The physical severity of chronic fatigue syndrome varies. Most commonly, patients with CFS report that they have trouble fulfilling both home and work responsibilities.
Many CFS sufferers cannot work more than part-time. In unusual cases, patients are severely disabled and even bedridden. Such patients can do virtually nothing -- even light housework.
Patients with CFS are more likely to lose their jobs, possessions, and support from friends and family than are people who have other conditions that cause fatigue.
Most patients say that while fatigue is the most incapacitating symptom, mental impairment, such as an inability to concentrate or remember, is the most distressing symptom. The effects of CFS on mental functioning are complex. Some experts believe that the impaired mental functioning is due to depression, which is common in CFS patients. However, one study found that CFS patients have slower motor speed and reduced working memory than those without the condition, and these changes were independent of any psychological conditions or medication use.
Athough general intelligence is not impaired, CFS patients may test lower in certain mental functions, particularly speed and efficiency in processing complex information, and 40 - 60% have memory impairments. This impaired mental function occurs even if there is no depression or other psychiatric disorders.
Because the illness remains elusive and poorly defined, and there are few objective measures for recovery, experts have found it difficult to determine the long-term course of the disease. Many patients are not covered by insurance or have difficulty finding good care, so available statistics may be incorrect. Bearing these factors in mind, some studies have reported that more than half of patients who complain of chronic fatigue are still fatigued at 2 years. Although a variety of studies have attempted to identify factors that predict a more chronic or severe course, no clear conclusions can be made. Even if patients get progressively worse, however, the disorder is not fatal.
Although children with symptoms of chronic fatigue have not been as rigorously studied as adults, limited evidence suggests that CFS can be significantly disabling in young people. Studies report that adolescents who meet the criteria for CFS also have greater anxiety, depression, and school absenteeism than their peers. One study found that children with CFS have more difficulty than usual paying attention and remembering, which may explain why these kids have more trouble in school than their peers.
Still, some studies indicate that children have a better prognosis than adults and most will recover after 1 - 4 years. Several studies have indicated that cognitive-behavioral therapy is an effective treatment for adolescents with CFS.
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