Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T20:40:53.687Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship between prior psychiatric disorder and chronic fatigue: evidence from a national birth cohort study

Published online by Cambridge University Press:  02 November 2007

S. B. Harvey ,
M. Wadsworth ,
S. Wessely  and
M. Hotopf
S. B. Harvey
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
M. Wadsworth
Affiliation:
MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and UCL Medical School, London, UK
S. Wessely
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
M. Hotopf*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
*
*Address for correspondence: Professor M. Hotopf, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Increased rates of psychiatric disorder have previously been reported in those diagnosed with chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME), although the direction of causation in this relationship has not been established. We aimed to test the hypothesis that individuals with self-reported CFS/ME have increased levels of psychiatric disorder prior to the onset of their fatigue symptoms.

Method

A total of 5362 participants were prospectively followed with various measures of personality, psychiatric disorder and fatigue levels collected over the first 43 years of their life. CFS/ME was identified through self-report during a semi-structured interview at age 53 years.

Results

Thirty-four (1.1%) of the 3035 subjects assessed at age 53 years reported a diagnosis of CFS/ME. CFS/ME was more common among females, but there was no association between CFS/ME and either social class, social mobility or educational level. Those with psychiatric illness between the ages of 15 and 36 years were more likely to report CFS/ME later in life with an odds ratio (OR, adjusted for sex) of 2.65 [95% confidence interval (CI) 1.26–5.57, p=0.01]. Increased levels of psychiatric illness, in particular depression and anxiety, were present prior to the occurrence of fatigue symptoms. There was a dose–response relationship between the severity of psychiatric symptoms and the likelihood of later CFS/ME. Personality factors were not associated with a self-reported diagnosis of CFS/ME.

Conclusions

This temporal, dose–response relationship suggests that psychiatric disorders, or shared risk factors for psychiatric disorders, are likely to have an aetiological role in some cases of CFS/ME.

Keywords

Anxietychronic fatigue syndromedepressionfatiguemyalgic encephalomyelitis
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 7 , July 2008 , pp. 933 - 940
Copyright
Copyright © 2007 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

Afari, N, Buchwald, D (2003). Chronic fatigue syndrome: a review. American Journal of Psychiatry 160, 221–236.CrossRefGoogle ScholarPubMed
David, AS (1991). Postviral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.CrossRefGoogle ScholarPubMed
Department of Education and Science (1972). Burnham Further Education Committee Grading Courses. HMSO: London.Google Scholar
Dittner, AJ, Wessely, SC, Brown, RG (2004). The assessment of fatigue: a practical guide for clinicians and researchers. Journal of Psychosomatic Research 56, 157–170.CrossRefGoogle ScholarPubMed
Endicott, NA (1999). Chronic fatigue syndrome in private practice psychiatry: family history of physical and mental health. Journal of Psychosomatic Research 47, 343–354.CrossRefGoogle ScholarPubMed
Eysenck, HJ (1959). Manual of the Maudsley Personality Inventory. University of London Press: London.Google Scholar
Fukuda, K, Straus, SE, Hickie, I, Sharpe, MC, Dobbins, JG, Komaroff, A (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine 121, 953–959.CrossRefGoogle ScholarPubMed
Henderson, M, Tannock, C (2004). Objective assessment of personality disorder in chronic fatigue syndrome. Journal of Psychosomatic Research 56, 251–254.CrossRefGoogle ScholarPubMed
Hotopf, M, Noah, N, Wessely, S (1996). Chronic fatigue and minor psychiatric morbidity after viral meningitis: a controlled study. Journal of Neurology, Neurosurgery and Psychiatry 60, 504–509.CrossRefGoogle ScholarPubMed
Jason, LA, Richman, JA, Rademaker, AW, Jordan, KM, Plioplys, AV, Taylor, RR, McCready, W, Huang, CF, Plioplys, S (1999). A community-based study of chronic fatigue syndrome. Archives of Internal Medicine 159, 2129–2137.CrossRefGoogle ScholarPubMed
Kato, K, Sullivan, PF, Evengard, B, Pedersen, NL (2006). Premorbid predictors of chronic fatigue. Archives of General Psychiatry 63, 1267–1272.CrossRefGoogle ScholarPubMed
Lindelow, M, Hardy, R, Rodgers, B (1997). Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale. Journal of Epidemiology and Community Health 51, 549–557.CrossRefGoogle ScholarPubMed
ONS (1990). Standard Occupational Classification. Office for National Statistics: London.Google Scholar
Petersen, I, Thomas, JM, Hamilton, WT, White, PD (2006). Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort. Quarterly Journal of Medicine 99, 49–55.CrossRefGoogle Scholar
Pintner, R, Loftus, JJ, Alster, B (1937). Aspects of Personality Inventory: Test and Manual. World Book Co.: New York.Google Scholar
Prins, JB, van der Meer, JW, Bleijenberg, G (2006). Chronic fatigue syndrome. Lancet 367, 346–355.CrossRefGoogle ScholarPubMed
Reyes, M, Nisenbaum, R, Hoaglin, DC, Unger, ER, Emmons, C, Randall, B, Stewart, JA, Abbey, S, Jones, JF, Gantz, N, Minden, S, Reeves, WC (2003). Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Archives of Internal Medicine 163, 1530–1536.CrossRefGoogle ScholarPubMed
Rodgers, B, Mann, SA (1986). The reliability and validity of PSE assessments by lay interviewers: a national population survey. Psychological Medicine 16, 689–700.CrossRefGoogle ScholarPubMed
StataCorp (2005). Stata Statistical Software. Release 9.1. Stata Corporation: College Station, TX.Google Scholar
Steele, L, Dobbins, JG, Fukuda, K, Reyes, M, Randall, B, Koppelman, M, Reeves, WC (1998). The epidemiology of chronic fatigue in San Francisco. American Journal of Medicine 105, 83S–90S.CrossRefGoogle ScholarPubMed
Torres-Harding, SR, Jason, LA, Turkoglu, OD (2005). Family medical history of persons with chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome 12, 25–35.CrossRefGoogle Scholar
Viner, R, Hotopf, M (2004). Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study. British Medical Journal 329, 941.CrossRefGoogle ScholarPubMed
Wadsworth, M, Kuh, D, Richards, M, Hardy, R (2006). Cohort profile: the 1946 National Birth Cohort (MRC National Survey of Health and Development). International Journal of Epidemiology 35, 49–54.CrossRefGoogle ScholarPubMed
Wessely, S, Hotopf, M, Sharpe, M (1998). Chronic Fatigue and its Syndromes. Oxford University Press: Oxford.CrossRefGoogle Scholar
White, PD, Thomas, JM, Kangro, HO, Bruce-Jones, WD, Amess, J, Crawford, DH, Grover, SA, Clare, AW (2001). Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis. Lancet 358, 1946–1954.CrossRefGoogle ScholarPubMed
Wing, JK, Cooper, JE, Sartorius, N (1974). Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program. Cambridge University Press: Cambridge.Google Scholar
Wing, JK, Mann, SA, Leff, JP, Nixon, JM (1978). The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine 8, 203–217.CrossRefGoogle ScholarPubMed