DePaul Symptom Questionnaire

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The DePaul Symptom Questionnaire (DSQ) is a self-report assessment created by Leonard Jason and the Chronic Fatigue Syndrome Project at DePaul University, Chicago, Illinois, US.

Developed in 2010 to operationalize the Canadian Consensus Criteria,[1] the DSQ provides clinicians and researchers concrete directives to assess ME/CFS-symptoms. With 54 questions in total, the DSQ assesses key symptoms of ME/CFS such as fatigue, post-exertional malaise, sleep, pain, neurological/cognitive impairments and autonomic, neuroendocrine and immune symptoms. At each item, participants have to rate the frequency and severity of the symptom on a scale from 0 to 4. The DSQ has shown good test-retest reliability[2] and internal consistency[3] and is available on redcap[4] for researchers to use.

In a Norwegian comparison with physician assessments, the DSQ scored a sensitivity of 92% and a specificity of 75%.[5] This indicated that the DSQ is a useful tool in detecting and screening symptoms, but that a follow-up medical examination is necessary to confirm the diagnosis and identify possible exclusionary medical and psychiatric disorders.

When tested against the Multidimensional Fatigue Inventory-20 and the RAND SF-36 Health Survey, the DePaul Symptom Questionnaire showed more reliability in consistently assessing for ME/CFS symptoms. The post-exertional malaise subscale was able to optimally differentiate between patients with ME/CFS and controls.[6]

In 2018 the Common Data Elements working group on PEM, formed by NINDS and the CDC, recommended the use of 5 items from the DSQ to screen patients for the presence of post-exertional malaise.[7] This decision has however been criticised by patients. A document formulated by the Science for ME PEM working group argued that the PEM subscale of the DSQ is too much focused on the feeling of fatigue and fails to adequately assess the delayed onset and prolonged recovery of PEM, as often reported by ME/CFS patients.[8]  In response to these concerns the DePaul research group has recently revised the DSQ PEM subscale to include 5 new items that can be used after the initial screening. An analysis showed that these supplementary questions (especially those asking about the duration of PEM) helped to differentiate ME/CFS patients from controls with MS or post-polio syndrome.[9]

In 2019, the questionnaire was revised and tested to improve its psychometric properties, increase its diagnostic reliability, and assess symptoms required by case definitions. The resulting instrument was named the DSQ-2.[10]

Studies[edit | edit source]

