Tired and depressed or just tired. A review of psychiatric morbidity associated with chronic fatigue syndrome

Author: Hillier, J., Farmer, A.

Source:
Arab Journal of Psychiatry. 6(1), May 1995, 1-12.
Assessed the psychiatric morbidity of 100 patients with chronic fatigue syndrome (CFS) in Cardiff, UK (F. Farmer et al, 1995). The Ss were given a comprehensive physical examination, interviewed by a senior psychiatrist using the Schedule for the Clinical Assessment of Neuropsychiatry (SCAN), and reinterviewed with SCAN 11 mo later. A comparison group of 50 healthy Ss were also interviewed with SCAN. 97% of CFS Ss and 2% of controls fulfilled criteria for "neurasthenia," a CFS category introduced into the International Classification of Diseases 10 (ICD-10) which is not available in Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). If the exclusion criteria are used, 40% of CFS Ss and no controls fulfilled neurasthenia criteriNearly 80% of CFS Ss had an ICD-10 sleep disorder diagnosis, while 34% had a current depressive or somatoform disorder and 23% an anxiety disorder Over time, there was a slight trend for the psychiatric morbidity of CFS Ss to improve, although the percentages of sleep disorders remained the same. Although the Cardiff group findings are similar to those of R. Lloyd et al (1993) for DSM-III-R major depression, both studies report lower rates than for consensus figures of David at al (1991). There are higher rates for anxiety disorders in the Cardiff and Lloyd's studies.