AHMF: 98 Conference: McGregor

SCL-90-R Psychological Inventory Responses in Patients With CFS

NR McGregor, RH Dunstan, HL Butt [1], TK Roberts, IJ Klineberg, M Zerbes.

Collaborative Pain Research Unit:
Department of Biological Sciences
The University of Newcastle
Callaghan
NSW 2308, Australia.
Neurobiology Research Unit
Centre for Oral Health Research
University of Sydney
Westmead Hospital
Westmead
NSW 2084, Australia.
1 Division of Microbiology and Infectious Diseases
Hunter Area Pathology Service
John Hunter Hospital
Newcastle
NSW 2305, Australia.

A study of 20 chronic fatigue syndrome (CFS) patients and 45 age and sex matched control subjects assessed the psychological attributes of by using the Symptom Check List-90-revised (SCL-90-R) psychological inventory.

The CFS patients had increases in the SCL-90-R somatization, obsessive compulsive, depression, anxiety and phobic anxiety dimension scores. Nineteen of 20 CFS patients had somatization T-scores 363 (p &LT; 0.0001) suggestive of a somatization disorder. Multiple regression analysis indicated that somatization was the most important SCL-90-R-defined dimension discriminating CFS from control subjects. Depression and anxiety were not found to be important inter-group determinants. The dimension scores were each related to specific changes in the urinary excretion of organic and amino acids, suggesting that each dimension is biochemically distinct and has an organic basis.

Cluster analysis of dimension profiles revealed that several distinct clusters could be discerned on the basis of the SCL-90-R responses. The results of this analysis showed that the profile with increased prevalence (P &LT; 0.0001) in CFS patients was associated with increased excretion of CFSUM1 (P &LT; 0.005) and had increases in somatization, obsessive compulsion and depression dimension scores. CFSUM1 was the primary correlate for the somatization dimension (model &LT; 0.0008) but was not associated with any other SCL-90-R defined dimension.

Another unidentified urinary metabolite, coded UM15, was the primary correlate for depression (model P &LT; 0.0004), was associated with multiple dimension elevations by both cluster and logistic regression analysis, and the excretion of this compound was unrelated to CFSUM1. These results indicated that, in this CFS cohort, the SCL-90-R defined psychological changes were strongly associated with changes in the biochemical homeostasis of patients, suggestive of an organic basis to CFS.