Euba R, Chalder T, Deale A, Wessely S
Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, London.
Br J Psychiatry. 1996 Jan;168(1):121-6. doi: 10.1192/bjp.168.1.121.
To evaluated the characteristics of Chronic Fatigue Syndrome (CFS) in primary and tertiary care.
A comparison of subjects fulfilling criteria for CFS, identified as part of a prospective cohort study in primary care, compared to 79 adults fulfilling the same criteria referred for treatment to a specialist CFS clinic.
Hospital cases were more likely to belong to upper socio-economic groups, and to have physical illness attributions. They had higher levels of fatigue and more somatic symptoms, and were more impaired functionally, but had less overt psychological morbidity. Women were over-represented in both primary care and hospital groups. Nearly half of those referred to a specialist clinic did not fulfil operational criteria for CFS.
The high rates of psychiatric morbidity and female excess that characterise CFS in specialist settings are not due to selection bias. On the other hand higher social class and physical illness attributions may be the result of selection bias and not intrinsic to CFS.
评估初级保健和三级保健中慢性疲劳综合征（CFS）的特征。
将在初级保健中作为前瞻性队列研究一部分被确定符合CFS标准的受试者，与79名符合相同标准并被转诊至专科CFS诊所接受治疗的成年人进行比较。
医院病例更有可能属于社会经济地位较高的群体，且有身体疾病归因。他们疲劳程度更高，躯体症状更多，功能受损更严重，但明显的心理疾病发病率较低。女性在初级保健组和医院组中所占比例均过高。将近一半转诊至专科诊所的患者不符合CFS的操作标准。
专科环境中CFS所具有的高精神疾病发病率和女性比例过高并非由于选择偏倚。另一方面，较高的社会阶层和身体疾病归因可能是选择偏倚的结果，而非CFS所固有。
