Katon W J, Buchwald D S, Simon G E, Russo J E, Mease P J
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195.
J Gen Intern Med. 1991 Jul-Aug;6(4):277-85. doi: 10.1007/BF02597420.
To identify psychiatric differences between patients with chronic fatigue and those with rheumatoid arthritis and to investigate whether patients meeting Centers for Disease Control (CDC) criteria for chronic fatigue syndrome (CFS) can be differentiated from patients with chronic fatigue on measures of disability and psychosocial distress.
Cross-sectional study comparing 98 patients with chronic fatigue with 31 patients with rheumatoid arthritis on structured psychiatric interviews and patient questionnaires. Nineteen patients meeting CDC criteria for CFS were compared with 79 patients with chronic fatigue not meeting CDC criteria on questionnaires measuring disability and psychosocial distress.
Consecutive patients with chronic fatigue were selected from a chronic fatigue clinic at the University of Washington, and 31 consecutive patients with rheumatoid arthritis were sampled from a private rheumatology practice.
Patients with chronic fatigue had a significantly higher prevalence of lifetime major depression and somatization disorder than did patients with rheumatoid arthritis. Patients with chronic fatigue also had a significantly higher prevalence of current and lifetime psychiatric diagnoses. Only 19 of 98 patients with chronic fatigue met CDC criteria for CFS. Patients meeting CDC criteria for CFS could not be differentiated from the larger group of patients with chronic fatigue on any study variable.
Patients with chronic fatigue have a significantly higher burden of psychiatric illness than do patients with rheumatoid arthritis. The psychiatric illness preceded the development of chronic fatigue in over half the patients. Centers for Disease Control criteria for CFS did not select a subset of chronic fatigue patients who could be differentiated on disability or psychosocial parameters from patients with chronic fatigue who did not meet CDC criteria.
确定慢性疲劳患者与类风湿性关节炎患者之间的精神差异，并调查符合美国疾病控制中心（CDC）慢性疲劳综合征（CFS）标准的患者在残疾和心理社会困扰测量方面是否可与慢性疲劳患者区分开来。
横断面研究，对98例慢性疲劳患者和31例类风湿性关节炎患者进行结构化精神访谈和患者问卷调查。将19例符合CDC慢性疲劳综合征标准的患者与79例不符合CDC标准的慢性疲劳患者进行问卷调查，以测量残疾和心理社会困扰情况。
从华盛顿大学慢性疲劳诊所选取连续的慢性疲劳患者，从一家私人风湿病诊所抽取31例连续的类风湿性关节炎患者。
慢性疲劳患者终生重度抑郁症和躯体化障碍的患病率显著高于类风湿性关节炎患者。慢性疲劳患者当前和终生精神疾病诊断的患病率也显著更高。98例慢性疲劳患者中只有19例符合CDC慢性疲劳综合征标准。在任何研究变量上，符合CDC慢性疲劳综合征标准的患者与更大的慢性疲劳患者群体无法区分。
慢性疲劳患者的精神疾病负担显著高于类风湿性关节炎患者。超过半数患者的精神疾病先于慢性疲劳出现。CDC慢性疲劳综合征标准并未选出一组在残疾或心理社会参数方面可与不符合CDC标准的慢性疲劳患者区分开来的慢性疲劳患者亚组。
