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A majority of those who filled out the questionnaire (258 people) had what the researchers considered long-duration CFS – in this case the median number was 18 years. Short duration CFS, about 3 years, accounted for 28 of those surveyed, and 79 healthy controls were included. Their findings indicate that those with long-duration CFS score higher in terms of severity of symptoms -- which they believe to be significantly related to increased problems with cognition. In contrast, a characteristic of those with short-duration CFS, who had not yet hit a 4-7 year mark, was a highly likelihood of using denial as a coping strategy. As might be expected, CFS patients of whatever length of illness experienced other disorders concurrent to CFS, as compared to the healthy subjects. And in terms of self-evaluation, many of those with CFS saw the disease culprit as viral or stress-related.

In looking at this data, researchers confirmed cognitive problems were greater for those with long-duration CFS, and comorbid diseases greater for all those with CFS. It is this last point that they feel supports the hypothesis that hypersensitivity and viruses play a role in the pathogenesis of CFS.

OBJECTIVE: Our objective was to evaluate symptom patterns in patients with chronic fatigue syndrome (CFS) who were ill for 10 or more years.

METHODS: This cross-sectional self-report study compared patient groups with long-duration (median = 18 years; n = 258) and short-duration (median = 3 years; n = 28) CFS to a group of healthy significant others (n = 79) on symptomatic, neurocognitive, and psychological variables. Data were gathered from a 574-item postal questionnaire.

RESULTS: A principal-components analysis of CFS symptom data yielded a three-factor solution: cognitive problems; flu-like symptoms; and neurologic symptoms. Compared with the short-duration CFS group, the long-duration group had significantly higher CFS symptom severity scores (p < 0.04), largely attributable to increased cognitive difficulties. A subgroup comparison of subjects ill for < 3 years versus those ill 4-7 years suggested that denial coping strategies were more likely in those participants with the shorter illness duration. Significant differences between both CFS groups and healthy controls were found in a number of comorbid disorders. Participants with CFS most often endorsed immune/viral abnormalities and persistent stress as important perceived causes of their illness.

CONCLUSION: Participants with long-duration CFS reported a large number of specific cognitive difficulties that were greater in severity than those reported by participants with short-duration CFS. The pattern of comorbid disorders in the CFS groups was consistent with hypersensitivity and viral reactivation hypotheses.

Source: Friedberg F, Dechene L, McKenzie MJ 2nd, Fontanetta R, J Psychosom Res 2000 Jan; 48(1):59-68, Department of Mathematics, Fitchburg State College, MA, USA, PubMed.