Authors
Slobodan Sekulić1, Anđelija Petrović2, Tatjana Redžek-Mudrinić3, Ivana Peričin-Starčević3, Modra Murovska4
1Klinika za Neurologiju, Klinički Centar Vojvodine, Medicinski Fakultet Novi Sad, Novi Sad, Srbija
2Medicinski Fakultet Novi Sad, Novi Sad, Srbija
3Klinika za Pedijatriju, Institut za Zdravstvenu Zaštitu Dece i Omladine Vojvodine, Medicinski Fakultet Novi Sad, Novi Sad, Srbija
4August Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Latvia
The paper was received on 20.04.2017 / Accepted on. 25.05.2017.
Correspondence to
Slobodan Sekulić,
Klinički Centar Vojvodine, Klinika za Neurologiju,
Medicinski Fakultet
21000 Novi Sad, Hajduk Veljkova 1-7,
e-mail: nadlak@yahoo.com
e-mail: slobodan.sekulic@mf.uns.ac.rs
telefon 0643886715
Abstract
Chronic Fatigue Syndrome (CGS) is a complex medical entity with a severe acquired fatigue of unknown cause as a hallmark. Fatigue is continually present for at least 6 months with various degree of disability. Published data about prevalence in general population of the USA varies between 0.007% and 2.8%. Incidence of CFS in general population is 180 per 100 000 persons. This syndrome represents significant socioeconomic burden for patients, their families and community. Direct costs are related to diagnostic program and medical treatment. Indirect costs are caused by: decreased working productivity, sick leave, and increased use of the social care. The annual total value of lost productivity in the United States was $9.1 billion, which represents about $20,000 per person with CFS. In Great Britain with population of 65 million, estimated annual losses because of decreased productivity caused by CFS could be as high as 102.2 million pounds. Data about incidence of patients with the CFS as well as socioeconomic impact in Republic of Serbia are missing. Joining to COST Action “CA15111 - European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” Republic of Serbia will alleviate access to the basic medical knowledge as well as clinical praxis related to the CFS. Introducing protocol as a tool for making diagnosis of CFS will provide data about incidence of CFS. Identification of the patients with CFS, establishing national database, will allow access of the patients to clinical research centers in Europe with final goal of proper therapy.
Key words:
Chronic fatigue syndrome, myalgic encephalomyelitis, consequence, Serbia
Sažetak
Sindrom hroničnog zamora (SHZ) je kompleksni medicinski entitet čije je glavno obeležje izražena stečena slabost nepoznate etiologije, a koja je prisutna najmanje 6 meseci u kontinuitatu i limitira funkcionalni kapacitet pacijenta i uzrokuje različit stepen njegovog onesposobljavanja. Publikovani podaci ukazuju da prevalenca SHZ u opštoj populaciji u SAD varira u zavisnosti od studije do studije i iznosi od 0.007% do 2.8%. Incidenca (SHZ) je oko 180 slučajeva na 100 000 stanovnika ili 0.18%. Ovaj sindrom predstavlja značajan uzrok socioekonomskog opterećenja za obolele osobe, njihovu familiju kao i društvenu zajednicu. Direktni troškovi bolesti se odnose na medicinske radnje koje su deo dijagnostičkog programa i lečenja. Indirektni materijalni troškovi su posledica: 1. smanjene produktivnosti, 2. odsustva zbog bolovanja, 3. zavisnosti od socijalne pomoći. Procenjeni ukupni godišnji troškovi nastali usled ovog sindroma u USA su 9.1 milijarda dolara ili 20 000 dolara po jednom pacijentu obolelom od CFS. Procenjuje se da je u Velikoj Britaniji koja ima 65 miliona stanovnika godišnji gubitak zbog neproduktivnosti usled odsustvovanja sa posla osoba obolelih od SHZ 102.2 miliona funti. Podaci o incidence obolelih i socio-ekonomskom značaju SHZ u Republici Srbiji nedostaju. Pridruživanje Republike Srbije COST Akciji "CA15111 - European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome” će omogućiti transfer znanja i kliničke prakse iz zemalja Evropske Unije u odnosu na ovo oboljenje. Uvođenje protokola za postavljanje dijagnoze CFS će omogućiti utvrđivanje njegove incidence. Prepoznavanje SHZ, formiranje nacionalnog registra pacijenata bi omogućilo pacijentima pristup najsavremenijim dijagnostičkim i istraživačkim centrima Evrope sa ciljem odgovarajuće terapije.
Ključne reči:
Sindrom hroničnog umora, mijalgički encefalomijelitis, posledice, Srbija.
