The Reality Of C.F.S... Facts and Figures...

Since the start of this website... a support network has been established... which can and is a godsend for folks that are struggling at home.. with nowhere to turn.. I intend to do my best to help and support those who contact me....

Lately I have found through talking to others.... we all have one thing in common... "some sort of trauma which as happened in our life" and last night in particular, I had a lengthy conversation about this subject and I have received a lot of feedback from others in this particular position... especially when they are feeling very emotional.. and after trusts sets in.. they start to expand on there previous lifestyles... and low and behold... everyone has or is still struggling to come to terms with a previous trauma in whatever capacity... I would like to hear some feedback on this particular subject... so, after reading this.. it would be extremely helpful to add a comment to my guestbook

Case study

One girl in particular throughout her childhood... was beaten... and abused... at the age of 17 she decided to leave home.. and try to get her life back on track... but although she was now out of this equation... she was worried about her siblings.. so she reported the offender to the appropriate department.. she was strong minded and would not back down.. regardless... eventually the case was going to court.. but the offender was not brave enough to face conviction.. he committed suicide... she tried throughout the years to achieve a comfortable lifestyle... whilst she watched her siblings.. turn to drugs... she was a survivor... or so she thought... she now struggles with C.F.S.

Trauma.. so far, has became a combining factor for those who are struggling with C.F.S more so... when I was made aware of the following document...

This documentation is from an unknown origin

November 10, 2006 — Two separate population-based trials, both published in the November issue of the Archives of General Psychiatry, suggest that childhood trauma/stress and emotional instability are connected to adult development of chronic fatigue syndrome (CFS).

"The causes of CFS are unknown and effective prevention strategies remain elusive," write Christine Heim, PhD, from the Centers for Disease Control and Prevention (CDC), Emory University School of Medicine in Atlanta, Georgia, and colleagues. "A growing literature suggests that early adverse experience increases the risk for a range of negative health outcomes, including fatiguing illnesses. Identification of developmental risk factors for CFS is critical to inform pathophysiological research and devise targets for primary prevention."

This case-control study compared 43 cases with current CFS with 60 nonfatigued controls identified from a general population sample of 56,146 adult residents of Wichita, Kansas. Primary endpoints were self-reported childhood trauma (sexual, physical, and emotional abuse, and emotional and physical neglect) and psychopathology (depression, anxiety, and posttraumatic stress disorder).

Compared with controls, the CFS cases reported significantly higher levels of childhood trauma and psychopathology. Exposure to childhood trauma was associated with a 3- to 8-fold increased risk for CFS across different trauma types, and there was a graded relationship between the degree of trauma exposure and CFS risk. Childhood trauma was associated with greater severity of CFS symptoms, as well as with symptoms of depression, anxiety, and posttraumatic stress disorder. The presence of concurrent psychopathology increased the risk for CFS conveyed by childhood trauma.

"This study provides evidence of increased levels of multiple types of childhood trauma in a population-based sample of clinically confirmed CFS cases compared with nonfatigued controls," the authors write. "Our results suggest that childhood trauma is an important risk factor for CFS.... Studies scrutinizing the psychological and neurobiological mechanisms that translate childhood adversity into CFS risk may provide direct targets for the early prevention of CFS."

Study limitations include small sample size, the possibility that CFS cases with childhood trauma were more likely to participate in the survey than were CFS cases without childhood trauma or controls with childhood trauma, reliance on retrospective and uncorroborated self-reports of childhood experiences, focus on familial childhood trauma and not on occurrences outside the family or other types of events such as childhood illnesses, lack of differentiation between contact sexual abuse and noncontact harassment, and failure to consider effects of adulthood traumas and life stresses that might mediate the relationship between childhood adversity and CFS.

"Our observations lend support for the hypothesis that CFS represents a disorder of adaptation that is promoted by early environmental insults, leading to failure to compensate in response to challenge," the authors conclude. "Integrating our findings with results from developmental neuroscience emphasizes the need to revise prevailing dichotomous approaches that differentiate between psychological and biological contributors to CFS."

The Chronic Fatigue Syndrome Program of the US CDC conducted this study. The authors have disclosed no relevant financial relationships.

The second study, by Kenji Kato, PhD, from Karolinska Institutet in Stockholm, Sweden, and colleagues, prospectively evaluated the association of premorbid self-reported stress and personality with chronic fatigue–like illness.

Using the Swedish Twin Registry, the investigators conducted a prospective, nested case-control study in a population-based community sample of 19,192 twins born between January 1, 1935, and December 31, 1958. Computer-assisted telephone interviews conducted between 1998 and 2002 obtained information about current CFS-like illnesses. Using a questionnaire mailed in 1972-1973, the investigators evaluated self-reported stress, based on a single question, and personality scales of emotional instability and extraversion in the Eysenck Personality Inventory. They estimated relative risks with case-control analyses matched for age and sex, and co-twin control analyses comparing discordant pairs.

Matched case-control analyses revealed that higher emotional instability and self-reported stress in the premorbid period were associated with higher risk for chronic fatigue–like illness (odds ratios, 1.72 and 1.64, respectively). In co-twin control analyses, relative risk for emotional instability decreased to 1.02, but relative risk of stress increased dramatically to 5.81. Extraversion was not associated with fatigue.

