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Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

The functional status and well being of people with myalgic encephalomyelitis/chronic fatigue syndrome and their carers

Authors: Luis C Nacul, Eliana M Lacerda, Peter Campion, Derek Pheby, Maria de L Drachler, José C Leite, Fiona Poland, Amanda Howe, Shagufta Fayyaz, Mariam Molokhia

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome or ME/CFS is largely based on clinical history, and exclusion of identifiable causes of chronic fatigue. Characterization of cases and the impact of interventions have been limited due to clinical heterogeneity and a lack of reliable biomarkers for diagnosis and outcome measures. People with ME/CFS (PWME) often report high levels of disability, which are difficult to measure objectively. The well being of family members and those who care for PWME are also likely to be affected. This study aimed to investigate the functional status and well being of PWME and their lay carers, and to compare them with people with other chronic conditions.

Methods

We used a cross sectional design to study 170 people aged between 18 and 64 years with well characterized ME/CFS, and 44 carers, using SF-36 v2™. Mean physical and mental domains scores (scales and component summaries) were calculated and compared internally and externally with reference standards for the general population and for population groups with 10 chronic diseases.

Results

SF-36 scores in PWME were significantly reduced, especially within the physical domain (mean norm-based Physical Component Summary (PCS) score = 26.8), but also within the mental domain (mean norm-based score for Mental Component Summary (MCS) = 34.1). The lowest and highest scale scores were for "Role-Physical" (mean = 25.4) and "Mental Health" (mean = 36.7) respectively. All scores were in general lower than those for the general population and diseased-specific norms for other diseases. Carers of those with ME/CFS tended to have low scores in relation to population norms, particularly within the mental domain (mean = 45.4).

