Journal of IiME Volume 2 Issue 2 www.investinme.org Family Illnesses Among People with ME/CFS: Blood Versus Non-Blood Relatives (continued) rheumatoid factor and antinuclear antibody), hepatitis B, Lyme disease screen, HIV screen and urinalysis. A tuberculin skin test was also performed. If the TB skin test was positive, a follow-up chest x-ray was conducted to rule out tuberculosis. The project physician performed a detailed medical examination to detect evidence of diffuse adenopathy, hepatosplenomegaly, synovitis, neuropathy, myopathy, cardiac or pulmonary dysfunction. This medical examination was used to confirm the diagnosis of ME/CFS, according to the Fukuda et al. (1994) criteria and to rule out exclusionary medical conditions. Family history of illness: Family history of medical illness was obtained from self report data completed by participants. Participants were asked: "have any of your relatives been diagnosed with the following medical conditions?” Medical conditions included diabetes, Lupus, Multiple Sclerosis, Fibromyalgia, and ME/CFS. The participants were asked to report on these conditions for both blood (i.e., biological mother, father, grandparents, sibling, children, other) and non-blood relatives (i.e., spouse, stepparent/primary care giver, adopted children and other). Seventeen possible blood relatives include: mother, father, daughter, son, brother, sister, aunt, uncle, grand father, grand mother, great grand father, great grand mother, great aunt, great uncle, nephew, niece, and cousin. Seventeen possible non-blood relatives include: spouse, mother in-law, father in-law, adoptive mother, adoptive father, adopted son, adopted daughter, step-mother, step-father, stepdaughter, step-son, step-brother, step-sister, sister in-law, brother in-law, grand father inlaw, and grand mother in-law. We computed the number of participants reporting a family history of each illness. Statistical Analyses The occurrence of each medical illness (i.e., diabetes, lupus, Fibromyalgia, Multiple Invest in ME (Charity Nr. 1114035) Sclerosis, and CFS) between the bloodrelated family members and non-bloodrelated family members of these participants with ME/CFS was examined with McNemar tests. The effect size was computed using a procedure described by Green and Salkind (2003) for the McNemar Test. The difference in the proportions of participants who fell into the two family relative types was computed for each illness to obtain the effect size index. Cohen’s (1988) guidelines for interpreting effect size; 0.01 = small effect, 0.06 = moderate effect and 0.14 = large effect, was used to estimate the strength of the effect sizes. Results The McNemar analyses indicated significant higher percentages of diabetes, Lupus, Fibromyalgia and ME/CFS among blood than non-blood relatives (see Table 1). Of the total of 114 participants, 42.1% (N = 48) reported that they had blood-related family members who had diabetes, whereas 4.4% (N = 5) reported having non-blood family members with diabetes ( p < .01 with an effect size index of 0.38). A person could have more than one family member of non-family member with diabetes, and for the blood relatives, there were a total of 75 cases of diabetes, whereas there were a total of only 5 cases for non-blood relatives. Among the 48 individuals with ME/CFS who had a blood relative with diabetes, 15 (31.3%) indicated that they had 2 or more blood relatives with diabetes (none of the non-blood relatives had 2 or more relatives). Most cases of diabetes occurred for parents (especially the father), with fewer cases among siblings, and with only one report of a child with diabetes. Among the 114 participants who had diagnosed ME/CFS, one reported having diabetes and two reported having borderline diabetes. The individual with diabetes had a mother with diabetes, but the two participants who reported borderline (continued on page 8) Page 7/74

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