The Development of the DePaul Symptom Questionnaire: Original, Expanded, Brief, and Pediatric Versions, 2018, Jason

Andy

Andy

Retired committee member
Abstract
One of the key requirements of a reliable case definition is the use of standardized procedures for assessing symptoms. This article chronicles the development of the DePaul Symptom Questionnaire (DSQ) to assess symptoms of the major chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) case definitions. The original questionnaire has been modified and expanded over time to more fully capture symptoms from various adult case definitions, and a brief as well as pediatric version have also been developed. The DSQ has demonstrated very good psychometric properties in terms of test-retest reliability and sensitivity/specificity, as well as construct, predictive, and discriminant validity. The DSQ allows for a clear characterization of a patient's illness and allows scientists and clinicians to improve diagnostic reliability and validity when employing case definitions of ME and CFS.
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Open access at https://www.frontiersin.org/articles/10.3389/fped.2018.00330/full
 
The DePaul Symptom Questionnaire for chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME)

It's another short descriptive post today as I bring the paper by Len Jason & Madison Sunnquist [1] to your attention charting "the development of the DePaul Symptom Questionnaire (DSQ) to assess symptoms of the major chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) case definitions."

I say this is a descriptive post because the Jason/Sunnquist paper provides some important technical details about the DSQ and its evolution; all from a research group who seem to be pretty clued into ME/CFS and its very wide range of clinical presentation (see here).

There are some important aspects included in the paper; not least a focus on the issue of post-exertional malaise (PEM), something which has been a real focus to these researchers (see here). The other very welcomed side to the Jason/Sunnquist paper are the various links to the DSQ derivatives all provided free of charge.
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https://questioning-answers.blogspot.com/2018/12/the-depaul-symptom-questionnaire-for-CFS-ME.html

by Paul Whitely

eta:
 
The development of a short form of the DePaul Symptom Questionnaire
2019 Jul 18
Abstract
PURPOSE/OBJECTIVE:
The DePaul Symptom Questionnaire (DSQ) is a widely used instrument that assesses common symptoms of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). The DSQ has strong psychometric properties; however, it consists of 99 items, and the energy limitations and cognitive difficulties experienced by individuals with ME and CFS may hinder their ability to easily complete the questionnaire.

METHOD:
The current study examined symptom prevalence and discriminative ability to develop a short form of the DSQ (DSQ-SF).

RESULTS:
The resulting short form questionnaire consists of 14 items that were highly prevalent among individuals with ME and CFS. Additionally, the items demonstrated the ability to differentiate individuals with ME and CFS from adult controls and, to a lesser extent, individuals with multiple sclerosis.

CONCLUSIONS/IMPLICATIONS:
The DSQ-SF may serve as an effective, brief screening tool for symptoms of ME and CFS. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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https://www.ncbi.nlm.nih.gov/pubmed/31318234
 
It's hard to tell from this abstract whether it includes any new information from what was in the 2018 paper at the top of this thread. That had a section about the SF DSQ and a link to the questions included in it.
The full paper isn't on sci-hub yet.
 
MSEsperanza said:
The DSQ-SF is freely available at REDCap's (34) shared library: https://redcap.is.depaul.edu/surveys/?s=HCT7J8EWPC

Seems to me still far from ideal. I like however that it's really short and simple.
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It covers many symptoms, though I feel it doesn't quite capture PEM for me. It needs to be able to capture things like delayed effects, prolonged recovery, etc.

Flu-like stuff is covered but sensory symptoms are reduced solely to chemical sensitivity and food intolerance, which I don't think quite gets to the heart of the matter.

I understand it has to be brief but next-day soreness and tiredness after minimal exercise don't seem specific enough to me when other things are left out. They could just be signs of being unfit or overdoing it.
 
adambeyoncelowe said:
I understand it has to be brief but next-day soreness and tiredness after minimal exercise don't seem specific enough to me when other things are left out. They could just be signs of being unfit or overdoing it.
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Soreness really doesn't work here. It's the right term for normal exercise reaction, this is different and it creates confusion with the deconditioning trope. "Next-day increase in symptoms" is probably closer to it. It's definitely lacking in sensory stimuli. Noise sensitivity is not the most disabling by itself but it severely limits normal activities because holy crap is the world LOUD all the damn time. Everywhere there's noise and more noise stacked on layers of constant noise.

Headaches should probably be a category of their own. Technically part of flu-like symptoms but it can have its own severity and it turns out headaches can have their own headache, anyway definitely more similar to the kinds of headache that come with the flu, rather than typical ones.

Not perfect. Still 10x better than any other questionnaire so far and 100x more than some of those commonly used in practice like the useless CFQ. I like the frequency-severity approach, this is the right way to do it.
 
MSEsperanza said:
The DSQ-SF is freely available at REDCap's (34) shared library: https://redcap.is.depaul.edu/surveys/?s=HCT7J8EWPC

Seems to me still far from ideal. I like however that it's really short and simple.
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My main concern is that they've left the effect of pacing out of the equation. Those not pushing themselves will report lower frequency and severity of symptoms which won't reflect how reduced their function really is. Whereas those pushing through will report feeling more awful more often even if they're actually less severe.

The questionnaire would possibly work very well as a way to track how successfully people are pacing. But for diagnostic purposes it needs some questions along the lines of "if you went for a half hour walk today, would you get a significant increase in symptoms tomorrow or the day after?", and repeating the same question with a few different types and levels of activity.
 
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