Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-17T19:13:13.820Z Has data issue: false hasContentIssue false
  • English
  • Français

The existence of a fatigue syndrome after glandular fever

Published online by Cambridge University Press:  09 July 2009

P. D. White ,
J. M. Thomas ,
J. Amess ,
S. A. Grover ,
H. O. Kangro  and
A. W. Clare
P. D. White*
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
J. M. Thomas
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
J. Amess
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
S. A. Grover
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
H. O. Kangro
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
A. W. Clare
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London
*
1Address for correspondence: Dr P. D. White, Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London EC1A 7BE.
Get access Rights & Permissions [Opens in a new window]

Synopsis

This prospective cohort study was designed to test whether a distinct fatigue syndrome existed after the onset of glandular fever. Two hundred and fifty primary care patients, with either glandular fever or an ordinary upper respiratory tract infection (URTI) were interviewed three times in the 6 months after the clinical onset of their infection. At each interview a standardized psychiatric interview was given and physical symptoms were assessed.

There were 108 subjects with an Epstein-Barr virus (EBV) infection; 83 subjects had glandular fever not caused by EBV and 54 subjects had an ordinary URTI. Five subjects were excluded because they had no evidence of an infection. Principal components analyses of symptoms supported the existence of a fatigue syndrome, particularly in the two glandular fever groups. The addition of symptoms not elicited by the standard interviews gave the full syndrome. This included physical and mental fatigue, excessive sleep, psychomotor retardation, poor concentration, anhedonia, irritability, social withdrawal, emotional lability, and transient sore throat and neck gland swelling with pain. A fatigue syndrome probably exists after glandular fever.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 5 , September 1995 , pp. 907 - 916
Copyright
Copyright © Cambridge University Press 1995

