A comparison of health-related factors between patients diagnosed with ME/CFS and patients with a related symptom picture but no ME/CFS diagnosis: a cross-sectional exploratory study

Abstract

Background In chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS), the capacity for activity and participation is strongly limited. The disease definition is very broad, and considering the lack of evidence for best treatment, it is important to understand what is ME/CFS-specific in the biopsychosocial perspective in comparison with similar syndromes. The objective was to study the difference between those diagnosed with ME/CFS and those with similar symptoms but no ME/CFS diagnosis for self-perceived level of physical activity, work ability, anxiety/depression, and health-related quality of life. Methods This was a clinical cross-sectional study with data collected from mailed questionnaires. The following variables were compared between patients diagnosed with ME/CFS (n = 205) and those with similar symptoms but no diagnosis (n = 57); level of physical activity, Work ability index (WAI), Hospital anxiety and depression scale (HAD-A/HAD-D), and RAND-36 Physical functioning, Role limitations due to physical health problems, Role limitations due to personal or emotional problems, Social functioning, Energy/fatigue, Bodily pain, Emotional well-being, and General health perceptions. The Chi-squared test (nominal data), the Mann-Whitney U test, the Student’s t test and regression analysis were used to analyze the data. Results The group diagnosed with ME/CFS had a more impaired physical and mental exertion ability as compared to the group that had similar symptoms but was not diagnosed with ME/CFS, shown by a RAND-36 lower index of physical role functioning, social functioning, energy, worse pain and poorer overall health (p ≤ 0.05). In contrast, no significant group differences emerged for weekly level of physical activity, work ability, anxiety/depression, and RAND-36 Emotional role limitation and well-being. Conclusion Our results indicate that those with a diagnosis of ME/CFS are characterized by an impaired ability for physical or mental exertion, worse pain, and poorer overall health as compared to individuals with similar symptoms but for whom ME/CFS-diagnosis was not established. The results may be cautiously interpreted as support when focusing on patients’ self-care in terms of management of energy levels. The results must however be verified in future studies.

Epidemiology of Myalgic Encephalomyelitis among individuals with self-reported Chronic Fatigue Syndrome in British Columbia, Canada, and their health-related quality of life

“…Similar to our findings, a clinical-based cross-sectional study found that, compared to people with other fatiguing symptoms, people with ME/CFS had a lower index of physical role functioning and social functioning, lower energy, worse pain and poorer overall health [48]. However, they found no difference in mental components such as anxiety, emotional role limitation, and no significant differences in physical activity and work ability.…”

Anxiety and depression in patients with non-site-specific cancer symptoms: data from a rapid diagnostic clinic

“…Furthermore, psychological distress commonly concurs with chronic health conditions, which may negatively impact QoL, and health related outcomes associated with anxiety and depression ( 27 – 29 ). Whilst an RDC is in the first instance designed to speed up cancer diagnostics, only 7% of our patients ultimately have a cancer diagnosis ( 8 ).…”

“…Conversely, it is worth considering that underlying anxiety and/or depressive disorders might be contributing to NSS symptoms. For instance, patients with anxiety and/or depression often report higher levels of pain intensity compared to the general population, and the remission of an underlying depression has been linked to reduced pain severity ( 27 , 36 ). Additionally, as previously mentioned, the DSM-V outlines various NSS symptoms (i.e., weight loss and fatigue), within their criteria for major depressive disorder and generalized anxiety disorder ( 10 , 37 ).…”

Myalgic encephalomyelitis/chronic fatigue syndrome from current evidence to new diagnostic perspectives through skeletal muscle and metabolic disturbances

“…Indeed, diagnosis is possibly biased by comorbidities if the diagnosed fatigue‐based disease does not fully explain symptom's characteristics 9 . An imbalance of activity–recovery, persistent negative psychosocial stress, worse pain, impaired abilities to recover from physical or mental exertion, and poorer overall health have been recorded in individuals diagnosed with ME/CFS compared to those with similar symptoms but having no ME/CFS diagnosis 165 …”

“…9 An imbalance of activity-recovery, persistent negative psychosocial stress, worse pain, impaired abilities to recover from physical or mental exertion, and poorer overall health have been recorded in individuals diagnosed with ME/CFS compared to those with similar symptoms but having no ME/CFS diagnosis. 165 From a phenomenological point of view, burnout syndromes present similarities with ME/CFS, even though burnout has been historically contextualized within a psychological setting. 166 Non-resolved fatigue accumulation overlaps with many conditions, including the overtraining syndrome, whose multi-systemic nature is usually analyzed by means of endocrine markers, immune pathways, and electrophysiological evidence.…”