Journal of Chronic Fatigue Syndrome

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Journal of Chronic Fatigue Syndrome

(ISSN: 1057-3321)

Volume: 14 Issue: 1

Cover Date: 2007

Prepublication

CONTENTS

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EDITORIAL

Elke Van Hoof, Kenny De Meirleir, Neil McGregor

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ORIGINAL RESEARCH

Service Utilization, Barriers to Service Access, and Coping

in Adults with Chronic Fatigue Syndrome

Rosemary A. Underhill, Ruth O'Gorman

Objective:

In a sample of 47 adults with CFS, we aimed to describe

patterns of service utilization, identify barriers to service access,

and explore the relationship between service utilization and

coping styles.

Method:

A questionnaire assessing service utilization frequency and

barriers to service access was administered to a sample of 47

individuals with CFS. The Illness Management Questionnaire

was used to assess relationships between coping styles and

service utilization.

Results:

A Cochran's Q test of homogeneity revealed that medical and

CFS self-help services were most frequently used and

rehabilitation services were least frequently used. In terms of

service accessibility, 80.9% of participants reported at least one

barrier. Lack of financial (including insurance) resources and

lack of knowledge about service availability were the two most

frequently reported. In terms of coping styles, symptom focusing

was positively associated with use of CFS self-help services

and with use of in-home services and social service agencies.

Information seeking was negatively associated with use of

in-home and social service agencies and with use of mental

health services.

Conclusion:

These findings can be used by health-care professionals and

advocacy-based organizations to develop programs focused on

mass education campaigns for health-care providers, increase

knowledge of service availability among individuals with CFS,

and to understand relationships between certain types of coping

styles and service preferences.

Keywords:

Chronic fatigue syndrome, service utilization, access, coping

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The Feasibility of Reviewing Chronic Fatigue Syndrome

Clients at a Distance: A Teleconference Pilot Study

Gwyneth C. Weatherburn, Amelia Goldsmith Lister, J.

Findley

Objective:

There continues to be a shortage of clinical staff specialising in

the treatment of CFS (ME). In order to access specialist care,

many clients have to undertake long or difficult journeys that may

exacerbate their symptoms. This exploratory study aimed to

reduce these travel problems by the introduction of a

Teleconference Review Clinic (TRC).

Method:

A TRC was booked for six CFS clients who would normally have

face-to-face review by specialists 44 miles away.

Questionnaires were used to elicit the views of both clients

being reviewed and clinicians undertaking the review at a

distance. Differences in distances travelled by clients for

conventional face to face and telemedicine review were

calculated and comments about the teleconference made by

clients and therapists were noted.

Results:

There was general satisfaction with the quality of the pictures

and sound during the reviews. Clinicians were able to obtain all

the information required to undertake all clinical assessments.

For two clients the clinical management was changed after the

consultation and for one client an issue was identified that

required referral to another clinician. For clients who lived nearer

to the teleconference hospital, the journey saved ranged

between 1 mile and 85.8 miles, the mean being 64.2 miles.

Conclusion:

This pilot study does suggest that telemedicine in this area of

medicine is logistically viable and effective, and indicates that a

larger study is needed.

Keywords: Chronic fatigue syndrome, teleconference, review

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Changes in Functional Status in Chronic Fatigue

Syndrome Over a Decade: Do Age and Gender Matter?

lind M. s, L. Komaroff

Objective:

Patients with chronic fatigue syndrome (CFS) have substantial

deficits in functional capacity, but the course of these deficits

over time has not often been studied. This study measured

functional capacity on three occasions over a decade, in

patients with CFS.

Methods:

The study was a longitudinal cohort study, and employed the

Medical Outcomes Study Short-Form 36 (SF-36) instrument to

assess physical and mental/ emotional functional status.

Results:

Physical function, as reflected in several different scales,

improved modestly but significantly over time, particularly for

patients aged 18-60 years and for women. Mental/emotional

function was not substantially impaired at the outset of the study,

and did not change over time.