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

Acheson, E. D. (1959). The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuro-myasthenia. American Journal of Medicine 26, 569–595.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn revised (DMS-III-R). American Psychiatric Association: Washington, DC.Google Scholar
Anonymous, (1971). Infectious mononucleosis and its relationship to EB virus antibody. A joint investigation by university health physicians and P.H.L.S. laboratories. British Medical Journal 4, 643–646.CrossRefGoogle Scholar
Beard, G. M. (1869). Neurasthenia, or nervous exhaustion. Boston Medical and Surgical Journal 3, 217–221.CrossRefGoogle Scholar
Behan, P. O., Behan, W. M. & Bell, E. J. (1985). The postviral fatigue syndrome – an analysis of the findings in 50 cases. Journal of Infection 10, 211–222.Google Scholar
Benjamin, J. E. & Hoyt, R. C. (1945). Disability following post-vaccinal (yellow fever) hepatitis: a study of 200 patients manifesting delayed convalescence. Journal of the American Medical Association 128, 319–324.CrossRefGoogle Scholar
Bertram, G., Dreiner, N., Krueger, G. R., Ramon, A., Ablashi, D. V., Salahuddin, S. Z. & Balachandram, N. (1991). Frequent double infection with Epstein-Barr virus and human herpes virus-6 in patients with acute infectious mononucleosis. In Vivo 5, 271–279.Google Scholar
Blakely, A. A., Howard, R. C., Sosich, R. M., Murdoch, J. C., Menkes, D. B. & Spears, G. F. (1991). Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome. Psychological Medicine 21, 347–362.Google Scholar
Bock, G. R. & Whelan, J. (eds.) (1993). Chronic Fatigue Syndrome. CIBA Foundation Symposium 173. John Wiley and Sons: Chichester, New York.Google Scholar
Bruce-Jones, W. D. A., White, P. D., Thomas, J. M. & Clare, A. W. (1994). The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever. Psychological Medicine 24, 651–659.Google Scholar
Buchwald, D., Goldenberg, D. L., Sullivan, J. L. & Komaroff, A. L. (1987). The ‘chronic, active Epstein-Barr virus infection’ syndrome and primary fibromyalgia. Arthritis and Rheumatism 30, 1132–1136.Google Scholar
Buchwald, D., Cheney, P. R., Peterson, D. L., Henry, B., Wormsley, S. B., Geiger, A., Ablashi, D. V., Salahuddin, S. Z., Saxinger, C. & Biddle, R. (1992). A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpes virus type 6 infection. Annals of Internal Medicine 116, 103–113.CrossRefGoogle Scholar
Caravati, C. M. (1944). Posthepatitis syndrome. Southern Medical Journal 37, 251–257.Google Scholar
Chatfield, C. & Collins, A. J. (1980). Principal component analysis. In Introduction to Multivariate Analysis (ed. Chatfield, C. and Collins, A. J.), pp. 57–81. Chapman and Hall: London.Google Scholar
David, A. S. (1991). Postviral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.Google Scholar
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837–844.Google Scholar
Hartmann, W. M., Sall, J. P. & Sarle, W. S. (1990). The factor procedure. In SAS/STAT User's Guide (version 6, 4th edn, vol. 1). SAS Institute Inc.: Cary, North Carolina.Google Scholar
Henle, W., Henle, G. E. & Horwitz, C. A. (1974 a). Epstein-Barr virus specific diagnostic tests in infectious mononucleosis. Human Pathology 5, 551–565.CrossRefGoogle ScholarPubMed
Henle, G., Henle, W. & Horwitz, C. A. (1974 b). Antibodies to Epstein-Barr virus-associated nuclear antigen in infectious mononucleosis. Journal of Infectious Diseases 130, 231–239.Google Scholar
Holmes, G. P., Kaplan, J. E., Gantz, N. M., Komaroff, A. L., Schonberger, L., Straus, S. E., Jones, J. F., Dubois, R. E., Cunningham Rundles, C., Pahwa, S., Tosato, G., Zegans, L. S., Purtilo, D. T., Brown, N., Schooley, R. T. & Brus, I. (1988). Chronic fatigue syndrome: a working case definition. Annals of Internal Medicine 108, 387–389.Google Scholar
Isaacs, R. (1948). Chronic infectious mononucleosis. Blood 3, 858–861.Google Scholar
Jones, J. F., Ray, C. G., Minnich, L. L., Hicks, M. J., Kibler, R. & Lucas, D. O. (1985). Evidence for active Epstein-Barr virus infection in patients with persistent, unexplained illnesses: elevated anti-early antigen antibodies. Annals of Internal Medicine 102, 1–7.Google Scholar
Kangro, H. O., Osman, H. K., Lau, Y. L., Heath, R. B., Yeung, C. Y. & Ng, M. H. (1994). Seroprevalence of antibodies to human herpes viruses in England and Hong Kong. Journal of Medical Virology 43, 91–96.Google Scholar