"Elevated premorbid stress is a significant risk factor for chronic fatigue–like illness, the effect of which may be buffered by genetic influences," the authors write. "Emotional instability assessed 25 years earlier is associated with chronic fatigue through genetic mechanisms contributing to both personality style and expression of the disorder. These findings suggest plausible mechanisms for chronic fatiguing illness."

Study limitations include inability to distinguish between direct causality and confounding, cases diagnosed by telephone interviews without clinical assessment, possible recovery or recall bias, and stress measured only once based on a subjective self-report.

"Our findings suggest that although both stress and emotional instability are important, emotional instability has endogenous, moderating effects mediated by familial factors whereas stress has exogenous, direct effects on the occurrence of chronic fatigue," the authors conclude.

The National Institute of Neurological Disorders and Stroke, the Swedish Department of Higher Education, the Swedish Scientific Council, and AstraZeneca supported this study. The authors have disclosed no relevant financial relationships.

Arch Gen Psychiatry. 2006;63:1258-1266.

Learning Objectives for This Educational Activity

Upon completion of this activity, participants will be able to:

Clinical Context

In the December 15, 1994, issue of the Annals of Internal Medicine, CFS was defined by Fukuda and colleagues as at least 6 months of "unexplained persistent or relapsing fatigue" that significantly reduces activities, is unrelieved by rest, and is accompanied by 4 or more of the following 8 symptoms:

While the etiology of CFS is not clear, Afari and Buchwald's review in the February 2003 issue of the American Journal of Psychiatry noted risk factors for CFS, including female sex, genetics, personality traits, behavioral traits, and physical and emotional stressors. A study by Van Houdenhove and colleagues in the January-February 2001 issue of Psychosomatics reported CFS patients were more likely to have been abused during childhood.

Each point increase in Childhood Trauma Score led to 6% increased risk for CFS. Each increase in exposure type led to 77% increased risk for CFS.

Most effective subscales to differentiate between CFS and control groups were sexual abuse and emotional neglect.

Moderate to severe exposure to trauma was more common in CFS group vs control group (63% vs 37%; P = .009).

In CFS group, childhood trauma exposure subjects had more severe CFS as measured by the CDC Symptom Inventory scores.

Psychopathology was more common in CFS vs control groups.

Self-rating Depression Scale mean score was higher in CFS vs control groups (54.6 vs 37.6; P < .001), with more CFS patients having mild (35% vs 10%), moderate (30% vs 0%), and severe depression (5% vs 0%).

State Anxiety Inventory mean score was higher in CFS vs control groups (37.3 vs 26.6; P < .001), with more CFS patients having at least a 75th-percentile score indicating high anxiety (40% vs 2%; P < .001).

Davidson PTSD Scale mean total score was higher in CFS vs control groups (28.3 vs 5.4; P < .001) with likely PTSD greater in CFS vs control groups (29% vs 0%; P < .001).

Per Diagnostic Interview Schedule for DSM-IV results, anxiety disorders, including PTSD, were more common in CFS vs control groups currently (16% vs 2%; P = .009) and lifetime (30% vs 8%; P = .004); lifetime major depression diagnosis did not differ significantly.

Childhood Trauma Scores correlated with depression, anxiety, and PTSD symptom scores.

CFS risk due to childhood trauma exposure increased as level of psychopathology increased from low to high.

Study limitations included small sample size, use of self-reports, inclusion of limited types of trauma, and exclusion of adulthood trauma.

Pearls for Practice

Childhood trauma, including sexual abuse, physical abuse and neglect, and emotional abuse and neglect, is associated with a 3- to 8-fold increased risk for CFS in adults, with a greater degree of trauma exposure leading to greater CFS risk.

Risk for CFS associated with childhood trauma increases with greater depression, anxiety, and PTSD symptoms.

It makes sense doesn't it... well maybe... it's the missing link to understanding... C.F.S.. meanwhile.. we will still have to struggle amongst the negativity of realism of this condition... some of us are luckier than others... as in receiving help, appropriate benefits... etc... but there are many more.. who receive nothing... and are tired of fighting for what they should and are rightfully entitled to.. what we really need is recognition that we are not depressed... or hypochondriacs... and it's about time.. that we were treated accordingly...

My friend.. sent me a link to another site earlier... they have introduced a petition to be taken to the various departments.. to get C.F.S recognised for the reality of the condition...

The petition creator states that...

The latest DWP Guidelines and PACE are still directing the Health Service to treat ME sufferers with GET and CBT (a tool used for mental illnesses) despite the mounting evidence from a vast amount of research proving that ME is an organic not a psychosomatic disease and that the treatments forced onto those affected do in fact cause more harm than good and can worsen the condition of patients. Money should instead be invested in research into the physiologocal aetiology of ME/CFS and its treatment. Patients should not be forced into becoming psychiatric cases or lose their benefits.

So please visit... and register your support.. I have.. and so have many others... together we can make this work... well hopefully.... after all nothing ventured nothing gained...

Deadline to register: 22 January 2008

Hey... to date there are only two days left to register your support.. with the hope that we as sufferers will at least gain an ounce of recognition... with regards to our seemingly "invisible illness"

If you have not registered your support yet, please do... as the time element of hope is ticking away....