Identified Sub Groups
From [2017] Study
- fibromyalgia, myofascial pain, multiple chemical hypersensitivity, sicca syndrome, epicondylitis, and thyroiditis
- “comprised mainly older women, with low educational level, unemployment, high levels of fatigue, and poor quality of life;”
- alterations of ligaments and subcutaneous tissue, hypovitaminosis D, psychopathology, ligamentous hyperlaxity, and endometriosis.
- comprised mainly older women, with low educational level, unemployment, high levels of fatigue, and poor quality of life;
- with hardly any comorbidities, comprising mainly younger women, university students or those already employed, with lower levels of fatigue, and better quality of life;
- poorly defined comorbidities;
- hypercholesterolemia.
Other Diagnosis
From 2000 Study
- Self diagnosis of CFS [2013]
- Sleep Disorder: 49.8% (especially obstructive sleep apnea syndrome)
- Definite CFS: 23.3%
- A psychiatric disorder was diagnosed in 45.2%; mostly mood and anxiety disorder.
- Incidence of getting IBS:
- chronic fatigue syndrome (CFS) – 92%;
- fibromyalgia (FM) – 77%;
- temporomandibular disorder (TMD) – 64%
- Hyperacusis [2016]: Noise sensitivity
- CFS – 3.2%
- fibromyalgia – 4.2%
- IBS -4.8%
- Anxiety Disorder – 47%
- postural orthostatic tachycardia syndrome
Symptoms
From 2016 Australia Study according to the definition of CFS (Fukuda or International Consensus Criteria). Percentage is given in ( )
| Symptom | Fukuda | ICCa |
| Fatigue, n (%) | ||
| Fatigued | 162 (100.0) | 171 (100.0) |
| Postexertional malaise | 68 (38.9) | 171 (100.0) |
| PENEe | 25 (15.4) | 171 (100.0) |
| Cognition, n (%) | ||
| Confusion | 52 (32.1) | 69 (40.4) |
| Disorientation | 40 (24.7) | 77 (45.0) |
| Difficulty processing information | 51 (31.5) | 65 (38.0) |
| Difficulty making decisions | 53 (32.7) | 66 (38.6) |
| Slowed speech | 46 (28.4) | 75 (43.9) |
| Difficulty reading | 44 (27.2) | 78 (45.6) |
| Poor short-term memory | 54 (33.3) | 63 (36.8) |
| Pain, n (%) | ||
| Headaches | 51 (31.5) | 64 (37.4) |
| Muscle pain | 53 (32.7) | 65 (38.0) |
| Joint pain | 54 (33.3) | 62 (36.3) |
| Abdomen pain | 42 (25.9) | 71 (41.5) |
| Chest pain | 48 (29.6) | 73 (42.7) |
| Sleep disturbances, n (%) | ||
| Insomnia | 46 (28.4) | 69 (40.4) |
| Prolonged sleep | 51 (31.5) | 57 (33.3) |
| Reversed sleep | 25 (15.4) | 84 (49.1) |
| Frequent awakenings | 47 (29.1) | 71 (41.5) |
| Awakening earlier than expected | 43 (26.5) | 72 (42.1) |
| Vivid dreams or nightmares | 42 (25.9) | 75 (43.9) |
| Unrefreshed sleep | 54 (33.3) | 63 (36.8) |
| Sensory, perceptual, and motor disturbances, n (%) | ||
| Inability to focus vision | 47 (29.0) | 69 (40.4) |
| Sensitivitiesf | 50 (30.9) | 68 (39.8) |
| Poor depth perception | 30 (18.5) | 78 (45.6) |
| Muscle weakness | 52 (32.1) | 65 (38.0) |
| Twitching | 49 (30.3) | 70 (40.9) |
| Poor coordination | 49 (30.3) | 67 (39.2) |
| Feeling unsteady on feet | 44 (27.2) | 70 (40.9) |
| Immune (infectious), n (%) | ||
| Sore throat | 45 (27.8) | 73 (42.7) |
| Tender lymph nodes | 46 (28.4) | 75 (43.9) |
| Sinusitis | 46 (28.4) | 69 (40.4) |
| Recurrent or persistent infections | 46 (28.4) | 71 (41.5) |
| Gastrointestinal and genitourinary, n (%) | ||
| Nausea | 44 (27.2) | 73 (42.7) |
| Abdominal pain | 42 (25.9) | 76 (44.4) |
| Bloating | 50 (30.9) | 66 (38.6) |
| Irritable bowelg | 46 (28.4) | 65 (38.0) |
| Intolerancesh | 45 (27.8) | 68 (39.8) |
