Research News
The latest information on research, treatment and diagnosis of CFIDS

Overlapping conditions studied
A study published in the January 24 issue of Archives of Internal Medicine looked at approximately 100 patients with chronic fatigue syndrome (CFS), fibromyalgia (FM), or temporomandibular joint disorder (TMJ) to determine whether they shared symptoms in common, or suffered from over-lapping conditions. Researchers relied on patients' self-reporting of whether they had been diagnosed with any of 10 other conditions, as well as physical exams.

The study found that individuals with CFS, FM or TMJ often suffer from other overlapping conditions that are not diagnosed, including interstitial cystitis and chronic tension-type headache. Irritable bowel syndrome in particular was underdiagnosed in all three groups (it was a missed diagnosis in 92% of the CFS patients).

The patients also shared a number of symptoms, including generalized pain sensitivity, sleep and concentration difficulties and gastrointestinal complaints. But the conditions also presented a number of distinguishing symptoms. Patients with CFS and FM had fatigue, joint aches and burning or shooting muscle pain while patients with TMJ did not. Unique symptoms for CFS included fever or sore throat; for FM, a more frequent history of low back pain.

Seasonal onset of CFS?
Two recent research papers have suggested that onset of CFS may be tied to particular times of the year. A small study published in January 2000 issue of the journal Chronobiology International looked at the dates when 69 patients whose onset was sudden (over a two-day period) became ill.

The onset dates were distinctly nonrandom---peaking from November through January and lowest from April through May. This supports the hypothesis that infectious illness may trigger the onset of CFS.

Similar findings were published in the March 2000 issue of the Journal of the Royal Society of Medicine. Researchers found that the majority of 50 British children with CFS developed the illness between September and December. Study authors speculate that because the children were on average 11 years old, the onset may coincide with the beginning of secondary school and an increased risk for stress and infection.

Impact of psychiatric history
If you think your physician is writing your medical complaints off to psychiatric problems, you might be right. A study published in the March 2000 issue of The Journal of General Internal Medicine shows doctors are less likely to suspect serious illness in patients with a history of depression or mental disorders.

Researchers at the University of Iowa mailed questionnaires presenting two hypothetical patient cases to 300 randomly selected family doctors and asked for their "recommendations." The cases involved sudden onset of severe headaches or abdominal pain. One group of doctors received no additional information about the patients, the other group was told the patients had a history of unexplained physical symptoms. Doctors who were told of the patients' histories were significantly less likely to think there might be a serious problem and order further tests.

Long-term symptom patterns
A study of 398 patients who have had CFS for more than 10 years has shown that those individuals report a larger number of specific cognitive problems that are greater in severity than those reported by individuals who were ill for a shorter period of time (less than seven years).

This was the first published study to describe a large sample of patients with a long duration of illness. Most of the long-term sufferers, who had been ill an average of 16 years, experienced onset at a young age and showed a higher percentage of infection with viral and immune-related illnesses, including allergies, chronic sinus infections, mononucleosis and hepatitis. The long-term patient group also reported higher rates of depression and fibromyalgia, which may further the level of impairment.

The study, published in the Journal of Psychosomatic Research (vol. 48, 2000: 59-68), was funded by The CFIDS Association of America.

Please keep in mind that research studies with less than 500 patients are generally not considered statistically valid and may be questioned by the medical community. The Chronicle reports on smaller studies due to the lack of large-scale research projects being funded and to keep you updated on emerging trends that may become the focus of larger studies later on.