The role of depression in pain, psychophysiological syndromes and medically unexplained symptoms associated with chronic fatigue syndrome

Background: The association between depression and pain, function, medicall y unexplained symptoms and psychophysiological syndromes such as irritable bowel syndrome has not been explored before in chronic fatigue syndrome. Me thods: Cross-sectional controlled study of the current prevalence of psycho physiological syndromes, pain, function and Lifetime prevalence of medicall y unexplained symptoms in 77 out-patients with chronic fatigue syndrome (CF S) without DSM-III-R depression, 42 CFS out-patients with DSM-LII-R depress ion and 26 out-patient with primary DSM-LU-R depression. Results: Both CFS groups differed significantly from the primary depression group but not eac h other in the prevalence of tension headaches (P < 0.001), reporting of wi despread bodily pain (P < 0.001) and the number of lifetime medically unexp lained symptoms (P < 0.001). The three groups did not significantly differ in the prevalence of irritable bowel syndrome or fibromyalgia. CFS patients with depression were more impaired in social function than other CFS patie nts. Conclusion: Depression is not associated with the reporting of pain, p sychophysiological syndromes and medically unexplained symptoms in CFS pati ents. Depression is associated with decreased social function in CFS patien ts. Limitations: Study depended on recall of symptoms, not confirmed by med ical records and current investigations. Patients with depression were taki ng antidepressants. Clinical relevance: Treating depression in chronic fati gue syndrome is unlikely to diminish reporting of pain and medically unexpl ained symptoms but may improve social function. (C) 1999 Elsevier Science B .V. All rights reserved.