References
- Ostojic S, Stojanovic M, Drid P, Hoffman JR, Sekulic D, Zenic N. Supplementation with guanidinoacetic acid in women with chronic fatigue syndrome. Nutritiens 2016;8(2):72
- Beard, G. "Neurasthenia, or nervous exhaustion". Boston Med Surg J 1869:217–221.
- Americanitis-Blood Pressure and Nerves-By William S. Sadler, M.D., F.A.C.S. New York: The Macmillan Company, 1925. 176 pp.
- Afari N, Buchwald D; Buchwald. "Chronic fatigue syndrome: a review". Am J Psychiatry. 2003;160(2):221–36.
- Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, Jones JF, Dubois RE, Cunningham-Rundles C, Pahwa S; Kaplan; Gantz; Komaroff; Schonberger; Straus; Jones; Dubois; Cunningham-Rundles; Pahwa (1988). "Chronic fatigue syndrome: a working case definition". Ann Intern Med. 108 (3): 387–9.
- Dansie EJ, Furberg H, Afari N, Buchwald D, Edwards K, Goldberg J, Schur E, Sullivan PF.
- Conditions comorbid with chronic fatigue in a population-based sample. Psychosomat 2012;53(1):44-50.
- Devanur LD, Kerr JR. Chronic fatigue syndrome: a review. J Clin Virol 2006;37:139-150.
- Cleare JA. The neuroendocrinology of chronic fatigue syndrome. Endocr Rev 2003;24(2):236-252.
- Prins BJ, Jos WM. Chronic fatigue syndrome: a review. Lancet 2006;367:346-355.
- Wayne RS, Noonan C, Buchwald D. Mortalitzz in a cohort of chronically fatigued patients. Phychol Med 2006;36:1301-1306.
- Roberts E, Wessely S, Chalder T, Chang CK, Hotopf M. Mortality of people with chronic fatigue syndrome: a retrospective cohort study in England and Wales from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) Register. Lancet. 2016;387(10028):1638-43.
- McManimen SL, Devendorf AR, Brown AA, Moore BC, Moore JH, Jason LA. Mortality in Patients with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. Fatigue. 2016;4(4):195-207.
- Joyce J, Hotopf M, Wessely S. The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review. QJM 1997;90:223–33.
- Naviaux RK, Naviaux JC, Li K, Bright AT, Alaynick WA, Wang L, Baxter A, Nathan N, Anderson W, Gordon E. Metabolic features of chronic fatigue syndrome. Proc Natl Acad Sci U S A. 2016;113(37):E5472-80.
- Kato K, Sullivan PF, Evengård B, Pedersen NL. Premorbid predictors of chronic fatigue.
- Arch Gen Psychiatry. 2006;63(11):1267-72.
- Bassi N, Amital D, Amital H, Doria A, Shoenfeld Y. Chronic fatigue syndrome: characteristics and possible causes for its pathogenesis. Isr Med Assoc J. 2008;10(1):79-82.
- Reeves WC, Wagner D, Nisenbaum R, Jones JF, Gurbaxani B, Solomon L, Papanicolaou DA, Unger ER, Vernon SD, Heim C. Chronic fatigue syndrome--a clinically empirical approach to its definition and study. BMC Med. 2005;3:19.
- Reid S, Chalder T, Cleare A, Hotopf M, Weseli S. Chronic fatigue syndrome. BMJ 2000;320: 292-296.
- Bradley LA, McKendree-Smith NL, Alarcón GS; McKendree-Smith; Alarcón GS. Pain complaints in patients with fibromyalgia versus chronic fatigue syndrome. Curr Rev Pain 2000;4(2):148–57.
- Ngian GS, Guymer EK, Littlejohn GO. The use of opioids in fibromyalgia. Int J Rheum Dis. 2011;14(1):6–11.
- de Waal MW, Arnold IA, Eekhof JA, van Hemert AM: Somatoform disorders in general practice: prevalence, functional impairment and comorbidity with anxiety and depressive disorders. Br J Psychiatry 2004;184:470–476.
- Fink P, Sorensen L, Engberg M, Holm M,Munk-Jorgensen P: Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Psychosomat 1999;40:330–338.
- Toft T, Fink P, Oernboel E, Christensen K, Frostholm L, Olesen F: Mental disorders in primary care: prevalence and co-morbidity among disorders. Results from the functional illness in primary care (FIP) study. Psychol Med 2005;35:1175–1184.
- Brimmer DJ, Fridinger F, Lin JM, Reeves WC. U.S. healthcare providers’ knowledge, attitudes, beliefs, and perceptions concerning chronic fatigue syndrome. BMC Fam Pract. 2010;11:28
- Solomon L, Reeves WC. Factors influencing the diagnosis of chronic fatigue syndrome. Arch Intern Med. 2004;164(20):2241-2245.
