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The pathway from glandular fever to chronic fatigue syndrome: can the cognitive behavioural model provide the map?

Published online by Cambridge University Press:  21 July 2010

R. Moss-Morris ,
M. J. Spence  and
R. Hou
R. Moss-Morris*
Affiliation:
School of Psychology, University of Southampton, UK
M. J. Spence
Affiliation:
Psychological Medicine, The University of Auckland, New Zealand
R. Hou
Affiliation:
School of Medicine, University of Southampton, UK
*
*Address for correspondence: R. Moss-Morris, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, UK. (Email: [email protected])
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Abstract

Background

The cognitive behavioural model of chronic fatigue syndrome (CFS) suggests that the illness is caused through reciprocal interactions between physiology, cognition, emotion and behaviour. The purpose of this study was to investigate whether the psychological factors operationalized in this model could predict the onset of CFS following an acute episode of infectious mononucleosis commonly known as glandular fever (GF).

Method

A total of 246 patients with GF were recruited into this prospective cohort study. Standardized self-report measures of perceived stress, perfectionism, somatization, mood, illness beliefs and behaviour were completed at the time of their acute illness. Follow-up questionnaires determined the incidence of new-onset chronic fatigue (CF) at 3 months and CFS at 6 months post-infection.

Results

Of the participants, 9.4% met the criteria for CF at 3 months and 7.8% met the criteria for CFS at 6 months. Logistic regression revealed that factors proposed to predispose people to CFS including anxiety, depression, somatization and perfectionism were associated with new-onset CFS. Negative illness beliefs including perceiving GF to be a serious, distressing condition, that will last a long time and is uncontrollable, and responding to symptoms in an all-or-nothing behavioural pattern were also significant predictors. All-or-nothing behaviour was the most significant predictor of CFS at 6 months. Perceived stress and consistently limiting activity at the time of GF were not significantly associated with CFS.

Conclusions

The findings from this study provide support for the cognitive behavioural model and a good basis for developing prevention and early intervention strategies for CFS.

Keywords

Chronic fatigue syndromecognitive behavioural modelglandular feverpsychological distress and illness perceptions
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 5 , May 2011 , pp. 1099 - 1107
Copyright
Copyright © Cambridge University Press 2010

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