Prognosis

Long-Term Outlook in Adults

Because the illness remains elusive and poorly defined, and there are few objective measures for recovery, experts have found it difficult to determine the long-term course of the disease. Many patients are not covered by insurance or have difficulty finding good care, so available statistics may be incorrect. Bearing these factors in mind, some studies have reported that between 58 - 72% of patients who complain of chronic fatigue continue to experience it after a year. In one study, nearly 60% were still fatigued at 2 years. Even if patients get progressively worse, however, the disorder is not fatal.

Sudden or Gradual Onset. Some studies have observed that patients whose symptoms began abruptly following a severe viral illness recovered completely after 6 months to a year, whereas patients whose problems developed slowly and insidiously experienced symptoms for a longer period of time.

Severity of CFS. Many patients with moderate chronic fatigue have reported an increase in energy after a year or two. One small 1999 study observed that even after 4 years few patients with severe CFS had returned to their pre-illness state. It should be noted, however, that in another study, nearly all patients with severe CFS who were treated with a multidisciplinary rehabilitation program improved significantly and the gains were maintained for at least a year afterward.

Signs of Positive Outlook. According to one study, CFS patients who are more likely to experience improvement over time have the following positive signs:

• Can think clearly most of the time
• Have no other physical or emotional complaints beyond CFS symptoms
• Sleep well

Outlook in Children

Although children with symptoms of chronic fatigue have not been as rigorously studied as adults, limited evidence suggests that CFS can be significantly disabling in young people. Studies report that adolescents who meet the criterion for CFS also have greater anxiety, depression, and school absenteeism than their peers. Still, some studies indicate that children have a better prognosis than adults and that most will recover after 1 - 4 years. Several studies have indicated that cognitive-behavioral therapy is an effective treatment for adolescents with CFS.