Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T15:13:16.593Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological functioning, illness perception, mood and quality of life in chronic fatigue syndrome, autoimmune thyroid disease and healthy participants

Published online by Cambridge University Press:  15 January 2009

A. Dickson ,
A. Toft  and
R. E. O'Carroll
A. Dickson*
Affiliation:
School of Health and Social Sciences, Napier University, Edinburgh, UK
A. Toft
Affiliation:
Department of Endocrinology, Royal Infirmary of Edinburgh, Edinburgh, UK
R. E. O'Carroll
Affiliation:
Department of Psychology, University of Stirling, Stirling, UK
*
*Address for correspondence: Dr A. Dickson, School of Health and Social Sciences, Napier University, Edinburgh EH10 5LG, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This study attempted to longitudinally investigate neuropsychological function, illness representations, self-esteem, mood and quality of life (QoL) in individuals with chronic fatigue syndrome (CFS) and compared them with both healthy participants and a clinical comparison group of individuals with autoimmune thyroid disease (AITD).

Method

Neuropsychological evaluation was administered at two time points, five weeks apart. Twenty-one individuals with CFS, 20 individuals with AITD and 21 healthy participants were matched for age, pre-morbid intelligence, education level and socio-economic status (SES). All groups also completed measures of illness perceptions, mood, self-esteem and QoL at both time points.

Results

The CFS group showed significantly greater impairment on measures of immediate and delayed memory, attention and visuo-constructional ability, and reported significantly higher levels of anxiety and depression. After controlling for the effects of mood, the CFS group still demonstrated significant impairment in attention. The CFS group also reported significantly lower self-reported QoL than the AITD and healthy participants. In terms of illness perceptions, the AITD group believed that their condition would last longer, that they had more treatment control over their condition, and reported less concern than the CFS group.

Conclusions

These results suggest that the primary cognitive impairment in CFS is attention and that this is not secondary to affective status. The lower treatment control perceptions and greater illness concerns that CFS patients report may be causally related to their affective status.

Keywords

Attentioncognitive impairmentdepressionillness perceptionmemoryquality of life
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 9 , September 2009 , pp. 1567 - 1576
Copyright
Copyright © 2009 Cambridge University Press

