Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T05:00:25.258Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case–control study

Published online by Cambridge University Press:  09 July 2009

H. Cope ,
A. Mann ,
A. Pelosi  and
A. David
H. Cope*
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. Mann
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. Pelosi
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. David
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
*
1Address for correspondence: Dr Helen Cope, Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

This study investigated psychosocial morbidity, coping styles and health locus of control in 64 cases with and without chronic fatigue identified from a cohort of primary care patients recruited 6 months previously with a presumed, clinically diagnosed viral illness. A significant association between chronic fatigue and psychosocial morbidity, somatic symptoms and escape-avoidance coping styles was shown. Chronic fatigue cases were significantly more likely to have a past psychiatric history and a current psychiatric diagnosis based on a standardized clinical interview. Twenty-three of the cases fulfilled criteria for chronic fatigue syndrome (CFS). Such cases were significantly more fatigued than those not fulfilling criteria, but had little excess psychiatric disorder. A principal components analysis provided some evidence for chronic fatigue being separable from general psychosocial morbidity but not from the tendency to have other somatic complaints. Past psychiatric history and psychological distress at the time of the viral illness were risk factors for psychiatric ‘caseness’ 6 months later, while presence of fatigue, psychologising attributional style and sick certification were significant risk factors for CFS. These findings extend a previous questionnaire study of predictors of chronic ‘post-viral’ fatigue.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 6 , November 1996 , pp. 1197 - 1209
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Blakely, A. A., Howard, R. C., Sosich, R. M., Murdoch, J. C., Menkes, D. B. & Spears, G. F. S. (1991). Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome. Psychological Medicine 21, 347–362.CrossRefGoogle ScholarPubMed
Bruce-Jones, W. D. A., White, P. D., Thomas, J. M. & Clare, A. W. (1994). The effect of social disadvantage on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever. Psychological Medicine 24, 651–659.CrossRefGoogle Scholar
Buchwald, D. & Garrity, D. (1994). Comparison of patients with chronic fatigue syndrome, fibromyalgia and multiple chemical sensitivities. Archives of Internal Medicine 154, 2049–2053.CrossRefGoogle ScholarPubMed
Butler, S., Chalder, T., Ron, R. & Wessely, S. (1991). Cognitive behaviour therapy in chronic fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry 54, 153–158.CrossRefGoogle ScholarPubMed
Cathébras, P. J., Robbins, J. M., Kirmayer, L. J. & Hayton, B. (1992). Fatigue in primary care: prevalence, psychiatric comorbidity, illness behaviour and outcome. Journal of General Internal Medicine 7, 276–286.CrossRefGoogle ScholarPubMed
Cope, H., David, A., Pelosi, A. & Mann, A. (1994 a). Predictors of chronic ‘post viral’ fatigue. Lancet 344, 864–868.CrossRefGoogle Scholar
Cope, H., David, A. & Mann, A. (1994 b). ‘Maybe it's a virus’: beliefs about viruses, symptom attributional style and psychological health. Journal of Psychosomatic Research 38, 89–98.CrossRefGoogle ScholarPubMed
David, A. S. (1991). The post viral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.CrossRefGoogle ScholarPubMed
David, A., Pelosi, A., McDonald, E. & Mann, A. (1990). Tired, weak or in need of rest: fatigue among general practice attenders. British Medical Journal 301, 1199–1202.CrossRefGoogle ScholarPubMed
