Chapter Two, Course WB3151
Course of Illness
To date, there are no reliable predictors of the long-term course of CFS and no treatments or patient characteristics have been associated with full recovery. Most people with CFS report a pattern of relapse and remission and changes in the nature and severity of symptoms (Nisenbaum et al., 2003). The clinical course of illness ranges from substantial recovery to worsening symptoms (Reyes et al., 1997). Many patients experience improved function over time and are able to increase their work and other activities even though they continue to experience symptoms. Clinical research suggests that younger age at onset, shorter duration of illness, milder fatigue and absence of comorbid psychiatric illnesses lead to better prognoses (Afari and Buchwald, 2003; Joyce, Hotopf and Wessely, 1997). However, the timing of diagnosis, duration of illness, and initiation of therapy in relation to outcome of illness have not been studied prospectively (Nisenbaum et al., 2003). These variables may be important in view of the better prognosis seen for patients who are cared for by their primary care providers versus those subsequently seen in tertiary or specialty care centers (Joyce et al., 1997).
Content Source: National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)