Disability and risk factors for unemployment in chronic fatigue syndrome: a comparison with multiple sclerosis

Aim: To compare disease impact on functioning in patients with chronic fatigue syndrome (CFS) and multiple sclerosis (MS). Methods: Fifty-four patients with CFS after giardiasis, 43 patients with moderate MS and 96 healthy controls were included. Comprehensive evaluation included the Fatigue Severity Scale (FSS), Short-Form Health Survey (SF-36), Hospital Anxiety and Depression Scale (HADS) and these neuropsychological tests: Paced Auditory Serial Addition Test (PASAT), Selective Reminding Test and Symbol Digit Modalities Test. Long-term sickness disability was also registered. Results: Eighteen CFS patients were partly employed and among MS patients eight were partly and six fully employed. CFS and MS patients scored worse on the FSS and all subscores of SF-36 than controls (all p < .05). CFS patients scored worse (all p < .01) than patients with MS on these measurers: FSS, vitality subscale of the SF-36 and the HADS, whereas MS patients scored worse (p < .01) than CFS patients on most neuropsychological tests. Long-term sickness disability in CFS was associated with short illness duration, and the SF-36 physical function and general health subscales, whereas long-term sickness disability in MS was associated with FSS, PASAT, Symbol Digit Modalities, and the SF-36 physic& function, bodily pain, role limitations due to physical problems, and social functioning subscales (all p <= .05). Conclusion: The main self-reported disabilities in CFS patients were associated with severe fatigue, low physical function and low social functioning, whereas disability in MS patients seems more multifactorial. Level of unemployment was higher in CFS patients compared to MS patients.