- Afari N, Buchwald D. Chronic fatigue syndrome: a review. Am J Psychiatry. 2003;160(2):221-236
- Reyes M, Gary HE Jr, Dobbins JG, et al. Surveillance for chronic fatigue syndrome—four U.S. cities, September 1989 through August 1993. MMWR CDC Surveill Summ. 1997;46(2):1-13.
- Lawrie SM, Pelosi AJ. Chronic fatigue syndrome in the community: prevalence and associations. Br J Psychiatry 1995;166(6):793-797.
- Steele L, Dobbins JG, Fukuda K, et al. The epidemiology of chronic fatigue in San Francisco Am J Med. 1998;105(3A):83S- 90S.
- Jason LA, Richman JA, Rademaker AW, et al. A communitybased study of chronic fatigue syndrome. Arch Intern Med 1999;159(18):2129-2137.
- Wessely S, Chalder T, Hirsch S, Wallace P, Wright D. The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. Am J Public Health 1997;87(9):1449-1455.
- Reyes M, Nisenbaum R, Hoaglin DC, et al. Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Arch Intern Med 2003;163(13):1530-1536.
- Reynolds KJ, Vernon, SD, Bouchery E, Reeves, WC. The economic impact of chronic fatigue syndrome. Cost Effectiveness and Resource Allocation, 2004;2:4–13.
- Smith GR Jr, Monson RA, Ray DC. Psychiatric consultation in somatization disorder. A randomized controlled study. N Engl J Med 1986;314: 1407–1413.
- Labott SM, Preisman RC, Popovich J Jr, Iannuzzi MC. Health care utilization of somatizing patients in a pulmonary subspecialty clinic. Psychosomatics 1995;36: 122–128.
- Barsky AJ, Ettner SL, Horsky J, Bates DW. Resource utilization of patients with hypochondriacal health anxiety and somatization. Med Care 2001;39:705–715.
- Barsky AJ, Orav EJ, Bates DW. Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Arch Gen Psychiatry 2005; 62: 903–910.
- Konnopka A, Schaefert R, Heinrich S, Kaufmann C, Luppa M, Herzog W, König HH.
- Economics of medically unexplained symptoms: a systematic review of the literature. Psychother Psychosom. 2012;81(5):265-75.
- Chandran A, Schaefer C, Ryan K, Baik R, McNett M, Zlateva G. The comparative economic burden of mild, moderate, and severe fibromyalgia: results from a retrospective chart review and cross-sectional survey of working-age U.S. adults. J Manag Care Pharm 2012;18: 415-26.
- Fjorback LO, Carstensen T, Arendt M, Ornbol E, Walach H, Rehfeld E et al. Mindfulness therapy for somatization disorder and functional somatic syndromes: analysis of economic consequences alongside a randomized trial. J Psychosom Res 2013;74:41-8.
- Rask MT, Rosendal M, Fenger-Gron M, Bro F, Ornbol E, Fink P. Sick leave and work disability in primary care patients with recent-onset multiple medically unexplained symptoms and persistent somatoform disorders: a 10-year follow-up of the FIP study. Gen Hosp Psychiatry 2015;37:53-9.
- Hunter M. Chronic fatigue syndrome could be costing UK economy pound 100m a year, study says. BMJ. 2011;343:d5905.
- Missen A, Hollingworth W, Eaton N, Crawley E. The financial and psychological impacts on mothers of children with chronic fatigue syndrome (CFS/ME). Child Care Health Dev 2012;38(4):505-12.
- Rawley EM, Emond AM, Sterne JAC. Unidentified Chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics. Bmj Open 2011;1:e000252.
- Rangel L, Garralda ME, Levin M, et al. The course of severe chronic fatigue syndrome in childhood. J R Soc Med 2000;93:129–34.
- Garralda ME, Rangel L. Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders. J Child Psychol Psychiatry 2004;45:543–52.
- Missen A, Hollingworth W, Eaton N, et al. The financial and psychological impacts on mothers of children with chronic fatigue syndrome (CFS/ME). Child Care Health Dev 2012;38:505–12.
- Vincent A, Brimmer DJ, Whipple MO, Jones JF, Boneva R, Lahr BD, Maloney E, St Sauver JL, Reeves WC. Prevalence, incidence, and classification of chronic fatigue syndrome in Olmsted County, Minnesota, as estimated using the Rochester Epidemiology Project. Mayo Clin Proc. 2012;87(12):1145-52.
UDK: 616.891.4(497.11)
COBISS.SR-ID 239025164
PDF Sekulić S. et al. MD-Medical Data 2017;9(2): 075-079