Conclusions

ME/CFS is disabling and has a greater impact on functional status and well being than other chronic diseases such as cancer. The emotional burden of ME/CFS is felt by lay carers as well as by people with ME/CFS. We suggest the use of generic instruments such as SF-36, in combination of other objective outcome measurements, to describe patients and assess treatments.
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Literature
1.
go back to reference Baker R, Shaw EJ: Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. Bmj. 2007, 335: 446-448. 10.1136/bmj.39302.509005.AE.CrossRefPubMedPubMedCentral Baker R, Shaw EJ: Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. Bmj. 2007, 335: 446-448. 10.1136/bmj.39302.509005.AE.CrossRefPubMedPubMedCentral
2.
go back to reference Carruthers B, Jain AK, De Meirleir KL, Peterson DL, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles AP, Sherkey JA, van de Sande MI: Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. Journal of chronic fatigue syndrome. 2003, 11: 7-115.CrossRef Carruthers B, Jain AK, De Meirleir KL, Peterson DL, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles AP, Sherkey JA, van de Sande MI: Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. Journal of chronic fatigue syndrome. 2003, 11: 7-115.CrossRef
3.
go back to reference Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994, 121: 953-959.CrossRefPubMed Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994, 121: 953-959.CrossRefPubMed
4.
go back to reference WHO: International Classification of Functioning, Disability and Health (ICF). 2001, Geneva: World Health Organization WHO: International Classification of Functioning, Disability and Health (ICF). 2001, Geneva: World Health Organization
5.
go back to reference Pinquart M, Sorensen S: Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging. 2003, 18: 250-267.CrossRefPubMed Pinquart M, Sorensen S: Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging. 2003, 18: 250-267.CrossRefPubMed
6.
go back to reference Pheby D, Lacerda E, Nacul L, Drachler MD, Campion P, Howe A, Poland F, Curran M, Featherstone V, Fayyaz S, Sakellariou D, de Carvalho Leite JC: A Disease Register for ME/CFS : Report of a Pilot Study. BMC Res Notes. 2011, 4: 139-10.1186/1756-0500-4-139.CrossRefPubMedPubMedCentral Pheby D, Lacerda E, Nacul L, Drachler MD, Campion P, Howe A, Poland F, Curran M, Featherstone V, Fayyaz S, Sakellariou D, de Carvalho Leite JC: A Disease Register for ME/CFS : Report of a Pilot Study. BMC Res Notes. 2011, 4: 139-10.1186/1756-0500-4-139.CrossRefPubMedPubMedCentral
7.
go back to reference Horton SM, Poland F, Kale S, Drachler Mde L, de Carvalho Leite JC, McArthur MA, Campion PD, Pheby D, Nacul L: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adults: a qualitative study of perspectives from professional practice. BMC Fam Pract. 2010, 11: 89-10.1186/1471-2296-11-89.CrossRefPubMedPubMedCentral Horton SM, Poland F, Kale S, Drachler Mde L, de Carvalho Leite JC, McArthur MA, Campion PD, Pheby D, Nacul L: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in adults: a qualitative study of perspectives from professional practice. BMC Fam Pract. 2010, 11: 89-10.1186/1471-2296-11-89.CrossRefPubMedPubMedCentral
8.
go back to reference Drachler M de L, Leite JC, Hooper L, Hong CS, Pheby D, Nacul L, Lacerda E, Campion P, Killett A, McArthur M, Poland F: The expressed needs of people with chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. BMC Public Health. 2009, 9: 458-10.1186/1471-2458-9-458.CrossRef Drachler M de L, Leite JC, Hooper L, Hong CS, Pheby D, Nacul L, Lacerda E, Campion P, Killett A, McArthur M, Poland F: The expressed needs of people with chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. BMC Public Health. 2009, 9: 458-10.1186/1471-2458-9-458.CrossRef
9.
go back to reference Lacerda EM, Nacul L, Pheby D, Shepherd C, Spencer P: Exploring the feasibility of establishing a disease-specific post-mortem tissue bank in the UK: a case study in ME/CFS. J Clin Pathol. 2010, 63: 1032-1034. 10.1136/jcp.2010.082032.CrossRefPubMed Lacerda EM, Nacul L, Pheby D, Shepherd C, Spencer P: Exploring the feasibility of establishing a disease-specific post-mortem tissue bank in the UK: a case study in ME/CFS. J Clin Pathol. 2010, 63: 1032-1034. 10.1136/jcp.2010.082032.CrossRefPubMed
10.
go back to reference Osoba T, Pheby D, Gray S, Nacul L: The Development of an Epidemiological Definition for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal of Chronic Fatigue Syndrome. 2008, 14: 61-84.CrossRef Osoba T, Pheby D, Gray S, Nacul L: The Development of an Epidemiological Definition for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal of Chronic Fatigue Syndrome. 2008, 14: 61-84.CrossRef
11.
go back to reference Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's manual for the SF-36v2™ health survey. 2007, Lincoln: QualityMetric Incorporated Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's manual for the SF-36v2™ health survey. 2007, Lincoln: QualityMetric Incorporated
12.
go back to reference Buchwald D, Pearlman T, Umali J, Schmaling K, Katon W: Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals. Am J Med. 1996, 101: 364-370. 10.1016/S0002-9343(96)00234-3.CrossRefPubMed Buchwald D, Pearlman T, Umali J, Schmaling K, Katon W: Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals. Am J Med. 1996, 101: 364-370. 10.1016/S0002-9343(96)00234-3.CrossRefPubMed
