THE PROGNOSIS OF CHRONIC FATIGUE AND CHRONIC FATIGUE SYNDROME - A SYSTEMATIC REVIEW

The prognosis of chronic fatigue syndrome and chronic fatigue has been studied in numerous small case series. We performed a systematic revi ew of all studies to determine the proportion of individuals with the conditions who recovered at follow-up, the risk of developing alternat ive physical diagnoses, and the risk factors for poor prognosis. A lit erature search of all published studies which included a follow-up of patients with chronic fatigue syndrome or chronic fatigue were perform ed. Of 26 studies identified, four studied fatigue in children, and fo und that 54-94% of children recovered over the periods of follow-up. A nother five studies operationally defined chronic fatigue syndrome in adults and found that <10% of subjects return to pre-morbid levels of functioning, and the majority remain significantly impaired. The remai ning studies used less stringent criteria to define their cohorts. Amo ng patients in primary care with fatigue lasting <6 months, at least 4 0% of patients improved. As the definition becomes more stringent the prognosis appears to worsen. Consistently reported risk factors for po or prognosis are older age, more chronic illness, having a comorbid ps ychiatric disorder and holding a belief that the illness is due to phy sical causes.