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  1. ↑ Brown, Abigail; Molly, Brown; Nicole, Porter; Meredyth, Evans; Jason, Leonard; Jessica, Hunnell; Valerie, Anderson; Lerch, Athena; De Meirleir, Kenny (April 1, 2010). "The Development of a Revised Canadian Myalgic Encephalomyelitis Chronic Fatigue Syndrome Case Definition". American Journal of Biochemistry and Biotechnology. 6. doi:10.3844/ajbbsp.2010.120.135.
  2. ↑ Jason, Leonard A.; So, Suzanna; Brown, Abigail A.; Sunnquist, Madison; Evans, Meredyth (January 1, 2015). "Test-Retest Reliability of the DePaul Symptom Questionnaire". Fatigue: Biomedicine, Health & Behavior. 3 (1): 16–32. doi:10.1080/21641846.2014.978110. ISSN 2164-1846. PMC 4788471. PMID 26973799.
  3. ↑ Brown, Abigail A.; Jason, Leonard A. (2014). "Validating a measure of myalgic encephalomyelitis/chronic fatigue syndrome symptomatology". Fatigue : biomedicine, health & behavior. 2 (3): 132–152. doi:10.1080/21641846.2014.928014. ISSN 2164-1846. PMC 4871625. PMID 27213118.
  4. ↑ "DePaul Symptom Questionnaire 2.0 (DSQ-2)". redcap.is.depaul.edu. Retrieved October 1, 2018.
  5. ↑ Strand, Elin B.; Lillestøl, Kristine; Jason, Leonard A.; Tveito, Kari; Diep, Lien My; Valla, Simen Strand; Sunnquist, Madison; Helland, Ingrid B.; Herder, Ingrid (January 2, 2016). "Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study". Fatigue: Biomedicine, Health & Behavior. 4 (1): 52–62. doi:10.1080/21641846.2015.1126026. ISSN 2164-1846.
  6. ↑ 6.0 6.1 Murdock, KW; Wang, XS; Shi, Q; Cleeland, CS; Fagundes, CP; Vernon, Suzanne D. (2016), "The utility of patient-reported outcome measures among patients with myalgic encephalomyelitis/chronic fatigue syndrome.", Quality of Life Research, doi:10.1007/s11136-016-1406-3, PMID 27600520
  7. ↑ https://www.commondataelements.ninds.nih.gov/Doc/MECFS/PEM_Subgroup_Summary.pdf
  8. ↑ "S4ME: Submission to the public review on Common Data Elements for ME/CFS: Concerns with the proposed measure of post-exertional malaise". Science for ME. Retrieved October 1, 2018.
  9. ↑ Cotler, Joseph; Holtzman, Carly; Dudun, Catherine; Jason, Leonard A. (September 11, 2018). "A Brief Questionnaire to Assess Post-Exertional Malaise". Diagnostics (Basel, Switzerland). 8 (3). doi:10.3390/diagnostics8030066. ISSN 2075-4418. PMID 30208578.
  10. ↑ Bedree, Helen; Sunnquist, Madison; Jason, Leonard A. (August 12, 2019). "The DePaul Symptom Questionnaire-2: a validation study". Fatigue: Biomedicine, Health & Behavior: 1–14. doi:10.1080/21641846.2019.1653471. ISSN 2164-1846.
  11. ↑ Brown, Abigail A.; Jason, Leonard A. (2014), "Validating a measure of myalgic encephalomyelitis/chronic fatigue syndrome symptomatology.", Fatigue: biomedicine, health & behavior, 2 (3): 132-152, doi:10.1080/21641846.2014.928014
  12. ↑ Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; Furst, Jacob; Cid, Marjoe; Farietta, Jillianna; Kot, Bobby; Bloomer, Craig; Nicholson, Laura; Williams, Yolonda; Jantke, Rachel; Newton, Julia L; Strand, Elin Bolle (2015), "Factor Analysis of the DePaul Symptom Questionnaire: Identifying Core Domains", Journal of Neurology and Neurobiology, 1 (4), doi:10.16966/2379-7150.114
  13. ↑ Jason, Leonard A.; So, Suzanna; Brown, Abigail A.; Sunnquist, Madison; Evans, Meredyth (January 1, 2015). "Test-Retest Reliability of the DePaul Symptom Questionnaire". Fatigue: Biomedicine, Health & Behavior. 3 (1): 16–32. doi:10.1080/21641846.2014.978110. ISSN 2164-1846. PMC 4788471. PMID 26973799.
  14. ↑ Strand, Elin B.; Lillestøl, Kristine; Jason, Leonard A.; Tveito, Kari; Diep, Lien My; Valla, Simen Strand; Sunnquist, Madison; Helland, Ingrid B.; Dammen, Toril (2016), "Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study.", Fatigue: Biomedicine, Health & Behavior, 4 (1): 52-62, doi:10.1080/21641846.2015.1126026
  15. ↑ Cotler, Joseph; Holtzman, Carly; Dudun, Catherine; Jason, Leonard A. (September 11, 2018). "A Brief Questionnaire to Assess Post-Exertional Malaise". Diagnostics. 8 (3): 66. doi:10.3390/diagnostics8030066.
  16. ↑ Jason, Leonard; Sunnquist, Madison. "The Development of the DePaul Symptom Questionnaire: Original, Expanded, Brief and Pediatric Versions". Frontiers in Pediatrics. doi:10.3389/fped.2018.00330.
  17. ↑ Bedree, Helen; Sunnquist, Madison; Jason, Leonard A. (August 12, 2019). "The DePaul Symptom Questionnaire-2: a validation study". Fatigue: Biomedicine, Health & Behavior: 1–14. doi:10.1080/21641846.2019.1653471. ISSN 2164-1846.

cognition Thought processes, including attention, reasoning, and memory.

relating to hormones that influence the nervous system[1]

neuroendocrine relating to hormones that influence the nervous system

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

See post-exertional malaise.

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

subjective outcome An outcome of a clinical trial that depends on the judgement or opinion of the assessor or patient, e.g. asking if fatigue has increased or decreased "a little" or "a lot", patient questionnaires like the Chalder Fatigue Scale, and other patient-reported outcome measures (PROMs).

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