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Prognostic Factors for Persons With Idiopathic Chronic Fatigue
Arthur J. Hartz, MD, PhD;
Evelyn M. Kuhn, PhD;
Suzanne E. Bentler, MS;
Paul H. Levine, MD;
Richard London, MD
Arch Fam Med. 1999;8:495-501.
Background The simultaneous examination of a large number of patient characteristics in a prospective study of patients with chronic fatigue.
Objective To compare the relative importance of these characteristics as prognostic factors.
Methods The data analyzed were from 199 subjects in a registry of persons who were aged 18 years or older and had idiopathic fatigue for at least 6 months. All subjects completed an extensive baseline questionnaire that provided information about fatigue, demographic characteristics, medical conditions, lifestyle, sleeping habits, psychological characteristics, and the presence of criteria for chronic fatigue syndrome. Changes in fatigue severity from baseline to 2-year follow-up were tested for an association with risk factors at baseline and with changes in symptoms other than fatigue during the follow-up period.
Results The following characteristics at baseline significantly and independently predicted greater fatigue improvement: less unclear thinking, fewer somatoform symptoms not used to define chronic fatigue syndrome, infrequent awakening, fewer hours sleeping, and being married. Of 29 subjects who at baseline reported no somatoform symptoms unrelated to chronic fatigue syndrome and who thought clearly most of the time, 8 substantially improved, compared with 1 of 29 subjects who had more than 2 somatoform symptoms and never thought clearly (P = .01). Improvements in the following symptoms were significantly and independently associated with improvements in fatigue: unclear thinking, depression, muscle aches, and trouble falling asleep.
Conclusions This study identified characteristics of subjects that seem to be of prognostic importance for idiopathic chronic fatigue. Symptoms that change concomitantly with changes in fatigue may be intrinsically linked to fatigue.
From the Department of Family Medicine, University of Iowa College of Medicine, Iowa City (Dr Hartz and Ms Bentler); the Medical College of Wisconsin, Department of Family and Community Medicine, Milwaukee (Drs Kuhn and London); and the George Washington School of Public Health, Department of Epidemiology, Washington, DC (Dr Levine).
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