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Prognosis for myalgic encephalomyelitis and chronic fatigue syndrome
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=== Illness duration === Although many physicians believe that patients would benefit from earlier diagnosis and treatment, evidence for this is currently lacking.<ref>[https://kce.fgov.be/sites/default/files/atoms/files/d20081027358.pdf Stordeur S, Thiry N, Eyssen M. Chronisch Vermoeidheidssyndroom: diagnose, behandeling en zorgorganisatie. Health Services Research (HSR). Brussel: Federaal Kenniscentrum voor de Gezondheidszorg (KCE); 2008. KCE reports 88A (D/2008/10.273/58).]</ref> Studies have generally been inconsistent regarding the duration of illness as a predictor of outcome. (see table below). {| class="wikitable" | colspan="2" |<small>Does duration of illness impact prognosis?</small> |- |<small>Yes</small> |<small>No</small> |- |<small>Vercoulen et al., 1996.<ref name="Vercoulen1996" /></small> |<small>Wilson et al., 1994.<ref name="Wilson1994" /></small> |- |<small>Ray et al., 1997.<ref name="Ray1997" /></small> |<small>Bombardier et al., 1995.<ref name="Bombardier1995" /></small> |- |<small>Reyes et al., 1999.<ref name="Reyes1999" /></small> |<small>Pheley et al., 1999.<ref name="Pheley1999" /></small> |- |<small>Nisenbaum et al., 2003.<ref name="Nisenbaum2003" /></small> |<small>Hill et al., 1999.<ref name="Hill1999" /></small> |- |<small>Nyland et al., 2014.<ref name="Nyland2014" /></small> |<small>Anderson et al., 2004.<ref name="Andersen2004" /></small> |} The CDC information website has been criticized for suggesting early intervention leads to better outcomes. In a detailed critique [[Jaime Seltzer]] from #[[The MEAction Network|MEAction]] wrote: <blockquote>"Anyone who has gone undiagnosed for years or even decades understands that an accurate diagnosis and useful management strategies — such as avoiding overactivity and providing symptomatic relief — can improve quality of life. But there is no evidence that early intervention affects the likelihood of full recovery. When the CDC has been so cautious regarding what it recommends as treatment, this assertion, which is insupportable with current evidence, stands out."<ref name=":0" /></blockquote>[[Fred Friedberg|Friedberg]] et al. compared ME/CFS patients with a median length of illness of 18 years compared to a group of ME/CFS-patients who had been ill for less than three years. Few differences existed between the two groups; although those with long illness duration had more [[Cognitive dysfunction|cognitive difficulties]] (they also reported more sexual problems).<ref name="Friedberg2000">{{Cite journal | last = Friedberg | first = F. | last2 = Dechene | first2 = L. | last3 = McKenzie | first3 = M. J. | last4 = Fontanetta | first4 = R. | date = Jan 2000 | title = Symptom patterns in long-duration chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/10750631|journal=Journal of Psychosomatic Research|volume=48|issue=1 | pages = 59–68|issn=0022-3999|pmid=10750631}}</ref> In a study by [Santamarina-Perez et al. (2011), no association was found between illness duration and neuropsychological test results.<ref>{{Cite journal | last = Santamarina-Perez | first = Pilar | last2 = Eiroa-Orosa | first2 = Francisco Jose | last3 = Freniche | first3 = Verónica | last4 = Moreno-Mayos | first4 = Aurea | last5 = Alegre | first5 = José | last6 = Saez | first6 = Naia | last7 = Jacas | first7 = Carlos| date = Jul 2011 | title = Length of illness does not predict cognitive dysfunction in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/21846221|journal=Applied Neuropsychology|volume=18|issue=3|pages=216–222|doi=10.1080/09084282.2011.595448|issn=1532-4826|pmid=21846221}}</ref> [[Mady Hornig|Hornig]] et al. did find a distinct an increase in [[cytokine]] expression in the plasma of ME/CFS patients with illness duration less than three years, an increase that was not present in patients with longer illness duration.<ref>{{Cite journal | last = Hornig | first = Mady | last2 = Montoya | first2 = José G. | last3 = Klimas | first3 = Nancy G. | last4 = Levine | first4 = Susan | last5 = Felsenstein | first5 = Donna | last6 = Bateman | first6 = Lucinda | last7 = Peterson | first7 = Daniel L. | last8 = Gottschalk | first8 = C. Gunnar | last9 = Schultz | first9 = Andrew F. | date = 2015-02-01 | title = Distinct plasma immune signatures in ME/CFS are present early in the course of illness|url=http://advances.sciencemag.org/content/1/1/e1400121|journal=Science Advances|language=en|volume=1|issue=1| pages = e1400121|doi=10.1126/sciadv.1400121|issn=2375-2548}}</ref>
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