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Immunology/Psychiatry Chronic Fatigue Clinics Compared

People with chronic fatigue syndrome, regardless of aetiology, require psychosocial as well as physical management.

This is the conclusion of researchers in England following a comparison of chronic fatigue syndrome outpatients at two different fatigue clinics, one immunology-based and one psychiatry-based.

Psychological distress proved to be high and equal in both groups of these patients, report Dr P D White and colleagues from the Departments of Psychological Medicine and Immunology, Barts and the London, Queen Mary's School of Medicine and Dentistry, University of London, London.

Since such hospital clinics are run by various disciplines, this can cause problems both for doctors trying to refer people to the appropriate clinic and for researchers trying to generalise findings from one type of clinic to others.

These authors randomly selected 73 chronic fatigue syndrome outpatients for this study -- 37 from an immunology and 36 from a psychiatry fatigue clinic.

Participants were then compared on demographic factors, symptoms, disability, quality of life, psychological distress and illness attributions.

The patients from the two clinics were found to be closely similar: in specific symptoms, disability, quality of life, psychological distress and previous attendance to mental health professionals. Levels of psychological distress were equal and high in both groups.

The proportion of men was greater among those attending the immunology rather than the psychiatry clinic. Moreover, 64 percent of the immunology group attributed their fatigue to physical factors versus 31 percent of the psychiatry group.

The findings suggest research data from one type of chronic fatigue clinic can be generalised to others, suggest the authors.

Clinically similar patients are referred to different clinics, with the choice of clinic possibly influenced by the individual patient's beliefs about her or his illness.

Whatever the aetiology of the disorder, however, and whatever department the clinic operates within, the emotional distress in all of these patients underlines the need for their psychosocial as well as physical management, the authors conclude.
J R Soc Med 2002 Sep;95(9):440-4 "A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry."

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