What is chronic fatigue syndrome? Heterogeneity within an international multicentre study
What is chronic fatigue syndrome? Heterogeneity within an international multicentre study
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DOI：
10.1046/j.1440-1614.2001.00888.x
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发表时间：
2001-08-01
影响因子：
4.6
通讯作者：
Lloyd, A
中科院分区：
文献类型：
--
作者：
Wilson, A;Hickie, I;Lloyd, A
目的：我们试图比较八个国际中心的慢性疲劳 (CF) 和相关综合征患者的特征，并根据症状概况对这些受试者进行细分。然后根据临床数据测试子类的有效性。方法：临床诊断为 CF 的受试者填写了一份包含 119 项的自我报告问卷，以提供临床症状数据和其他信息，如病程和功能障碍。使用主成分分析和潜在特征分析 (LPA) 生成子类。结果：744 名受试者返回完整的数据集（平均年龄 40.8 岁，平均病程 7.9 年，女性与男性比例 3:1）。总体而言，受试者报告典型 CF 症状（疲劳、神经心理功能障碍、睡眠障碍）的比例很高。使用 LPA，生成了两个子类。第一类（68%样本）的特点是：年龄较小，男女比例较低；发作持续时间较短；病前、当前和家族性精神疾病发病率较低；并且，功能障碍较少。二级受试者（32%）的特征更符合躯体形式疾病。研究中心之间的亚类患病率存在显着差异（第二类范围为 6-48%）。结论：基于标准的 CF 及相关综合征的诊断方法并未选择同质的患者组。虽然患者的细分对于进一步的病因学和治疗研究至关重要，但分配此类亚类的基础仍然存在争议。
Objective: We sought to compare the characteristics of patients presenting with chronic fatigue (CF) and related syndromes in eight international centres and to subclassify these subjects based on symptom profiles. The validity of the subclasses was then tested against clinical data.Method: Subjects with a clinical diagnosis of CF completed a 119-item self-report questionnaire to provide clinical symptom data and other information such as illness course and functional impairment. Subclasses were generated using a principal components-like analysis followed by latent profile analysis (LPA).Results: 744 subjects returned complete data sets (mean age 40.8 years, mean length of illness 7.9 years, female to male ratio 3:1). Overall, the subjects had a high rate of reporting typical CF symptoms (fatigue, neuropsychological dysfunction, sleep disturbance). Using LPA, two subclasses were generated. Class one (68% sample) was characterized by: younger age, lower female to male ratio; shorter episode duration; less premorbid, current and familial psychiatric morbidity; and, less functional disability. Class two subjects (32%) had features more consistent with a somatoform illness. There was substantial variation in subclass prevalences between the study centres (Class two range 6-48%).Conclusions: Criteria-based approaches to the diagnosis of CF and related syndromes do not select a homogeneous patient group. While substratification of patients is essential for further aetiological and treatment research, the basis for allocating such subcategories remains controversial.