Hickie Ian, Davenport Tracey, Vernon Suzanne D, Nisenbaum Rosane, Reeves William C, Hadzi-Pavlovic Dusan, Lloyd Andrew
Brain and Mind Research Institute, Camperdown, NSW, Australia.
Aust N Z J Psychiatry. 2009 Jan;43(1):25-35. doi: 10.1080/00048670802534432.
The validity of the diagnosis of chronic fatigue syndrome and related chronic fatigue states remains controversial, particularly in psychiatry. This project utilized international epidemiological and clinical research data to test construct validity across diagnostic categories, health-care settings and countries. Relevant demographic, symptom and diagnostic data were obtained from 33 studies in 21 countries. The subjects had fatigue lasting 1-6 months (prolonged fatigue), or >6 months (chronic fatigue), or met diagnostic criteria for chronic fatigue syndrome.
Common symptom domains were derived by factor analytic techniques. Mean scores on each symptom factor were compared across diagnostic categories, health-care settings and countries.
Data were obtained on 37,724 subjects (n = 20,845 female, 57%), including from population-based studies (n = 15,749, 42%), studies in primary care (n = 19 472, 52%), and secondary or specialist tertiary referral clinics (n = 2503, 7%). The sample included 2013 subjects with chronic fatigue, and 1958 with chronic fatigue syndrome. A five-factor model of the key symptom domains was preferred ('musculoskeletal pain/fatigue', 'neurocognitive difficulties', 'inflammation', 'sleep disturbance/fatigue' and 'mood disturbance') and was comparable across subject groups and settings. Although the core symptom profiles were similar, some differences in symptoms were observed across diagnostic categories, health-care settings and between countries.
The construct validity of chronic fatigue and chronic fatigue syndrome is supported by an empirically derived factor structure from existing international datasets.
慢性疲劳综合征及相关慢性疲劳状态的诊断有效性仍存在争议，尤其是在精神病学领域。本项目利用国际流行病学和临床研究数据，对不同诊断类别、医疗环境和国家的结构效度进行检验。从21个国家的33项研究中获取了相关的人口统计学、症状和诊断数据。受试者的疲劳持续时间为1 - 6个月（持续性疲劳）、超过6个月（慢性疲劳）或符合慢性疲劳综合征的诊断标准。
通过因子分析技术得出常见症状领域。比较各诊断类别、医疗环境和国家中每个症状因子的平均得分。
共获得37724名受试者的数据（n = 20845名女性，占57%），包括基于人群的研究（n = 15749名，占42%）、初级保健研究（n = 19472名，占52%）以及二级或专科三级转诊诊所研究（n = 2503名，占7%）。样本包括2013名慢性疲劳受试者和1958名慢性疲劳综合征受试者。一个由关键症状领域构成的五因素模型更受青睐（“肌肉骨骼疼痛/疲劳”、“神经认知困难”、“炎症”、“睡眠障碍/疲劳”和“情绪障碍”），且在不同受试者组和环境中具有可比性。尽管核心症状概况相似，但在不同诊断类别、医疗环境以及不同国家之间，症状存在一些差异。
现有国际数据集通过实证得出的因子结构支持了慢性疲劳和慢性疲劳综合征的结构效度。