Dryman, A. & Eaton, W. W. (1991). Affective symptoms associated with the onset of major depression in the community: findings from the US National Institute of Mental Health Epidemiological Catchment Area Programme. Acta Psychiatrica Scandinavica 84, 1–5.CrossRefGoogle Scholar
Folkman, S. & Lazarus, R. (1980). An analysis of coping in a middleaged community sample. Journal of Health and Social Behaviour 21, 219–239.CrossRefGoogle Scholar
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A. & Gruen, R. J. (1986). The dynamics of a stressful encounter: cognitive appraisal, coping and encounter outcomes. Journal of Personality and Social Psychology 48, 150–170.CrossRefGoogle Scholar
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G., Komaroff, A. and the International Chronic Fatigue Syndrome Study Group (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121, 953–959.CrossRefGoogle ScholarPubMed
Goldberg, D. P. & Huxley, P. (1991). Common Mental Disorders: A Biopsychosocial Model. Tavistock/Routledge: London.Google Scholar
Goldthorpe, J. H. & Hope, K. (1974). The Social Grading of Occupations. A New Approach and Scale. Clarendon Press: Oxford.Google Scholar
Hansen, V. & Jacobsen, B. K. (1989). Mental distress and social conditions and lifestyle in northern Norway. British Medical Journal 299, 85–88.CrossRefGoogle ScholarPubMed
Hickie, I., Lloyd, A., Wakefield, D. & Parker, G. (1990). The psychiatric status of patients with chronic fatigue syndrome. British Journal of Psychiatry 156, 534–540.CrossRefGoogle ScholarPubMed
Hickie, I., Lloyd, A., Hadzi-Pavlovic, D., Parker, G. & Wakefield, D. (1995). Can chronic fatigue syndrome be defined by distinct clinical features? Psychological Medicine 25, 925–935.CrossRefGoogle ScholarPubMed
Jenkins, R., Mann, A. H. & Belsey, E. (1981). The background, use and design of a short interview to assess social stress and support in research and clinical settings. Social Science and Medicine 15E, 195–203.Google Scholar
Katon, W. & Russo, J. (1992). Chronic fatigue syndrome criteria. A critique of the requirement for multiple physical complaints. Archives of Internal Medicine 152, 1604–1609.CrossRefGoogle ScholarPubMed
Katon, W. J., Buchwald, D. S., Simon, G. E., Russo, J. E. & Mease, P. J. (1991). Psychiatric illness in patients with chronic fatigue and rheumatoid arthritis. Journal of General Internal Medicine 6, 277–285.CrossRefGoogle Scholar
Kroenke, K., Wood, D. R., Mangelsdorff, A. D., Meier, N. & Powell, J. (1988). Chronic fatigue in primary care: prevalence, patient characteristics and outcome. Journal of the American Medical Association 260, 929–934.CrossRefGoogle Scholar
Lewis, G., Pelosi, A. J., Araya, R. & Dunn, G. (1992). Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychological Medicine 22, 465–486.CrossRefGoogle ScholarPubMed
Lewis, S., Cooper, C. L. & Bennett, D. (1994). Psychosocial factors and chronic fatigue syndrome. Psychological Medicine 24, 661–671.CrossRefGoogle ScholarPubMed
McDonald, E., David, A., Pelosi, A. & Mann, A. (1993). Chronic fatigue in general practice attenders. Psychological Medicine 23, 987–998.CrossRefGoogle Scholar
Manu, P., Matthews, D. & Lane, T. (1988). The mental health of patients with a chief complaint of fatigue: a prospective evaluation and follow-up. Archives of Internal Medicine 148, 2213–2217.CrossRefGoogle ScholarPubMed
Mumford, D. B., Bavington, J. T., Bhatnagar, K. S., Hussain, Y., Mirza, S. & Naraghi, M. M. (1991 a). The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent. British Journal of Psychiatry 158, 379–386.CrossRefGoogle ScholarPubMed
Mumford, D. B., Devereux, T. A., Maddy, P. J. & Johnston, J. V. (1991 b). Factors leading to the reporting of somatic symptoms by general practice attenders. British Journal of General Practice 41, 454–458.Google Scholar
