Who gets better?

The outcomes of ME/CFS can vary considerably between people. While some research reports say that recovery is a real possibility for some people, others say that recovery is rare though significant improvements can occur in about 40%. But is there any way of predicting what will happen to a particular patient? Are there any characteristics that can identify who is more likely to improve quicker?

A team from New Jersey Medical School has attempted to find factors related to the outcome of the illness. The researchers examined 94 women with ME/CFS, assessed the severity of their symptoms and physical impairments, and documented the presence of other illnesses. Over the next 2½ years, these women were contacted every six months and asked about their quality of life, physical functioning, disability and symptom severity. Importantly, instead of relying on judgments of improvement, the researchers estimated the perceived change in physical functioning using the standardized SF36 questionnaire. Interestingly, two-thirds of the women reported significant improvements in their physical functioning over the follow-up period, although none could have been considered to have made a full recovery. These women also reported less work-related disability, less fatigue, lower levels of pain, fewer symptoms of depressed mood, and fewer non-specific physical symptoms. Unfortunately, there were no defining characteristics that distinguished these patients from the others who did not improve or who got progressively worse — there were no differences between the two groups in baseline physical functioning, severity of symptoms, or rate of concomitant illness.

One finding does seem important, however. The patients who had a diagnosis of fibromyalgia as well as ME/CFS were three times less likely to improve, and it may be that patients with the other source of pain characteristic of fibromyalgia fare worse than those without this extra burden to carry.

Reference: Illness trajectories in the chronic fatigue syndrome: a longitudinal study of improvers versus non-improvers. Ciccone DS et al. J Nerv Ment Dis 2010 Jul; 198(7): 486-93.

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