ABSTRACT
BACKGROUND AND OBJECTIVE: To quantify the relationship between Chronic Fatigue Syndrome (CFS) and Type A Behaviour Pattern (TABP) PATIENTS AND METHOD: The Jenkins Activity Survey (JAS) was administered to 82 patients diagnosed with CFS to determine the prevalence of TABP. Subjects' mean z scores on the JAS were compared with those from the general population (healthy controls) and from patients with ischemic cardiopathy (pathologic controls). RESULTS: CFS patients' mean score on the JAS was 5 points higher than that of the general population (healthy controls) and 2 points higher than that of patients with ischemic cardiopathy. CONCLUSIONS: TABP appears to be related with CFS and should be taken into account in the treatment of these patients.
Subject(s)
Behavior , Fatigue Syndrome, Chronic/psychology , Type A Personality , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND AND OBJECTIVE: Multiple chemical sensitivity (MCS) is characterized by a loss of tolerance to various environmental chemicals. The objective of this study was to describe patients with MCS seen in our hospital. PATIENTS AND METHOD: Patients consecutively seen by the Toxicology and Chronic Fatigue Units who presented symptoms of MCS were included. The diagnosis was clinical. All patients completed the Quick Environmental Exposure and Sensitivity Inventory (QEESI) questionnaire. RESULTS: Fifty-two patients were included. The average age (standard deviation) was 47.2 (7.6) years, and 46 (88%) were females. The origin of the syndrome was related to occupational exposure to various chemical agents in 31 cases (59.6%), including occupational accidents in 14 patients (fumigation of the workplace with insecticides). In 20 patients (38.5%), the syndrome could not be associated with any toxic exposure and was considered a manifestation of chronic fatigue syndrome. The QEESI showed mean scores of 72.9 (18.6) on the chemical inhalant intolerance scale, 45.5 (20.6) on the other intolerances scale, 69.8 (20.6) on the symptom severity scale, 4.4 (1.8) on the masking index and 66.6 (21.7) on the life impact scale. All patients were followed up for a minimum of 12 months, and during this period they remained stable with no deaths. CONCLUSIONS: MCS normally affects middle-aged women. It is frequently triggered by exposure to chemical agents, especially insecticides. An association with chronic fatigue syndrome is common. The prognosis is good but the patients' quality of life is seriously affected.
Subject(s)
Multiple Chemical Sensitivity/diagnosis , Adult , Fatigue Syndrome, Chronic/complications , Female , Humans , Male , Middle Aged , Multiple Chemical Sensitivity/etiology , Occupational Exposure/adverse effects , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Chronic fatigue syndrome (CFS) produces physical and neurocognitive disability that significantly affects health-related quality of life (HRQL). Multidisciplinary treatment combining graded exercise therapy (GET) cognitive behavioural therapy (CBT) and pharmacological treatment has shown only short-term improvements. To compare the effects on HRQL of (1) multidisciplinary treatment combining CBT, GET, and pharmacological treatment, and (2) usual treatment (exercise counselling and pharmacological treatment) at 12 months of follow-up. Prospective, randomized controlled trial with a follow-up of 12 months after the end of treatment. Patients consecutively diagnosed with CFS (Fukuda criteria) were randomly assigned to intervention (n = 60) or usual treatment (n = 60) groups. HRQL was assessed at baseline and 12 months by the Medical Outcomes Study Short-Form questionnaire (SF-36). Secondary outcomes included functional capacity for activities of daily living measured by the Stanford Health Assessment Questionnaire (HAQ) and comorbidities. At baseline, the two groups were similar, except for lower SF-36 emotional role scores in the intervention group. At 12 months, the intervention did not improve HRQL scores, with worse SF-36 physical function and bodily pain scores in the intervention group. Multidisciplinary treatment was not superior to usual treatment at 12 months in terms of HRQL. The possible benefits of GET as part of multidisciplinary treatment for CFS should be assessed on an individual patient basis.