Journal of Health Psychology, Vol. 8, No. 4, 459-464 (2003)

© 2003 SAGE Publications

Comparing Symptoms of Chronic Fatigue Syndrome in a Community-Based Versus Tertiary Care Sample

Leonard A. Jason

DePaul University, USA

Audrius V. Plioplys

Mercy Hospital and Medical Center, USA

Susan Torres-Harding

Karina Corradi

DePaul University, USA

Chronic Fatigue Syndrome (CFS) is a debilitating condition characterized by six or more months of prolonged or relapsing, unexplained fatigue of new or definite onset and at least four of eight associated somatic and cognitive symptoms. Almost all studies of samples with patients with CFS have relied on referrals from physicians or health facilities. Underserved minorities, who not only tend to manifest higher levels of chronic illness, but are also less likely to seek and receive adequate medical care, have not been adequately represented in these studies. The present study compared two groups of individuals with CFS, one from a communitybased sample and another from a tertiary-based sample. Findings indicate that patients with CFS from tertiary care settings have a higher frequency of symptoms than those in the general population who have CFS.


Key Words: CFS • community-based • epidemiology • symptoms • tertiary


  • Buchwald, D., Umali, P., Umali, J., Kith, P., Pearlman, T., & Komaroff, A. L. (1995). Chronic fatigue and Chronic Fatigue Syndrome: Prevalence in a Pacific northwest health care system . Annals of Internal Medicine, 123, 81–88 .[Abstract/Free Full Text]
  • Davis, R. (1995). Racial differences in mortality: Current trends and perspectives. In G. E. Thomas (Ed.), Race and ethnicity in America: Meeting the challenge in the 21st century(pp. 115–126). Washington, DC: Taylor & Francis .
  • Denz-Penhey, H., & Murdoch, J. C. (1993). Service delivery for people with Chronic Fatigue Syndrome: A pilot action research study . Family Practice, 10(1), 14–18 .[Abstract]
  • Dutton, D. B. (1986). Social class, health and illness. In L. Aiken & D. Mechanic (Eds.), Applications of social science to clinical medicine, and health policy(pp. 31–62). New Brunswick, NJ: Rutgers University Press .
  • Euba, R., Chalder, T., Deale, A., & Wessely, S. (1996). A comparison of the characteristics of Chronic Fatigue Syndrome in primary and tertiary care . British Journal of Psychiatry, 168, 121–126 .[Abstract]
  • Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C.,Dobbins, J. G., & Komaroff, A. (1994). The Chronic Fatigue Syndrome: A comprehensive approach to its definition and study . Annals of Internal Medicine, 121, 953–959 .[Abstract/Free Full Text]
  • Gunn, W. J., Connell, D. B., & Randall, B. (1993). Epidemiology of Chronic Fatigue Syndrome: The Centers-for-Disease-Control study. In B. R. Bock & J. Whelan (Eds.), Chronic Fatigue Syndrome(pp. 83–101). New York: John Wiley & Sons .
  • Jason, L. A., Richman, J. A., Rademaker, A. W., Jordan, K. M., Plioplys, A. V, Taylor, R. et al. (1999). A community-based study of Chronic Fatigue Syndrome . Archives of Internal Medicine, 159, 2129–2137 .[Abstract/Free Full Text]
  • Jason, L. A., Taylor, R., Wagner, L., Holden, J., Ferrari, J. R., Plioplys, A. V. et al. (1995). Estimating rates of Chronic Fatigue Syndrome from a community based sample: A pilot study . American Journal of Community Psychology, 23, 557–568 .[ISI][Medline] [Order article via Infotrieve]
  • Jason, L. A., Wagner, L., Rosenthal, S., Goodlatte, J., Lipkin, D., Papernik, M. et al. (1998). Estimating the prevalence of Chronic Fatigue Syndrome among nurses . American Journal of Medicine, 105(3A), 91S–93S .[CrossRef][Medline] [Order article via Infotrieve]
  • Mechanic, D. (1983). The experience and expression of distress: The study of illness behavior and medical utilization. In D. Mechanic (Ed.), Handbook of health care and the health professions(pp. 591–607). New York: Free Press .
  • Reyes, M., Gary, H. E. Jr, Dobbins, J. G., Randall, B., Steele, L., Fukuda, K. et al. (1997). Surveillance for Chronic Fatigue Syndrome—four US cities, September, 1989 through August, 1993 . Morbidity and Mortality Weekly Report Surveillance Summaries, 46, 1–13 .
  • Reyes, M., Nisenbaum, R., Stewart, G., & Reeves, W. C. (1998). Update: Wichita population-based study of fatiguing illnesses . In L. A. Jason & W. Reeves (Chairpersons), New insights into the epidemiology of CFS. Symposium presented at the American Association for Chronic Fatigue Syndrome Conference, Cambridge, MA, October.
  • Richardson, A. D., & Piepho, R. W. (2000). Effect of race on hypertension and antihypertensive therapy . International Journal of Clinical Pharmacology Therapy, 38, 75–79 .
  • Richman, J. A., Flaherty, J. A., & Rospenda, K. M. (1994). Chronic Fatigue Syndrome: Have flawed assumptions derived from treatment-based studies? American Journal of Public Health, 84, 282–284 .[Abstract]
  • Wessely, S., Chalder, T., Hirsch, S., Wallace, P., & Wright, D. (1996). Psychological symptoms, somatic symptoms, and psychiatric disorder in chronic fatigue and Chronic Fatigue Syndrome: A prospective study in the primary care setting . American Journal of Psychiatry, 153, 1050–1059 .[Abstract]
  • Wessely, S., Chalder, T., Hirsch, S., Wallace, P, & Wright, D. (1997). The prevalence and morbidity of chronic fatigue and Chronic Fatigue Syndrome: A prospective primary care study . American Journal of Public Health, 87, 1449–1455 .[Abstract]