Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care

Objective. To evaluate the attributions of patients with chronic fatigue sy ndrome (CFS) and fibromyalgia (FM) consulting at a university fatigue and p ain clinic. Methods. Consecutive attenders (n = 192) who met the CFS criteria (n = 95) or FM criteria (n = 56) or who had medically unexplained chronic pain and/o r fatigue without meeting both criteria (CPF) (n = 41) were evaluated. All subjects completed an extended form of the Cause of Illness Inventory. Desc riptive statistics, frequency analyses, chi-square tests, one-way analysis of variance, and sequential Fisher least significant difference tests were performed. Results, In total, 48 patients reported physical causes only and 10 patient s psychosocial causes only; the majority (70%) mentioned both types of caus es. With regard to the contents, "a chemical imbalance in my body" (61%), " a virus" (51%), "stress" (61%), and '"emotional confusion" (40%) were repor ted most frequently. The diagnostic label did not have a significant influe nce on number and type of attributions. Small to moderate effect sizes were registered concerning the association of specific attributions and diagnos is, sex, duration of the symptoms, contact with a self-help group, and prem orbid depression. Conclusion. The majority of patients with CFS, FM, and CPF reported a great diversity of attributions open to a preferably personalized cognitive beha vioral approach. Special attention should be paid to patients with symptoms existing for more than one year and those who had previous contacts with a self-help group. They particularly show external, stable, and global attri butions that may compromise feelings of self-efficacy in dealing with the i llness.