Article Index

The actual severity of CFS

Most patients will describe the severity of their fatigue in CFS as being quite disabling.  However, it is possible to measure and even score the severity of fatigue in this illness and others by using an instrument, called the SF-36. It is a method that can assess patients, by applying a multidimensional health survey and specific health parameters, and then come up with scores—a demonstrable level of impairment within patient groups.

Dr. Komaroff reviewed a major study which demonstrated this technique (Komaroff A, et al, Amer J Med 101 (1996): 281)—see slide, SF36 Health Status Subscale Scores: CFS  vs. Comparison Groups)  by comparing the severity of illness among healthy individuals, patients with heart failure, depression, and CFS according to a number of illness variables. It should be noted that the study included a large number of patient subjects and healthy controls, and that the measurement instrument, SF-36, is considered one of the best for determining illness status.

A quick description of the results shows that the physical status of CFS and heart failure patients were nearly equal, much below that of healthy individuals and depressed patients. The bodily pain in CFS patients was the highest in all the groups. The health perception of the patients and their actual vitality and social function was the lowest of all the groups. And yet the mental health of CFS patients was substantially better than that of the depressed patient group.

How CFS hurts the economy

Dr. Komaroff discussed a U.S. Centers for Disease Control and Prevention (CDC) study that found, on average, a 37% decline among patients in ability to function in the household, and a 57% decline in function in the workforce. The estimated loss to the U.S. economy each year from the resulting productivity loss is $9.1 billion (and this does not count the cost of medical care for the illness.) This loss to the economy is greater than the bottom line of Wal-Mart, the biggest corporation in the world.

Is Chronic Fatigue Syndrome real?

Since CFS is still diagnosed primarily by its symptom complex—after elimination of other illnesses—a major question in the history of the illness has always been: is there objective evidence of pathological processes in the body that do not occur in healthy people, depressed people, or people with other illnesses? After 20 years of research, Dr. Komaroff answers unequivocally: “Yes.” He then asked the next question: “Do we understand how the symptoms are caused?” And he answered, “No, we don’t understand that yet.” Yet getting answers to the first question gets us nearer to answering the second question.