Chronic fatigue syndrome in military veterans with chronic pain: an investigation into prevalence, sociodemographic characteristics, psychiatric comorbidities, and healthcare usage

Chronic fatigue syndrome (CFS) is a debilitating condition. Although pain symptoms are not needed for diagnosis, CFS patients commonly report chronic pain (CP). CFS and CP are associated with increases in psychological conditions and healthcare usage. But it is unclear if there is an increased risk if someone has both conditions. Veterans experience relatively high rates of CFS and CP and may be an at-risk population for having both conditions. The current study examined how many VHA using Veterans with CP also have CFS, compared demographics of those with CP to those with CP+CFS, and compared the likelihood of having a psychological condition and likelihood of using CP-related healthcare among VHA users with CP+CFS, fibromyalgia or orofacial pain, using VA medical record information.

15,248 VHA users with CP also had CFS. VHA users with CP+CFS were younger, more female, White, and rural-dwelling, but the strength of these differences was small. VHA users with CP+CFS were more likely to have depression but were no more likely to have anxiety or PTSD, than fibromyalgia or orofacial pain. VHA users with CP+CFS were less likely to use pain care or mental health care than fibromyalgia, but more likely to use these services compared to orofacial pain. The findings indicate that VHA using Veterans with CP+CFS may not be that different demographically than VHA users with CP without CFS. As Veterans who use VHA with CP+CFS had low rates of specialty services (pain and mental health care), they may be underutilizing these VHA services. An important next step may be to investigate reasons for low usage rates.