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Prognosis of Chronic Fatigue in a Community-Based Sample

From the Department of Psychology, DePaul University, Chicago, IL.

Address reprint requests to: Dr. Leonard Jason, Department of Psychology, DePaul University, 2219 North Kenmore Ave., Chicago, IL 60614. Email: ljason{at}wppost.depaul.edu

OBJECTIVE: This study examined predictors of fatigue severity and predictors of continued chronic fatigue status at wave 2 follow-up within a random, community-based sample of individuals previously evaluated in a wave 1 prevalence study of chronic fatigue and chronic fatigue syndrome that originally took place between 1995 and 1997.

METHODS: Wave 1 data were from a larger community-based prevalence study of chronic fatigue syndrome. In the present study, a second wave of data were collected by randomly selecting a sample of participants from the wave 1 sample of 18,675 adults and readministering a telephone screening questionnaire designed to assess symptoms of chronic fatigue syndrome.

RESULTS: Findings revealed that wave 1 fatigue severity was a predictor of fatigue severity at wave 2 in the overall sample of individuals with and without chronic fatigue. In the smaller sample of individuals with chronic fatigue, wave 1 fatigue severity, worsening of fatigue with physical exertion, and feeling worse for 24 hours or more after exercise significantly predicted continued chronic fatigue status (vs. improvement) at wave 2 follow-up.

CONCLUSIONS: These findings underscore the prognostic validity of postexertional malaise in predicting long-term chronic fatigue and also highlight the importance of using population-based, representative random samples when attempting to identify long-term predictors of chronic fatigue at follow-up.

Key Words: epidemiology, • chronic fatigue, • chronic fatigue syndrome, • prognosis, • follow-up.

Abbreviations: CF = chronic fatigue;; CFS = chronic fatigue syndrome;; GHQ = General Health Questionnaire;; ROC = receiver operating characteristic.

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