Uit opvolgingsonderzoek van dr. Julia Newton en kollega's blijkt dat:
- De mate van "vermoeidheid" sterk gerelateerd aan
de ernst van autonome symptomen/orthostatische klachten, depressie en angst.
- De "vermoeidheid" aan het begin van de dag groot is,
afneemt in de middag en weer toeneemt in de avond.
Fatigue severity remains stable over time and independently associated with orthostatic symptoms in chronic fatigue syndrome: a longitudinal study.
J Intern Med. 2010 Oct 20. doi: 10.1111/j.1365-2796.2010.02306.x.
Jones DE, Gray J, Frith J, Newton JL.
fatigue variability over time
in chronic fatigue syndrome (CFS) and
the effect of other symptoms on its predictability.
Longitudinal cohort study of patients with CFS (Fukuda criteria).
Specialist CFS clinical service
100 patients who participated in a study of CFS symptoms in 2005
were revisited in 2009.
25 patients completed fatigue diaries
to address intra- and inter-day variability in perceived fatigue.
Main outcome measures:
fatigue impact scale (FIS),
Epworth sleepiness scale (ESS),
orthostatic grading scale (OGS) and
hospital anxiety and depression scale (HADS).
Changes in variables represented the differences between 2005 and 2009.
subjects rated fatigue on a scale of 0 (no fatigue) to 10 (severe fatigue)
four times a day for 5 weeks.
Symptom assessment tools were available in both 2005 and 2009 for 74% of patients.
FIS and HADS depression (HAD-D) and anxiety (HAD-A) scores
significantly improved during follow-up
whereas ESS and OGS remained stable.
FIS improved in 29/74 (39%) subjects, and by ≥10 points in 19 (26%).
FIS worsened by ≥10 points in 33/74 (45%) subjects.
On multivariate analysis,
independent predictors of current fatigue (FIS in 2009) were
FIS in 2005, HAD-D in 2009, OGS in 2009 and change in HAD-A.
Reported fatigue was stable from week to week and from day to day.
Patients reported higher fatigue in the morning (mean ± SD; 6.4 ± 2),
becoming significantly lower at lunchtime (6.2 ± 2; P < 0.05) and
increasing again to 7 ± 2 at bedtime.
is independently associated with
current autonomic symptom burden, current depression and change in anxiety during follow-up.
These findings have implications for targeted symptom management in CFS.