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

Abbey, SE, Garfinkel, PE (1990). Chronic fatigue syndrome and the psychiatrist. Canadian Journal of Psychiatry 35, 625–626.Google Scholar
Anderson, JJ, Ferrans, CE (1997). The quality of life of persons with chronic fatigue syndrome. Journal of Nervous Mental Disorders 185, 359–365.Google Scholar
Ax, S, Gregg, V, Jones, D (2001). Coping and illness cognitions: chronic fatigue syndrome. Clinical Psychology Review 21, 161–182.CrossRefGoogle ScholarPubMed
Broadbent, E, Petrie, KJ, Main, J, Weinman, J (2006). The Brief Illness Perception Questionnaire. Journal of Psychosomatic Research 60, 631–637.Google Scholar
Busichio, K, Tiersky, LA, DeLuca, J, Natelson, BH (2004). Neuropsychological deficits in patients with chronic fatigue syndrome. Journal of the International Neuropsychological Society 10, 278–285.Google Scholar
Campion, P, Bertie, C, Chalder, T, Cox, D, Fleming, C, Lant, A, MacIntyre, A, Moore, M, Patterson, D, Pearson, V, Pheby, D, Sweeney, N, Skyes, R, Weir, W; The National Task Force on CFS/ME (1998). NHS Services for People with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Westcare: Bristol.Google Scholar
Chalder, T, Deale, A, Wessely, S (1999). Management of chronic fatigue syndrome. In Difficult Clinical Problems in Psychiatry (ed.Lader, M. and Naber, D.), pp. 135–153. Martin Dunitz: London.Google Scholar
Chaudhuri, A, Behan, PO (2004). Fatigue in neurological disorders. Lancet 363, 978–988.Google Scholar
Christodoulou, C, DeLuca, J, Lange, G, Johnson, SK, Sisto, SA, Korn, L, Natelson, BH (1998). Relation between neuropsychological impairment and functional disability in patients with chronic fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry 64, 431–434.Google Scholar
Cooper, L (1997). Myalgic encephalomyelitis and the medical encounters. Sociology of Health and Illness 90, 17–37.Google Scholar
Cope, H, Mann, A, Pelosi, A, David, A (1996). Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case-control study. Psychological Medicine 26, 1197–1209.Google Scholar
Cope, H, Pernet, A, Kendall, B, David, A (1995). Cognitive functioning and magnetic resonance imaging in chronic fatigue. British Journal of Psychiatry 167, 593–597.Google Scholar
David, AS (1991). The post-viral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.CrossRefGoogle ScholarPubMed
DeLuca, J (1995). Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis and depression. Journal of Neurology, Neurosurgery and Psychiatry 28, 38–43.CrossRefGoogle Scholar
DeLuca, J, Christodoulou, C, Diamond, BJ, Rosenstein, ED, Kramer, N, Natelson, BH (2004). Working memory deficits in chronic fatigue syndrome: differentiating between speed and accuracy of information processing. Journal of the International Neuropsychological Society 10, 101–109.CrossRefGoogle ScholarPubMed
DeLuca, J, Johnson, SK, Beldowicz, D, Natelson, BH (1995). Neuropsychological impairment in chronic fatigue syndrome, multiple sclerosis and depression. Journal of Neurology, Neurosurgery and Psychiatry 56, 684–689.Google Scholar
Dickson, A, Knussen, C, Flowers, P (2007). Stigma and the delegitimation experience: an interpretative phenomenological analysis of people living with chronic fatigue syndrome. Psychology and Health 22, 851–867.Google Scholar
Edwards, R, Suresh, R, Lynch, S, Clarkson, P, Stanley, P (2001). Illness perceptions and mood in chronic fatigue syndrome. Journal of Psychosomatic Research 50, 65–68.Google Scholar
Fukuda, K, Straus, S, Hickie, I, Sharpe, M, Dobbins, J, Komaroff, A (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121, 953–959.Google Scholar
Grafman, J, Schwatz, V, Dale, JK, Scheffers, M, Houser, C, Straus, SE (1993). Analysis of neuropsychological functioning in patients with chronic fatigue syndrome. Journal of Neurology, Neurosurgery and Psychiatry 56, 684–689.Google Scholar
Hardt, J, Buschwald, D, Wilks, D, Sharpe, M, Nix, WA, Egle, UT (2001). Health-related quality of life in patients with chronic fatigue syndrome: an international study. Journal of Psychosomatic Research 51, 431–434.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.Google Scholar
