Farmer A, Jones I, Hillier J, Llewelyn M, Borysiewicz L, Smith A
Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff.
Br J Psychiatry. 1995 Oct;167(4):503-6. doi: 10.1192/bjp.167.4.503.
Different definitions of chronic fatigue syndrome (CFS) have different psychiatric exclusion criteria and this affects the type and frequency of associated psychiatric morbidity found. The operational criteria for neuraesthenia in ICD-10 vary in this and other respects from the Centers for Disease Control and Prevention (CDC) criteria for CFS. Neuraesthenia and associated psychiatric morbidity in CDC-defined CFS are evaluated.
CFS subjects and controls were interviewed with the Schedule for the Clinical Assessment of Neuropsychiatry (SCAN). The computerised scoring program for SCAN (CATEGO5) facilitates the assignment of operational definitions according to DSM-III-R and ICD-10. Subjects were re-interviewed with SCAN an average of 11 months later. No specific treatments or interventions were given during this period.
The majority of subjects fulfilled ICD-10 operational criteria for neuraesthenia and had two and a half times the rate of psychiatric morbidity as the healthy comparison group according to the CATEGO5 Index of Definition (ID). Approximately 80% of subjects fulfilled both DSM-III-R and ICD-10 criteria for sleep disorders. There was a significant fall in the number of subjects fulfilling criteria for depression and anxiety disorders and a significant increase in the number of subjects with no diagnosis for DSM-III-R criteria over time. There were no significant changes over time for any diagnosis according to ICD-10 criteria or for overall levels of psychopathology as reflected in CATEGO5 ID levels.
The ICD-10 'neuraesthenia' definition identifies almost all subjects with CDC-defined CFS. Fifty percent of CFS subjects also had depressive or anxiety disorders, some categories of which remit spontaneously over time.
慢性疲劳综合征（CFS）的不同定义具有不同的精神疾病排除标准，这会影响所发现的相关精神疾病的类型和发生率。国际疾病分类第10版（ICD - 10）中神经衰弱的操作标准在这方面及其他方面与美国疾病控制与预防中心（CDC）的CFS标准有所不同。本文对CDC定义的CFS中的神经衰弱及相关精神疾病进行评估。
采用神经精神病临床评估量表（SCAN）对CFS患者和对照组进行访谈。SCAN的计算机评分程序（CATEGO5）有助于根据《精神疾病诊断与统计手册》第三版修订本（DSM - III - R）和ICD - 10进行操作定义的赋值。平均11个月后，再次使用SCAN对受试者进行访谈。在此期间未给予任何特定治疗或干预。
根据CATEGO5定义指数（ID），大多数受试者符合ICD - 10中神经衰弱的操作标准，其精神疾病发生率是健康对照组的2.5倍。约80%的受试者符合DSM - III - R和ICD - 10的睡眠障碍标准。随着时间推移，符合抑郁和焦虑障碍标准的受试者数量显著下降，而不符合DSM - III - R标准的受试者数量显著增加。根据ICD - 10标准，任何诊断或CATEGO5 ID水平所反映的总体精神病理学水平随时间均无显著变化。
ICD - 10的“神经衰弱”定义涵盖了几乎所有CDC定义的CFS患者。50%的CFS患者还患有抑郁或焦虑障碍，其中一些类型会随时间自发缓解。