| Urinary urgency or frequency | 44 (27.2) | 68 (39.8) |
| Cardiovascular, n (%) | ||
| Orthostatic intolerancy | 46 (28.4) | 93 (54.4) |
| Ataxiai | 26 (16.1) | 90 (52.6) |
| Heart palpitations | 42 (25.9) | 65 (38.0) |
| Light headedness | 48 (29.6) | 70 (40.9) |
| Respiratory, n (%) | ||
| Air hunger | 44 (27.2) | 64 (37.4) |
| Labored breathing | 42 (25.9) | 67 (39.2) |
| Fatigue of chest muscles | 50 (30.9) | 68 (39.8) |
| Autonomic, n (%) | ||
| Abnormal body temperature | 41 (25.3) | 66 (38.6) |
| Fluctuating body temperature | 48 (29.6) | 67 (39.2) |
| Sweating episodes | 45 (27.8) | 67 (39.2) |
| Recurrent feverishness | 43 (26.5) | 75 (43.9) |
| Cold extremities | 45 (27.8) | 72 (42.1) |
| Intolerance of extremes temperature | 50 (30.7) | 67 (39.2) |
- The relationship between irritable bowel syndrome, functional dyspepsia, chronic fatigue and overactive bladder syndrome: a controlled study 6 years after acute gastrointestinal infection. [2015] – Odds of getting CFS are high.
- Comorbid personality disorders in chronic fatigue syndrome patients: a marker of psychopathological severity. [2015] “48.5% patients ..with the most frequent the Obsessive-Compulsive and Avoidant behaviors.
- Associations Between Cognitive Performance and Pain in Chronic Fatigue Syndrome: Comorbidity with Fibromyalgia Does Matter[2015]. “The CFS+FM but not the CFS-only group showed a significantly lower pressure pain thresholds [PPT], and enhanced temporal summation [TS], compared with controls.”
- “CFS patients have slow information-processing, and FM patients have impaired control of attention, perhaps due to chronic pain. Neuroimaging studies demonstrate cerebral abnormalities and a pattern of increased neural recruitment during cognitive tasks.” [2006]
- Gender differences in chronic fatigue syndrome [2016]. “The clinical phenotype of the men with CFS was young, single, skilled worker, and infection as the main triggering agent. Men had less pain and less muscle and immune symptoms, fewer comorbid phenomena, and a better quality of life…Fibromyalgia was present in 29% of men vs. 58% in women. “
- ” The percentage of patients and the degree of severity of cognitive symptoms, neurological and autonomic dysfunction was higher in FM patients (P<.001). FM patients scored higher on the fatigue impact scale (P<.001) and showed worse results in the quality of life questionnaire (P<.001).” [2014]
- Gene Expression Factor Analysis to Differentiate Pathways Linked to Fibromyalgia, Chronic Fatigue Syndrome, and Depression in a Diverse Patient Sample [2016]. “Expression of candidate genes can be grouped into meaningful clusters, and CFS and depression are associated with the same 2 clusters, but in opposite directions, when controlling for comorbid FMS.”
- Conditions comorbid with chronic fatigue in a population-based sample [2012].“Among participants with a CFS-like illness, lifetime prevalences of chronic widespread pain (CWP), irritable bowel syndrome (IBS),and major depressive disorder (MDD) were 41%, 16%, and 57% respectively. Participants reporting at least one of the three comorbid conditions were about 14 times more likely to have CFS-like illness than those without CWP, IBS, or MDD (95% confidence interval 8.1%-21.3%). Only MDD showed a temporal pattern of presentation during the same year as diagnosis of CFS-like illness.”
CFS Remission 