Conclusion:

This study found that physical function tended to improve for

many patients over time, despite the fact that theywere aging.

Physical function did not deteriorate with time.

Keywords:

CFS, functional status, SF-36, subgroups, over time

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Physiological Responses to Arm and Leg Exercise in

Women Patients with Chronic Fatigue Syndrome

Casimiro re, José Alegre, José Ventura, Ana

García-Quintana, Ramon Segura MD, PhD, Suarez,

Alberto Morales, Agusti Comella, Kenny De Meirleir

Patients affected by chronic fatigue syndrome (CFS)

characteristically show easy and unexplained fatigue after

minimal exertion that does not resolve with rest and is

associated with specific symptoms lasting for more than six

months.

Cardiopulmonary exercise testing is a valid procedure for

determining functional capacity in patients with CFS. We

compare cardioventilatory adaptation to exercise between a

group of eighty-five consecutive women patients affected by

CFS and a group of fifteen healthy women extremely sedentary

individuals, with the use of maximum incremental exercise

testing on a cycle ergometer and arm ergometer, assessing

possible differences.

The majority of values achieved at peak exhaustive exercise

were significantly lower in CFS patients than controls, including

the percentage of maximum oxygen uptake in arm physical test

(37.4 ± 10.0% in CFS vs. 58.9 ± 15.8% in controls) and leg

physical test (53.4 ± 15.0% in CFS patients vs. 76.2 ± 18.0% in

controls).

In conclusion, the CFS group show a lower work capacity in arm

or leg exercise that would not be justified exclusively by their

personal characteristics or deconditioning.

Keywords:

Chronic Fatigue Syndrome, maximal oxygen uptake, lactate

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Personality Profile of Patients with Chronic Fatigue

Syndrome

Olivier Le Bon, Bernard Cappeliez, Neu, Luc Stulens,

Guy Hoffmann, Michel Hansenne, Luc Lambrecht, Marc

Ansseau, Linkowski

Personality may play a role in the predisposition, the

precipitation and/or the maintenance of the CFS.

Thirty-six consecutively examined female patients hospitalised

for a sleep workup, filledout a Temperament and Character

Inventory (TCI) questionnaire. A MANOVA compared the

patients with a control group of females matched for age.

Significant scores were obtained for dimensions such as Harm

Avoidance, Reward Dependence, and Self-Directedness.

However, the only subdimension of Harm Avoidance that proved

significantly higher in CFS than in controls was " Fatigability, "

which is likely to overlap with the core CFS symptom.

All in all, the personality structure does not appear to play a

major role in the CFS.

Keywords:

Lipids, antioxidants, therapy, dietary supplement, fatigue,

mitochondria, chronic fatigue syndrome

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Body Mass Index and Fatigue Severity in Chronic Fatigue

Syndrome

Ellen A. Schur, Carolyn Noonan, Wayne R. , Jack

Goldberg, Dedra Buchwald

Background:

It is uncertain how much fatigue is related to weight in patients

with chronic fatigue syndrome (CFS). Objective: To assess the

association of body mass index (BMI) and fatigue in CFS

patients.

Methods:

Consecutive patients seen in a referral-based specialty clinic

were eligible if they met CFS criteria and had completed

required measures. Fatigue measures were the vitality subscale

of the Medical Outcomes Short-Form 36 and the global fatigue

index from the Multidimensional Assessment of Fatigue.

Results:

In women, there was no relationship between BMI and vitality

subscale or global fatigue index scores (P = 0.99 and P = 0.44).

For men, vitality subscale scores significantly decreased as BMI

increased (P = 0.02).

Conclusions:

In CFS patients, the prevalence of obesity was low despite risk

factors for weight gain. Fatigue severity and BMI were unrelated

in women with CFS, but this relationship may differ for men.

Keywords:

Chronic Fatigue Syndrome, fibromyalgia, fatigue, weight

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Table of Contents/Front Matter

DOI: 10.1300

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