Pawlikowska, T., Chalder, T., Hirsch, S. R., Wallace, P., Wright, D. J. M. & Wessely, S. C. (1994). A population based study of fatigue and psychological distress. British Medical Journal 308, 763–766.CrossRefGoogle ScholarPubMed
Philips, H. C. (1987). Avoidance behaviour and its role in sustaining chronic pain. Behavioural Research and Therapeutics 25, 273–279.CrossRefGoogle ScholarPubMed
Ray, C., Weir, W. R. C., Cullen, S. & Phillips, S. (1992). Illness perception and symptom components in chronic fatigue syndrome. Journal of Psychosomatic Research 36, 243–256.CrossRefGoogle ScholarPubMed
Ridsdale, L., Evans, A., Jerrett, W., Mandalia, S., Osler, K. & Vora, H. (1993). Patients with fatigue in general practice: a prospective study. British Medical Journal 307, 103–106.CrossRefGoogle ScholarPubMed
Robbins, J. M. & Kirmayer, L. J. (1991). Attributions of common somatic symptoms. Psychological Medicine 21, 1029–1045.CrossRefGoogle ScholarPubMed
Sharpe, M., Arhcard, L., Banatavala, J., Behan, P., Booth, R., Borysiewicz, L., Clare, A., Clifford, R. F., David, A., Edwards, R., Hawton, K., Lambert, H., Lane, R., Mann, A., McDonald, L., Mowbray, J., Pearson, D., Pelosi, A., Peters, T., Peto, T., Preedy, V., Smith, A., Smith, D., Taylor, D., Tyrell, D., Wallace, P., Warrell, D., Wessely, S., White, P., Wood, C. & Wright, D. (1991). Chronic fatigue syndrome: guidelines for research. Journal of the Royal Society Medicine 84, 118–121.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1970). STAI Manual for the State–Trait Anxiety Inventory. Consulting Psychologists Press: Palo Alto.Google Scholar
Walker, E. A., Katon, W. J. & Jemelka, R. P. (1993). Psychiatric disorders and medical care utilization among people in the general population who report fatigue. Journal of General Internal Medicine 8, 436–440.CrossRefGoogle ScholarPubMed
Ware, J., Sherbourne, C. & Davies, A. (1992). Developing and testing the MOS 20-Item Short-Form Health Survey: a general population application. In Measuring Functioning and Well-Being: The Medical Outcomes Study Approach (ed. Stewart, A. and Ware, J.), pp. 277–290. Duke University Press: Durham, NC.Google Scholar
Wallston, K. A., Wallston, B. S. & De Vellis, R. (1978). Development of the Multidimensional Health Locus of Control Scale. Health Education Monograph 6, 160–170.CrossRefGoogle Scholar
Wessely, S. & Powell, R. (1989). Fatigue syndromes: a comparison of chronic ‘post-viral’ fatigue with neuromuscular and affective disorders. Journal of Neurology, Neurosurgery and Psychiatry 52, 940–948.CrossRefGoogle Scholar
Wessely, S., Chalder, T., Hirsch, S., Pawlikowska, T., Wallace, P. & Wright, D. J. M. (1995). Postinfectious fatigue: a prospective cohort study in primary care. Lancet 345, 1333–1338.CrossRefGoogle ScholarPubMed
Wessely, S., Chalder, T., Hirsch, S., Wallace, P. & Wright, D. J. M. (1996 a). Psychological symptoms, somatic symptoms and psychiatric morbidity in chronic fatigue and chronic fatigue syndromeia prospective primary care study. American Journal of Psychiatry (in the press).Google Scholar
Wessely, S., Chalder, T., Hirsch, S., Wallace, P. & Wright, D. (1996 b). The epidemiology of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. American Journal of Public Health (in the press).CrossRefGoogle Scholar
White, P.Thomas, J., Amess, J., Grover, S., Kangro, H. & Clare, A. (1995). The existence of a fatigue syndrome after glandular fever. Psychological Medicine 25, 907–916.CrossRefGoogle ScholarPubMed
Wood, G. C., Bentall, R. P., Gopfert, M. & Edwards, R. H. T. (1991). A comparative psychiatric assessment of patients with chronic fatigue syndrome and muscle disease. Psychological Medicine 21, 619–628.CrossRefGoogle ScholarPubMed
World Health Organization (1978). Mental Disorders: Glossary and Guide to their Classification in Accordance with the 9th Revision of the International Classification of Diseases. World Health Organization: Geneva.Google Scholar