Factor analysis of unexplained severe fatigue and interrelated symptoms - Overlap with criteria for chronic fatigue syndrome

The objective of this study was to identify factors explaining the correlations among unexplained severe fatigue of different durations (1-5 months or greater than or equal to 6 months) and symptoms reported as being significant health problems during a preceding 4-week period. Between June and December of 1994, a cross-sectional, random digit dialing telephone survey was conducted among residents of San Francisco, California. All subjects who reported having severe fatigue lasting for greater than or equal to 1 month and a random sample of nonfatigued subjects were asked to participate in a detailed telephone interview. Data from 1,510 individuals aged 18-60 years who did not have medical or psychiatric conditions that could explain their severe fatigue were analyzed. Common factor analyses identified three correlated factors (defined as "fatigue-mood-cognition" symptoms, "flu-type" symptoms, and "visual impairment") that explained the correlations among fatigue lasting for greater than or equal to 6 months and 14 interrelated symptoms. No factor explained the correlations among fatigue lasting for 1-5 months and other symptoms. The combination of fatigue of greater than or equal to 6 months' duration and selected symptoms overlaps with published criteria used to define cases of chronic fatigue syndrome (CFS). Although symptoms described in this study were reported as appearing within the preceding month, and CFS symptoms must have been present for the previous 6 months, these results provide empirical support for the interrelations among unexplained fatigue of greater than or equal to 6 months' duration and symptoms included in the CFS case definition.