13.
go back to reference Buskila D: Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. Curr Opin Rheumatol. 2001, 13: 117-127. 10.1097/00002281-200103000-00005.CrossRefPubMed Buskila D: Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. Curr Opin Rheumatol. 2001, 13: 117-127. 10.1097/00002281-200103000-00005.CrossRefPubMed
14.
go back to reference Hardt J, Buchwald D, Wilks D, Sharpe M, Nix WA, Egle UT: Health-related quality of life in patients with chronic fatigue syndrome: an international study. J Psychosom Res. 2001, 51: 431-434. 10.1016/S0022-3999(01)00220-3.CrossRefPubMed Hardt J, Buchwald D, Wilks D, Sharpe M, Nix WA, Egle UT: Health-related quality of life in patients with chronic fatigue syndrome: an international study. J Psychosom Res. 2001, 51: 431-434. 10.1016/S0022-3999(01)00220-3.CrossRefPubMed
15.
go back to reference Herrell R, Goldberg J, Hartman S, Belcourt M, Schmaling K, Buchwald D: Chronic fatigue and chronic fatigue syndrome: a co-twin control study of functional status. Qual Life Res. 2002, 11: 463-471. 10.1023/A:1015635113159.CrossRefPubMed Herrell R, Goldberg J, Hartman S, Belcourt M, Schmaling K, Buchwald D: Chronic fatigue and chronic fatigue syndrome: a co-twin control study of functional status. Qual Life Res. 2002, 11: 463-471. 10.1023/A:1015635113159.CrossRefPubMed
16.
go back to reference Kennedy G, Abbot NC, Spence V, Underwood C, Belch JJ: The specificity of the CDC-1994 criteria for chronic fatigue syndrome: comparison of health status in three groups of patients who fulfill the criteria. Ann Epidemiol. 2004, 14: 95-100. 10.1016/j.annepidem.2003.10.004.CrossRefPubMed Kennedy G, Abbot NC, Spence V, Underwood C, Belch JJ: The specificity of the CDC-1994 criteria for chronic fatigue syndrome: comparison of health status in three groups of patients who fulfill the criteria. Ann Epidemiol. 2004, 14: 95-100. 10.1016/j.annepidem.2003.10.004.CrossRefPubMed
17.
go back to reference Komaroff AL, Fagioli LR, Doolittle TH, Gandek B, Gleit MA, Guerriero RT, Kornish RJ, Ware NC, Ware JE, Bates DW: Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups. Am J Med. 1996, 101: 281-290. 10.1016/S0002-9343(96)00174-X.CrossRefPubMed Komaroff AL, Fagioli LR, Doolittle TH, Gandek B, Gleit MA, Guerriero RT, Kornish RJ, Ware NC, Ware JE, Bates DW: Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups. Am J Med. 1996, 101: 281-290. 10.1016/S0002-9343(96)00174-X.CrossRefPubMed
18.
go back to reference Lin JM, Brimmer DJ, Maloney EM, Nyarko E, Belue R, Reeves WC: Further validation of the Multidimensional Fatigue Inventory in a US adult population sample. Popul Health Metr. 2009, 7: 18-10.1186/1478-7954-7-18.CrossRefPubMedPubMedCentral Lin JM, Brimmer DJ, Maloney EM, Nyarko E, Belue R, Reeves WC: Further validation of the Multidimensional Fatigue Inventory in a US adult population sample. Popul Health Metr. 2009, 7: 18-10.1186/1478-7954-7-18.CrossRefPubMedPubMedCentral
19.
go back to reference Myers C, Wilks D: Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Qual Life Res. 1999, 8: 9-16.CrossRefPubMed Myers C, Wilks D: Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Qual Life Res. 1999, 8: 9-16.CrossRefPubMed
20.
go back to reference Nijs J, Thielemans A: Kinesiophobia and symptomatology in chronic fatigue syndrome: a psychometric study of two questionnaires. Psychol Psychother. 2008, 81: 273-283. 10.1348/147608308X306888.CrossRefPubMed Nijs J, Thielemans A: Kinesiophobia and symptomatology in chronic fatigue syndrome: a psychometric study of two questionnaires. Psychol Psychother. 2008, 81: 273-283. 10.1348/147608308X306888.CrossRefPubMed
21.
go back to reference Rakib A, White PD, Pinching AJ, Hedge B, Newbery N, Fakhoury WK, Priebe S: Subjective quality of life in patients with chronic fatigue syndrome. Qual Life Res. 2005, 14: 11-19. 10.1007/s11136-004-1693-y.CrossRefPubMed Rakib A, White PD, Pinching AJ, Hedge B, Newbery N, Fakhoury WK, Priebe S: Subjective quality of life in patients with chronic fatigue syndrome. Qual Life Res. 2005, 14: 11-19. 10.1007/s11136-004-1693-y.CrossRefPubMed
22.
go back to reference Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, Papanicolaou DA, Unger ER, Vernon SD, Heim C: Chronic fatigue syndrome - a clinically empirical approach to its definition and study. BMC Med. 2005, 3: 19-10.1186/1741-7015-3-19.CrossRefPubMedPubMedCentral Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, Papanicolaou DA, Unger ER, Vernon SD, Heim C: Chronic fatigue syndrome - a clinically empirical approach to its definition and study. BMC Med. 2005, 3: 19-10.1186/1741-7015-3-19.CrossRefPubMedPubMedCentral
23.
go back to reference Wagner D, Nisenbaum R, Heim C, Jones JF, Unger ER, Reeves WC: Psychometric properties of the CDC Symptom Inventory for assessment of chronic fatigue syndrome. Popul Health Metr. 2005, 3: 8-10.1186/1478-7954-3-8.CrossRefPubMedPubMedCentral Wagner D, Nisenbaum R, Heim C, Jones JF, Unger ER, Reeves WC: Psychometric properties of the CDC Symptom Inventory for assessment of chronic fatigue syndrome. Popul Health Metr. 2005, 3: 8-10.1186/1478-7954-3-8.CrossRefPubMedPubMedCentral
