined CFS. Fifty per c
ent of CFS subjects also had depressive or anxiety disorders, some cat
egories of which remit spontaneously over time.