Katon, W. & Walker, E. A. (1993). The relationship of chronic fatigue to psychiatric illness in community, primary care and tertiary care samples. In Chronic Fatigue Syndrome (ed. Bock, G. R. and Whelan, J.), pp. 193–211. Ciba Foundation Symposium 173. John Wiley and Sons: Chichester.Google Scholar
Kraemer, H. C. (1983). Kappa coefficient. In The Encyclopedia of Statistical Sciences (ed. Johnson, N. L. and Kotz, S.), pp. 352–354. John Wiley and Sons: New York.Google Scholar
Lambore, S., McSherry, J. & Kraus, A. S. (1991). Acute and chronic symptoms of mononucleosis. Journal of Family Practice 33, 33–37.Google Scholar
Lawton, A. H., Rich, T. A., McLendon, S., Gates, E. H. & Bond, J. O. (1970). Follow-up studies of St Louis encephalitis in Florida: re-evaluation of the emotional and health status of the survivors five years after acute illness. Southern Medical Journal 63, 66–71.Google Scholar
Lee, C. L., Davidsohn, I. & Panczysyn, O. (1968). Horse agglutinins in infectious mononucleosis II – the spot test. American Journal of Clinical Pathology 49, 12–18.Google Scholar
Lepow, M. L., Coyne, N., Thompson, L. B., Carver, D. H. & Robbins, F. C. (1962). A clinical epidemiological and laboratory investigation of aseptic meningitis during the four-year period, 1955–1958. II. The clinical disease and its sequelae. New England Journal of Medicine 266, 1188–1193.Google Scholar
Lloyd, A. R., Wakefield, D., Boughton, C. & Dwyer, J. (1988). What is myalgic encephalomyelitis? Lancet i, 1286–1287.Google Scholar
Moldofsky, H. (1993). Fibromyalgia, sleep disorder and chronic fatigue syndrome. In Chronic Fatigue Syndrome (ed. Bock, G. R. and Whelan, J.), pp. 262–271. Ciba Foundation Symposium 173. John Wiley and Sons: Chichester.Google Scholar
Muller, R., Nylander, I., Larsson, L. E., Widen, L. & Frankenhaeuser, M. (1958). Sequelae of primary aseptic meningoencephalitis. A clinical, sociomedical, electroencephalographic and psychological study. Acta Psychiatrica et Neurologica Scandinavica 33, (Suppl. 126), 1–115.Google Scholar
Salit, I. E. (1985). Sporadic postinfectious neuromyasthenia. Canadian Medical Association Journal 133, 659–663.Google Scholar
Schooley, R. T. (1988). Chronic fatigue syndrome: a manifestation of Epstein-Barr virus infection? Current Clinical Topics in Infectious Diseases 9, 126–146.Google Scholar
Sharpe, M. C., Archard, L. C., Banatvala, J. E., Borysiewicz, L. K., Clare, A. W., David, A., Edwards, R. H., Hawton, K. E., Lambert, H. P., Lane, R. J., Mann, A., McDonald, L., Mowbray, J., Pearson, D., Pelosi, A., Peto, T., Preedy, V., Smith, A., Smith, D., Taylor, D., Tyrrell, D., Wallace, P., Wessely, S. & White, P. D. (1991). A report – chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine 84, 118–121.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General psychiatry 35, 773–782.Google Scholar
Straus, S. E., Tosato, G., Armstrong, G., Lawley, T., Preble, O. T., Henle, W., Davey, R., Pearson, G., Epstein, J. & Brus, I. (1985). Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection. Annals of Internal Medicine 102, 7–16.Google Scholar
Sumaya, C. V. & Ench, Y. (1985). Epstein-Barr virus infectious mononucleosis in children. I. Clinical and general laboratory findings. Pediatrics 75, 1003–1010.Google Scholar
Thompson, D. S., Godleski, J. & Herman, S. (1969). Prognosis post-infectious mononucleosis. Journal of the American College of Health Association 17, 453–457.Google Scholar
von Economo, C. (1931). Encephalitis lethargica: Its Sequelae and Treatment. Oxford University Press: London.Google Scholar
Wessely, S. (1990). Old wine in new bottles: neurasthenia and ‘ME’. Psychological Medicine 20, 35–53.CrossRefGoogle Scholar
White, P. (1989). Fatigue syndrome: neurasthenia revived. British Medical Journal 298, 1199–1200.Google Scholar
White, P. D. (1990). Fatigue and chronic fatigue syndromes. In Somatization: Physical Symptoms and Psychological illness (ed. Bass, C. M.), pp. 104–140. Blackwell Scientific Publications: Oxford.Google Scholar
White, P. D. (1993). A prospective study of fatigue and psychiatric illness following glandular fever. M.D. thesis, University of London.Google Scholar
World Health Organization (1990 a). Tenth Revision of the International Classification of Diseases, Chapter V (F): Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines, 10th edn.World Health Organization: Geneva.Google Scholar
World Health Organization (1990 b). ICD-10 Chapter V, Mental and Behavioural Disorders: Diagnostic Criteria for Research. World Health Organization: Geneva.Google Scholar