24.
go back to reference Posner N, Madl R, Siskind V: Pattern of functional impairment in CFS. Second world congress on chronic fatigue syndrome and related disorders; Brussels. Edited by: Free University of Brussels. 1999 Posner N, Madl R, Siskind V: Pattern of functional impairment in CFS. Second world congress on chronic fatigue syndrome and related disorders; Brussels. Edited by: Free University of Brussels. 1999
25.
go back to reference Smits M, van Rooy R, Nagtegaal J: Influence of melatonin on quality of life in patients with chronic fatigue syndrome and late melatonin onset. Journal of chronic fatigue syndrome. 2002, 10: 25-36. 10.1300/J092v10n03_03.CrossRef Smits M, van Rooy R, Nagtegaal J: Influence of melatonin on quality of life in patients with chronic fatigue syndrome and late melatonin onset. Journal of chronic fatigue syndrome. 2002, 10: 25-36. 10.1300/J092v10n03_03.CrossRef
26.
go back to reference Saris-Baglama R, Dewey C, Chisholm G, Plumb E, Kosinski M, Bjorner JB: QualityMetric Health Outcomes™ scoring software 2.0 user's guide. 2007, Lincoln: QualityMetric Incorporated Saris-Baglama R, Dewey C, Chisholm G, Plumb E, Kosinski M, Bjorner JB: QualityMetric Health Outcomes™ scoring software 2.0 user's guide. 2007, Lincoln: QualityMetric Incorporated
27.
go back to reference Kirkwood BR, Sterne JAC: Medical statistics. 2003, Oxford: Blackweel Science, 2 Kirkwood BR, Sterne JAC: Medical statistics. 2003, Oxford: Blackweel Science, 2
28.
go back to reference Jason LA, Benton MC, Valentine L, Johnson A, Torres-Harding S: The economic impact of ME/CFS: individual and societal costs. Dyn Med. 2008, 7: 6-10.1186/1476-5918-7-6.CrossRefPubMedPubMedCentral Jason LA, Benton MC, Valentine L, Johnson A, Torres-Harding S: The economic impact of ME/CFS: individual and societal costs. Dyn Med. 2008, 7: 6-10.1186/1476-5918-7-6.CrossRefPubMedPubMedCentral
29.
go back to reference Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's manual for the SF-36v2TM health survey. 2007, Lincoln: QualityMetric Incorporated Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Maruish ME: User's manual for the SF-36v2TM health survey. 2007, Lincoln: QualityMetric Incorporated
30.
go back to reference Anderson JS, Ferrans CE: The quality of life of persons with chronic fatigue syndrome. J Nerv Ment Dis. 1997, 185: 359-367. 10.1097/00005053-199706000-00001.CrossRefPubMed Anderson JS, Ferrans CE: The quality of life of persons with chronic fatigue syndrome. J Nerv Ment Dis. 1997, 185: 359-367. 10.1097/00005053-199706000-00001.CrossRefPubMed
31.
go back to reference Schweitzer R, Kelly B, Foran A, Terry D, Whiting J: Quality of life in chronic fatigue syndrome. Soc Sci Med. 1995, 41: 1367-1372. 10.1016/0277-9536(95)00124-P.CrossRefPubMed Schweitzer R, Kelly B, Foran A, Terry D, Whiting J: Quality of life in chronic fatigue syndrome. Soc Sci Med. 1995, 41: 1367-1372. 10.1016/0277-9536(95)00124-P.CrossRefPubMed
32.
go back to reference Solomon L, Nisenbaum R, Reyes M, Papanicolaou DA, Reeves WC: Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population. Health Qual Life Outcomes. 2003, 1: 48-10.1186/1477-7525-1-48.CrossRefPubMedPubMedCentral Solomon L, Nisenbaum R, Reyes M, Papanicolaou DA, Reeves WC: Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population. Health Qual Life Outcomes. 2003, 1: 48-10.1186/1477-7525-1-48.CrossRefPubMedPubMedCentral
33.
go back to reference Jason L, Brown M, Evans M, Anderson V, Lerch A, Brown A, Hunnell J, Porter N: Measuring substantial reductions in functioning in patients with chronic fatigue syndrome. Disabil Rehabil. 2011 Jason L, Brown M, Evans M, Anderson V, Lerch A, Brown A, Hunnell J, Porter N: Measuring substantial reductions in functioning in patients with chronic fatigue syndrome. Disabil Rehabil. 2011
34.
go back to reference Jenkinson C, Stewart-Brown S, Petersen S, Paice C: Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Community Health. 1999, 53: 46-50. 10.1136/jech.53.1.46.CrossRefPubMedPubMedCentral Jenkinson C, Stewart-Brown S, Petersen S, Paice C: Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Community Health. 1999, 53: 46-50. 10.1136/jech.53.1.46.CrossRefPubMedPubMedCentral
35.
go back to reference Make B, Jones JF: Impairment of patients with chronic fatigue syndrome. Journal of chronic fatigue syndrome. 1997, 3: 43-55.CrossRef Make B, Jones JF: Impairment of patients with chronic fatigue syndrome. Journal of chronic fatigue syndrome. 1997, 3: 43-55.CrossRef
36.
go back to reference Dimitrov M, Grafman J: Neuropsychological assessment of chronic fatigue syndrome. Journal of chronic fatigue syndrome. 1997, 3: 31-42. 10.1300/J092v03n04_05.CrossRef Dimitrov M, Grafman J: Neuropsychological assessment of chronic fatigue syndrome. Journal of chronic fatigue syndrome. 1997, 3: 31-42. 10.1300/J092v03n04_05.CrossRef
Metadata
Title
The functional status and well being of people with myalgic encephalomyelitis/chronic fatigue syndrome and their carers
Authors
Luis C Nacul
Eliana M Lacerda
Peter Campion
Derek Pheby
Maria de L Drachler
José C Leite
Fiona Poland
Amanda Howe
Shagufta Fayyaz
Mariam Molokhia
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-402

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