Longitudinal follow-up of employment status in patients with chronic fatigue syndrome after mononucleosis

BMJ Open. 2014 Nov 26;4(11):e005798. doi: 10.1136/bmjopen-2014-005798.

Abstract

Objective: To examine the effect of early clinical and demographic factors on occupational outcome, return to work or awarded permanent disability pension in young patients with chronic fatigue syndrome (CFS).

Design: Longitudinal cohort study.

Intervention: A written self-management programme including a description of active coping strategies for daily life was provided.

Setting, participants: Patients with CFS after mononucleosis were evaluated at Department of Neurology, Haukeland University Hospital during 1996-2006 (contact 1). In 2009 self-report questionnaires were sent to all patients (contact 2).

Primary and secondary outcome measures: Primary measure was employment status at contact 2. Secondary measures included clinical symptoms, and Fatigue Severity Scale (FSS) scores on both contacts, and Work and Social Adjustment Scale (WSAS) at contact 2.

Results: Of 111 patients at contact 1, 92 (83%) patients returned the questionnaire at contact 2. Mean disease duration at contact 1 was 4.7 years and at contact 2 11.4 years. At contact 1, 9 (10%) were part-time or full-time employed. At contact 2, 49 (55%) were part-time or full-time employed. Logical regression analysis showed that FSS≥5 at contact 2 was associated with depression, arthralgia and long disease duration (all at contact 1).

Conclusions: About half of younger patients with CFS with long-term incapacity for work experienced marked improvement including full-time or part-time employment showing better outcomes than expected. Risk factors for transition to permanent disability were depression, arthralgia and disease duration.

Keywords: OCCUPATIONAL & INDUSTRIAL MEDICINE.

MeSH terms

  • Activities of Daily Living
  • Adaptation, Psychological
  • Adult
  • Cohort Studies
  • Comorbidity
  • Disabled Persons / statistics & numerical data
  • Employment / statistics & numerical data*
  • Fatigue Syndrome, Chronic / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Infectious Mononucleosis / epidemiology*
  • Longitudinal Studies
  • Male
  • Norway / epidemiology
  • Return to Work / statistics & numerical data*
  • Risk Factors
  • Self Care / statistics & numerical data
  • Severity of Illness Index
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Young Adult