Financial, Occupational, and Personal Consequences of Disability in Patients with Chronic Fatigue Syndrome and Fibromyalgia Compared to Other Fatiguing Conditions

NASSIM P. ASSEFI, TIMOTHY V. COY, DONALD USLAN, WAYNE R. SMITH, and DEDRA BUCHWALD

ABSTRACT.

Objective. To examine the nature and degree of self-reported disability in patients with chronic fatigue syndrome (CFS) and its associated conditions, fibromyalgia (FM) and subsyndromal fatigue (CF), compared with a chronically fatiguing but unrelated medical condition (MED).

Methods. Six hundred and thirty patients evaluated at the University of Washington Chronic Fatigue Clinic were sent questionnaires asking them to identify the financial, occupational, and personal consequences of their fatiguing illness. Thorough medical evaluations had previously applied accepted criteria for defining CFS, FM, and CF.

Results. The FM groups (those with and without CFS) were among the least employed. Likewise, the FM and CFS groups, more frequently than the other groups, endorsed loss of material possessions (such as car), loss of job, and loss of support by friends and family, as well as recreational activities as a result of their fatiguing illness. There were no reliable differences between groups in use of disability benefits.

Conclusion. There is substantial illness-related disability among those evaluated at a specialized chronic fatigue clinic. Those reporting the most pervasive disability met criteria for FM either alone or in conjunction with CFS. Employers and personal relations of patients with chronic fatigue should make a greater effort to accommodate the illness-related limitations of these conditions, especially for those with FM and CFS. (J Rheumatol 2003;30:804-8)

Key Indexing Terms:

FIBROMYALGIA
CHRONIC FATIGUE SYNDROME
CHRONIC FATIGUE
DISABILITY
FINANCIAL LOSSES
PERSONAL LOSSES

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From the Department of Medicine, University of Washington; Creekside Behavioral Health, Bellevue; the Chronic Fatigue Clinic, Harborview Medical Center; and Northwest Counseling Associates, Seattle, Washington, USA.

Supported in part by grants RO1 AI26788, RO1 AG08240, and U19 AI38429 from the National Institute of Allergy and Infectious Disease and the National Institute of Mental Health (Dr. Buchwald).

N.P. Assefi, MD, Acting Instructor of Medicine and OB/GYN, University of Washington; T. Coy, PhD, Psychologist, Creekside Behavioral Health, Bellevue; D. Uslan, MA, MBA, Rehabilitation and Mental Health Counselor, Northwest Counseling Associates; W.R. Smith, PhD, Clinical Assistant Professor of Psychiatry; D. Buchwald, MD, Professor of Medicine, University of Washington.

Address reprint requests to Dr. N. Assefi, Harborview Medical Center, 325 9th Avenue, Box 359780, Seattle, Washington 98104, USA. E-mail: nassefi@u.washington.edu

Submitted April 10, 2002; revision accepted September 23, 2002.

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