Johnson, SK, DeLuca, J, Diamond, BJ, Natelson, BH (1998). Memory dysfunctioning in fatiguing illness: examining interference and distraction in short-term memory. Cognitive Neuropsychiatry 3, 269–285.CrossRefGoogle Scholar
Johnson, SK, DeLuca, J, Natelson, BH (1996). Depression in fatiguing illness: comparing patients with chronic fatigue syndrome, multiple sclerosis and depression. Journal of Affective Disorders 39, 21–30.Google Scholar
Katon, WJ, Buchwald, DS, Simon, GE, Russo, JE, Mease, PJ (1991). Psychiatric illness in patients with chronic fatigue and those with rheumatoid arthritis. Journal of General Internal Medicine 6, 277–285.Google Scholar
Komaroff, AL (1993). Clinical presentation of chronic fatigue syndrome. Ciba Foundation Symposium 173, 43–61.Google Scholar
Komaroff, AL, Buchwald, D (1991). Symptoms and signs of chronic fatigue syndrome. Revised Infectious Diseases 13, S8–S11.Google Scholar
Krupp, LB, Sliwinski, M, Masur, DM, Friedberg, F, Coyle, PK (1994). Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis. Archives of Neurology 51, 705–710.CrossRefGoogle ScholarPubMed
Lange, G, Steffener, J, Cook, DB, Bly, BM, Christodoulou, C, Liu, WC, DeLuca, J, Natelson, BH (2005). Objective evidence of cognitive complaints in chronic fatigue syndrome: a BOLD fMRI study of verbal working memory. Neuroimage 26, 513–524.Google Scholar
Leventhal, H, Nerenz, D, Steele, DJ (1989). Illness representations and coping with health threats. In Handbook of Psychology and Health (ed.Baum, A., Taylor, S. E. and Singer, J. E.), pp. 219–252. Erlbaum: Hillsdale, NJ.Google Scholar
MacDonald, KL, Osterholm, MT, LeDell, C, Persing, DH, Johnson, RC, Barker, JM, Peterson, PK (1996). A case-control study to assess possible triggers and co-factors in chronic fatigue syndrome. American Journal of Medicine 100, 548–554.CrossRefGoogle Scholar
Manu, P, Lane, TJ, Matthews, DA (1998). Somatization disorder in patients with chronic fatigue. Psychosomatics 30, 388–395.CrossRefGoogle Scholar
Marshall, PS, Forstot, M, Callies, A, Peterson, PK, Schenck, CH (1997). Cognitive slowing and working memory difficulties in chronic fatigue syndrome. Psychosomatic Medicine 59, 58–66.Google Scholar
McDonald, E, Cope, H, David, A (1993). Cognitive impairment in patients with chronic fatigue syndrome: a preliminary study. Journal of Neurology, Neurosurgery and Psychiatry 56, 812–815.Google Scholar
Michiels, V, de Gucht, V, Cludyts, R, Fischler, B (1999). Attention and information processing efficiency in patients with chronic fatigue syndrome. Journal of Clinical and Experimental Neuropsychology 21, 709–729.Google Scholar
Moss-Morris, R, Chalder, T (2003). Illness perceptions and levels of disability in patients with chronic fatigue syndrome and rheumatoid arthritis. Journal of Psychosomatic Research 22, 305–308.Google Scholar
Moss-Morris, R, Petrie, K (2001). Discriminating between chronic fatigue syndrome and depression: a cognitive analysis. Psychological Medicine 31, 469–479.Google Scholar
Moss-Morris, R, Petrie, KJ, Large, RG, Kydd, RR (1996). Neuropsychological deficits in chronic fatigue syndrome: artifact or reality? Journal of Neurology, Neurosurgery and Psychiatry 60, 474–477.Google Scholar
Parsons, T (1951). The Social System. The Free Press: New York.Google Scholar
Pepper, C, Krupp, L, Friedberg, F, Doscher, C, Coyle, P (1993). A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis and major depression. Journal of Neuropsychiatry and Clinical Neurosciences 5, 200–205.Google Scholar
Petrie, K, Moss-Morris, R, Weinman, J (1995). The impact of catastrophic beliefs on functioning in chronic fatigue syndrome. Journal of Psychosomatic Research 39, 31–37.Google Scholar
Pheby, D (1999). An Overview of the Recent Research Literature. Discussion document prepared for the Working Group on Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. University of the West of England: Bristol.Google Scholar
