Do patients fake it?

Problems with memory, concentration, attention and information processing are frequent and disabling symptoms associated with ME/CFS. In fact, around 90% of 2,073 patients in one large study reported cognitive symptoms, which can be made worse by physical or mental exertion. However, there is a view that ME/CFS patients are actually fine – it’s just that they put in less effort than other people during neurocognitive testing at clinics and research labs, possibly to obtain state benefits. It’s an insulting suggestion, but can it be true?

In 2012, researchers at the University of Adelaide in Australia examined whether suboptimal effort was associated with cognitive deficits, using an instrument called the Validity Indicator Profile (VIP) which, intriguingly, can distinguish between intentional and unintentional poor performance. However, in the 54 ME/CFS patients examined (44% of whom were on benefits), VIP performance was classified as ‘valid’, indicating high levels of effort and an intention to perform well – findings very similar to those seen in healthy people from the community.

Importantly, the receipt of benefits or a disability pension was not associated with the effort put in by patients, undermining the suggestion that patients fake cognitive deficits for financial gain.

Reference: Test effort in persons with Chronic Fatigue Syndrome when assessed using the Validity Indicator Profile. Cockshell & Mathias. J Clin Exper Neuropsych 2012; 34(7): 679-87