Estimating Chronic Fatigue Syndrome-Related Symptoms Among Nurses: A Preliminary Report

This is the first study to assess the prevalence of chronic fatigue syndrome (CFS)-related symptoms in a sample group of nurses. In the fall of l 991 a three-page questionnaire was sent to 3,400 nurses. Questions were based on definitions from the criteria described by Holmes et al. [1]. Stringent definitions were used to classify the nurses as having CFS-related symptoms. Exclusionary illnesses included hypothyroidism, diabetes, heart disease, and psychiatric disorders. Although it is possible that a number of medical and psychiatric conditions were being successfully treated or were a consequence of CFS, our questionnaire was not specific enough to assess these possibilities. Therefore, nurses with exclusionary medical or psychiatric problems were classified as not having CFS-related symptoms.

A total of 1,474 questionnaires were completed and returned, for a response rate of 43.4%. Two hundred two respondents (6%) checked an item indicating that they had experienced debilitating fatigue for >6 months. On the basis of self-reported information, 1 I nurses met two major criteria of Holmes et al. [I], (>50% reduction in level of daily activities, no exclusionary illnesses) and eight or more criteria for minor symptoms. While all 202 nurses indicated that they had experienced debilitating fatigue for at least 6 months, only 97 had >50% reduction in activity levels. Of those nurses, 39 had eight or more minor symptoms; however, 28 of those nurses had exclusionary medical or psychiatric disorders. In addition, 23 of the nurses reported that CFS had been diagnosed even though only one of these nurses met the criteria of Holmes et al. [1]. These findings must be interpreted with caution because there were no independent medical confirmations.

Nurses might be a high-risk group for CFS-related symptoms. Therefore, future studies might focus on identifying possible etiologic agents. In our ongoing follow-up study, we are reviewing data from standardized psychiatric interviews and the nurses’ medical files to diagnose CFS according to American, British, and Australian criteria.


l. Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a
working case definition. Ann Intern Med 1988; 108:387-9.
Reprints or correspondence: Dr. Leonard A. Jason, Department of Psychology, 2323 North Seminary Avenue, Chicago, Illinois 606 14.

Clinical Infectious Diseases 1994;18(Suppl 1):S54

Keywords: nurses cause agent prevalence jason