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Longitudinal analysis of symptoms reported by patients with chronic fatigue syndrome.
Nisenbaum R, Jones AB, Jones JF, Reeves WC.Longitudinal analysis of symptoms reported by patients with chronic fatigue syndrome.
Ann Epidemiol 10:458, 2000.
Summary
This publication is an abstract presented at the September 25-26, 2000 American College of Epidemiology Annual Meeting. The study has not yet been submitted in its entirety for publication.
Abstract
Purpose: To determine the effect of chronic fatigue syndrome (CFS) illness duration and onset type on the likelihood of reporting a symptom during successive follow-up periods.
Methods: In 1997, a two-phase, random-digit dialing survey was conducted in Wichita, Kansas, to estimate the prevalence of CFS. Phase I identified 56,154 respondents 18-69 years of age and screened for severe fatigue, extreme tiredness, or exhaustion lasting for 1 month or longer. In phase II an equal number of fatigued (n=7,176) and randomly selected non-fatigued subjects were asked about 8 CFS and 13 non-CFS symptoms, as well as the presence of specific medical and psychiatric conditions. Eligible respondents were clinically evaluated to establish CFS diagnosis. Phase II respondents were re-contacted at 12- (n=4331) and 24-months (n=4,266) for additional follow-up and diagnosis. In this study, we considered symptoms reported as being present most of the time during each successive observation period. Generalized estimating equations were used to model symptoms over time and to address study questions. Such a model accounts for correlations among repeated symptoms for each subject. We used an auto-regressive structure for the correlation matrix, assuming the correlations between each pair of repeated symptoms should decrease as the time between symptoms increased.
Results: There were 74 CFS patients who had been ill for 1 to 20 years (median = 6.3 years). Among these, 46 reported gradual and 28 reported sudden onset. Symptoms fluctuated over the course of illness. However, only stomach pain (non-CFS symptom) was more likely to be reported as duration of illness increased (p<0.05). There was no association between onset type and the likelihood of reporting a symptom during an interview, except that chills and severe headaches were more likely to be reported by sudden cases.
Conclusions: The likelihood of expressing CFS and non-CFS symptoms "most of the time" is the same across years of illness. More analyses are warranted to consider expression of symptoms for 36 months and severe symptoms.
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