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Unformatted text preview: Comparison of Patients With Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivities Dedra Buchwald, MD, Deborah Garrity, MD Background: Chronic fatiguesyndrome(CFS), fibro- myalgia (FM), and multiple chemical sensitivities (MCS) are conditions associatedwith fatigue and a variety of other symptoms that appear to share many clinical and demo- graphic features. Our objectives w e re to describe the simi- larities and differences among patients with CFS, FM, and MCS. Additional objectives w e re to determine how fre- quentlypatients with MCS and FM m e t the criteria for CFS and if they differed in their health locus of control. Methods: Demographic, clinical, and psychosocial m e a - s u re s w e re prospectively collected in 90 patients, 30 each with CFS, FM, and MCS. Patients w e re recruited from a university-based referral clinic devoted to the evalua- tion and treatm ent of chronic fatigue and three private practices. Variables included demographic features, symp- toms characteristic of each condition, psychological c o m - plaints, a m e a s u re of health locus of control, and infor- mation o n health care use. Results: Overall, the three patient groups w e r e remarkably similar in demographic characteristics and the presence of specificsymptoms. Patients with CFS and FM frequently reported symptoms compatible with MCS. Likewise, 70% of patients with FM and 30% of those with MCS m e t the crite ria for CFS. Health care u s e w a s substantial among patients with CFS, FM, and MCS, with a n average of 22.1, 39.7, and 23.3 visits, respectively, to a medical provider during the prior year. Health locus of control did n o t differ among the three populations. Conclusions: In general, demographic and clinical fac- tors and health locus of control do not clearly distin- guishpatients with CFS, FM, and MCS. Symptomstypi- cal of each disorder are prevalent in the other tw o conditions. (Arch Intern Med. 1994;154:2049-2053) Ch ron ic f a t i g u e syn¬ drome (CFS) is a disor¬ der that has received a n increasing am ount of at¬ tention o v e r the last few years. The hallmark of CFS is debilitat¬ ing fatigue of at least 6 months' duration accompanied by other symptoms such as fever, pharyngitis, painful lymph nodes, headache, myalgias, sleep disturbances, neurocognitive complaints, and depres¬ sion.12 It is m o re c o m m o n in w o m e n and frequently has its onset following a "flu-" like illness.2 Findings o n physical exami¬ nation a re infrequentand, at present, there is n o diagnostic test for CFS.23 Recently, the Centers for Disease Control and Pre¬ vention, Atlanta, Ga, has formulated spe¬ cific diagnostic criteria for CFS consist¬ ing of a combination of a m in im u m number of signs and symptoms.14 Fibromyalgia (FM) is a c o m m o n rheumatologic condition characterized by chronic myalgias, fatigue, and disrupted sleep, often associated with headache, ir¬ ritable bowel syndrome, and interstitial cystitis.5 It o c c u r s m o s t...
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This note was uploaded on 04/13/2010 for the course PSYCH 101 taught by Professor Gabbart during the Spring '08 term at Union College.
- Spring '08