Chapter Three, Course WB1032
Prognosis
Very few studies have attempted to follow the long-term course of CFS in defined populations outside of specialty referral clinics. A relapsing-remitting pattern and changes in symptoms, and their individual severity, is common (Nisenbaum et al., 2003). There is great individual variation in the course of illness, ranging from worsening symptoms to substantial recovery (Reyes et al., 1997) and many people experience improved function over time, allowing them to increase their work or other activities even though they continue to experience symptoms. Most data on prognosis comes from tertiary or specialty care centers, which generally see the sickest patients, and there is some suggestion that CFS patients cared for by primary care professionals have a better prognosis (Joyce, Hotopf and Wessely, 1997). Clinical research suggests that younger age at onset, shorter duration of illness, milder fatigue and absence of comorbid psychiatric illnesses lead to better prognosis (Afari and Buchwald, 2003; Joyce et al., 1997). Clinical experience suggesting that earlier diagnosis leads to better outcomes awaits formal testing (Nisenbaum et al., 2003). However, improvement is possible in any individual patient at any point in the course of the illness. More study is needed to understand predictors for recovery.
Content Source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)