MAKING SENSE OF CHRONIC-FATIGUE-SYNDROME - PATIENTS ACCOUNTS OF ONSET

Sixty patients with chronic fatigue syndrome were interviewed about th e onset of their illness, and the factors which they felt had contribu ted to that onset. Common themes in these qualitative data were episod es of infection, ''doing too much'' and stressful circumstances; in tw o-thirds of cases, accounts encompassed physical, behavioural and psyc hological factors. Patients described a gradual, sharp or phased onset , the latter involving a sharp onset but with a short term lifting of symptoms before worsening into chronic illness. A gradual onset was as sociated with longer duration of illness. Particular themes played a d ifferent role in patients' accounts, depending upon onset pattern. Wit h a sharp or phased onset the most common perceived trigger for the ab rupt change in health status was an episode of infection, but precedin g factors were often invoked to explain the effect that this had had. With a phased onset, subsequent compounding factors (typically overdoi ng things) were similarly cited to explain worsening and the long term effect of the trigger. Thus, patients provided complex and dynamic ac counts of illness onset, incorporating interacting factors.