| Jan van Roijen 2004-11-15, 10:06 pm |
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15 November 2004
Editorship : j.van.roijen@chello.nl
Outgoing mail scanned by Norton AV
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Quotes:
from Dr. Jason's research team study
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"....only one symptom, post-exertional malaise,
was found to occur significantly more frequently
in the CFS group in comparison to the MDD
group....."
from Dr. E. Borst, President of the
"Commission CFS" of the Health Counsil of the Netherlands:
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"...ME patients can be cured by graded exercise....."
from Dr. Mette Marie Andersen:
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"......When I was reading this study, and thinking of
how some institutions still insist on
recommending graded exercise to patients with
CFS, I was reminded of the 1980's AIDS activism,
where activists at demonstrations in front of
government buildings shouted:
Shame on you !....."
~jvr
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Mette Marie Andersen <mma@DOKTOR.DK>
Via: CO-CURE@LISTSERV.NODAK.EDU
The importance of the King & Jason, 2004 paper
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Hello Folks.
One study among the many studies on CFS published by
Jason's research team in Chicago deserves attention.
The study has previously been announced on Co-Cure, but I
haven't seen it given the credit it deserves.
The size of the paper is 20 pages and I myself had a tough time
reading it (with my current cognitive difficulties). However, in the
standing debate over CFS criteria, graded exercise etc., I find it
very important to grap the conclusion of this study.
In short (very short) the authors say that the occurence of _one_
symptom among the 65 symptoms tested for is statistically
different, when it comes to distinguishing CFS from both major
depression (MDD) and controls, and that symptom is
post-exertional malaise. In other words, post-exertional malaise
is simply the clue, if an ultra-short definition of how CFS differs
from MDD and healthy controls is requested !
The study then proceeds with the interesting aspect of using
symptom severity score to improve the Fukuda et al., criteria, but
that's another story. I have selected the most important parts of
the paper below:
Improving the diagnostic criteria and procedures for chronic
fatigue syndrome Biological Psychology, Volume 68, Issue 2,
Feb 2005, Pp 87-106
Caroline King [a] and Leonard A. Jason [b]
The goal of the present study was to identify methods for
improving the diagnostic criteria for CFS. Three groups of 15
participants each were recruited: participants with (1) CFS, (2)
major depressive disorder (MDD), and (3) healthy controls.
Using statistical procedures, three methods for improving the
diagnostic criteria were explored: identification of new
diagnostic symptoms, the use of severity ratings for
symptomatology, and the identification of standardized
measures that differentiate cases of CFS from other conditions.
<snip>
Results
<snip>
When looking specifically at the occurrence of fatigue and the
eight symptoms of the current U.S. case definition, only one
symptom, post-exertional malaise, was found to occur
significantly more frequently in the CFS group in comparison to
the MDD group. When comparing the CFS and control group,
fatigue and all eight of the symptoms were found to occur
significantly more often in the CFS group. <snip>
Discussion
<snip>
The analyses examining differences in symptom occurrence of
fatigue and the eight symptoms of the current U.S. case
definition amongst individuals with CFS, MDD, and healthy
controls revealed several interesting findings. First, both the
CFS group and the MDD group reported significantly more
symptoms than the control group. Fatigue and all eight of the
symptoms were found to occur significantly more often in the
CFS group than control group and fatigue and four other
symptoms occurred significantly more in the MDD group than
control group. Second, only one symptom, post-exertional
malaise, was found to occur significantly more frequently in the
CFS group in comparison to the MDD group.
<snip>
In an effort to identify new symptoms that might help distinguish
CFS from other conditions, group differences were examined for
symptom occurrence and symptom severity using the remaining
57 symptoms from the physical, cognitive, and emotional
checklist.
When looking at symptom occurrence, the following 12
symptoms were found to occur more frequently in the CFS group
than either the MDD or control group:
muscle weakness, feeling unsteady on feet, need to focus on
one thing at a time, confusion/disorientation, difficulty finding the
right word, frequently losing train of thought, slowness of thought,
hot and cold spells, feeling like having a temperature, feeling
chilled/shivery, chest pain, and upset stomach.
However, when looking at symptom severity, only 10 symptoms
were found to occur more frequently in the CFS group than either
the MDD or control group:
muscle weakness, need to nap each day, frequently losing train
of thought, difficulty finding the right word,
confusion/disorientation, hot and cold spells, feeling
chilled/shivery, night sweats, shortness of breath, and blurred
vision.
PS
When I was reading this study, and thinking of how some
institutions still insist on recommending graded exercise to
patients with CFS, I was reminded of the 1980's AIDS activism,
where activists at demonstrations in front of government
buildings shouted: Shame on you !
Regards,
Mette Marie Andersen, MD CFS-Information International
www.cfids-cab.org/cfs-inform
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