Rakib, A, White, PD, Pinching, AJ, Hedge, B, Newbery, N, Fakhoury, WK, Priebe, S (2005). Subjective quality of life in patients with chronic fatigue syndrome. Quality of Life Research 14, 11–19.CrossRefGoogle ScholarPubMed
Randolph, C (2002). Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The Psychological Corporation: New York.Google Scholar
Ray, C, Jefferies, S, Weir, WRC (1997). Coping and other predictors of outcome in chronic fatigue syndrome: a 1-year follow-up. Journal of Psychosomatic Research 43, 405–417.Google Scholar
Ray, C, Philips, L, Weir, WRC (1993). Quality of attention in chronic fatigue syndrome: subjective reports of everyday attention and cognitive difficulty and performance on tasks of focussed attention. British Journal of Clinical Psychology 32, 357–364.Google Scholar
Ray, C, Weir, WRC, Cullen, S, Phillips, S (1992). Illness perception and symptom components in chronic fatigue syndrome. Journal of Psychosomatic Research 36, 243–256.Google Scholar
Richman, JA, Jason, LA, Taylor, RR, Hahn, SC (2002). Feminist perspectives on the social construction of illness states. Health Care for Women International 22, 173–185.Google Scholar
Rosenberg, M (1989). Society and the Adolescent Self-Image, revised edition. Wesleyan University Press: Middletown, CT.Google Scholar
Ross, S, Fantie, B, Straus, SF, Grafman, J (2001). Divided attention deficits in patients with chronic fatigue syndrome. Applied Neuropsychology 8, 4–11.Google Scholar
Ruta, D, Garratt, A, Leng, M, Russell, I, McDonald, L (1994). A new approach to the measurement of quality of life: the Patient Generated Index. Medical Care 32, 1109–1126.Google Scholar
Sandman, CA, Barron, JL, Nackoul, K, Goldstein, J, Fidler, F (1993). Memory deficits associated with chronic fatigue immune dysfunction syndrome. Biological Psychiatry 33, 618–623.CrossRefGoogle ScholarPubMed
Schweitzer, R, Kelly, B, Foran, A, Terry, D, Whiting, J (1995). Quality of life in chronic fatigue syndrome. Social Science and Medicine 41, 1367–1372.CrossRefGoogle ScholarPubMed
Smith, A (1991). Cognitive changes in myalgic encephalomyelitis. In Post-viral Fatigue Syndrome (ed.Jenkins, R. and Mowbray, J.), pp. 179–204. John Wiley & Sons: Chichester.Google Scholar
Surawy, C, Hackman, A, Hawton, K, Sharpe, M (1995). Chronic fatigue syndrome: a cognitive approach. Behavioural Research Therapy 33, 535–544.Google Scholar
van der Linden, G, Chalder, T, Hickie, I, Koschera, A, Sham, P, Wessely, S (1999). Fatigue and psychiatric disorder: different or the same? Psychological Medicine 29, 863–868.Google Scholar
Van Hoof, E, Cluydts, R, De Meirleir, K (2003). Atopic depression as a secondary symptom in chronic fatigue syndrome. Medical Hypotheses 61, 52–55.Google Scholar
Ware, NC (1992). Suffering and the social construction of illness: more questions than answers. Journal of Epidemiology and Community Health 46, 92–97.Google Scholar
Wearden, A, Appleby, L (1997). Cognitive performance and complaints of cognitive impairment in chronic fatigue syndrome. Psychological Medicine 27, 81–90.CrossRefGoogle ScholarPubMed
Wechsler, D (1981). Wechsler Adult Intelligence Scale – Revised. The Psychological Corporation: New York.Google Scholar
Wessely, S, Nimnuan, C, Sharpe, M (1999). Functional somatic syndromes: one or many? Lancet 354, 936–939.Google Scholar
Wessely, S, White, PD (2004). There is only one functional somatic syndrome. British Journal of Psychiatry 185, 95–96.Google Scholar
WHO (1996). World Health Organization Quality of Life – Brief Form (WHOQoL-BREF). World Health Organization: Geneva.Google Scholar
Wood, GC, Bentall, RP, Gopfert, M, Dewey, ME, Edwards, RHT (1994). The differential response of chronic fatigue, neurotic and muscular dystrophy patients to experimental psychological states. Psychological Medicine 24, 357–364.Google Scholar
Zigmund, AS, Snaith, RP (1983). Hospital Anxiety and Depression Scale (HADS). Acta Psychiatrica Scandinavica 67, 361–370.Google Scholar