Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T21:32:02.132Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric symptoms, personality and ways of coping in chronic fatigue syndrome

Published online by Cambridge University Press:  09 July 2009

Antony A. Blakely ,
Rick C. Howard ,
Rowena M. Sosich ,
J. Campbell Murdoch ,
David B. Menkes  and
George F. S. Spears
Antony A. Blakely
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
Rick C. Howard*
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
Rowena M. Sosich
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
J. Campbell Murdoch
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
David B. Menkes
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
George F. S. Spears
Affiliation:
Department of Psychological Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
*
1Address for correspondence: Dr R. Howard, Department of Psychological Medicine, University of Otago Medical School, PO Box 913, Dunedin, New Zealand.
Get access Rights & Permissions [Opens in a new window]

Synopsis

This study aimed to investigate the psychological characteristics of chronic fatigue syndrome (CFS: Holmes et al. 1988). A battery of psychometric instruments comprising the General Health Questionnaire (GHQ), the Beck Depression Inventory (BDI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Lazarus Ways of Coping (WoC) inventory, was administered to a sample of clinically-defined CFS sufferers (N = 58), to a comparison group of chronic pain (CP) patients (N = 81) and to a group of healthy controls matched for sex and age with the CFS sample (N = 104). Considerable overlap was found between CFS and CP patients at the level of both physical and psychological symptoms. This raises the possibility that CFS sufferers are a sub-population of CP patients. However, while there was some commonality between CFS and CP patients in terms of personality traits, particularly the MMPI ‘neurotic triad’ (hypochondriasis, depression and hysteria), CFS patients showed more deviant personality traits reflecting raised levels on the first MMPI factor, emotionality. Moreover, results were not consistent with the raised emotionality being a reaction to the illness, but rather were consistent with the hypothesis that emotionality is a predisposing factor for CFS. The majority of CFS patients fell within four personality types, each characterized by the two highest MMPI scale scores. One type (N = 20) reported a lack of psychological symptoms or emotional disturbance contrary to the overall trend for the CFS sample. This group conformed to the ICD-10 classification of neurasthenia.

Type
Original Articles
Information
Psychological Medicine , Volume 21 , Issue 2 , May 1991 , pp. 347 - 362
Copyright
Copyright © Cambridge University Press 1991

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

Archer, M. I. (1987). The post-viral syndrome: a review. Journal of the Royal College of General Practitioners 37, 212–214.Google Scholar
Beck, A. T. & Beck, R. W. (1972). Screening depressed patients in family practice. A rapid technique. Postgraduate Medicine 52, 81–85.Google Scholar
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.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1986). The validation of the GHQ-28 and the use of the MMSE in neurological in-patients. British Journal of Psychiatry 148, 548–553.Google Scholar
Colligan, R. C., Osborne, D., Swenson, W. M. & Offord, K. P. (1983). The MMPI: A Contemporary Normative Study. Praeger Publishers: New York.Google Scholar
Colligan, R. C., Osborne, D., Swenson, W. M. & Offord, K. P. (1985). Using the 1983 norms for the MMPI: code-type frequencies in four clinical samples. Journal of Clinical Psychology 41, 629–633.Google Scholar
Corah, N. (1964). Neuroticism and extraversion in the MMPI: empirical validation and exploration. British Journal of Social and Clinical Psychology 3, 168–174.Google Scholar
Cox, G. B., Chapman, C. R. & Black, R. G. (1978). The MMPI and chronic pain: the diagnoses of psychogenic pain. Journal of Behavioral Medicine 1, 437–443.Google Scholar
Dahlstrom, W. G., Welsh, G. S. & Dahlstrom, L. E. (1972). An MMPI Handbook. Volume 1: Clinical Interpretation. University of Minnesota Press: Minneapolis.Google Scholar
Dahlstrom, W. G., Welsh, G. S. & Dahlstrom, L. E. (1975). An MMPI Handbook. Volume 2: Research Applications. University of Minnesota Press: Minneapolis.Google Scholar
David, A. S., Wessely, S. & Pelosi, A. J. (1988). Postviral fatigue syndrome: time for a new approach. British Medical Journal 296, 696–699.CrossRefGoogle ScholarPubMed
Editorial (1987). Depression, stress and immunity. Lancet i, 1467–1468.Google Scholar
Eichman, W. J. (1961). Replicated factors on the MMPI with female NP patients. Journal of Consulting and Clinical Psychology 25, 55–60.Google Scholar
Finlay-Jones, R. A. & Murphy, E. (1979). Severity of psychiatric disorder and the 30-item General Health Questionnaire. British Journal of Psychiatry 134, 609–616.Google Scholar
Folkman, S. & Lazarus, R. S. (1985). If it changes it must be a process: study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology 48, 150–170.CrossRefGoogle ScholarPubMed
Folkman, S., Lazarus, R. S., Gruen, R. & DeLongis, A. (1986). Appraisal, coping, health status and psychological symptoms. Journal of Personality and Social Psychology 50, 571–579.CrossRefGoogle ScholarPubMed
Freeman, C. W., Calsyn, D. A. & Louks, J. (1976). The use of the MMPI with low back patients. Journal of Clinical Psychology 32, 294–298.Google Scholar
Giedt, F. H. & Downing, L. (1961). An extraversion scale for the MMPI. Journal of Clinical Psychology 17, 156–159.Google Scholar
Goldberg, D. P. & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine 9, 139–145.Google Scholar
Graham, J. P. (1977). The MMPI: A Practical Guide. Oxford University Press: Oxford.Google Scholar
Greene, R. L. (1980). The MMPI. An Interpretative Manual. Grune & Stratton: New York.Google Scholar
Gynter, M. D., Altman, H. & Sletten, I. W. (1973). Replicated correlates of MMPI two-point types: the Missouri Actuarial System. Journal of Consulting and Clinical Psychology 40, 78–83.Google Scholar
Hathaway, S. R. & McKinley, J. C. (1940). A multiphasic personality schedule (Minnesota): construction of the schedule. Journal of Psychology 10, 249–254.CrossRefGoogle Scholar
Hiesel, J. S., Locke, S. E., Kraus, L. J. & Williams, R. M. (1986). Natural killer cell activity and MMPI scores of a cohort of college students. American Journal of Psychiatry 143, 1382–1386.Google Scholar
Holmes, G. P., Kaplan, J. E., Nelson, M., Gantz, N. M., Komaroff, A. L., Schonberger, L. B., Strauss, 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.CrossRefGoogle ScholarPubMed
Imboden, J. B., Canter, A. & Cluff, L. E. (1961). Convalescence from influenza. Archives of Internal Medicine 108, 393–399.Google Scholar
Jahanshahi, M. & Marsden, C. D. (1988). Personality in torticollis: a controlled study. Psychological Medicine 18, 375–387.Google Scholar
Kassebaum, G. S., Couch, A. R. & Slater, P. E. (1959). The factorial dimensions of the MMPI. Journal of Consulting and Clinical Psychology 23, 226–236.Google Scholar
Komaroff, A. L. (1988). Chronic fatigue syndromes: relationship to chronic viral infections. Journal of Virological Methods 21, 3–10.CrossRefGoogle ScholarPubMed
Kruesi, M. J. P., Dale, J. & Straus, S. E. (1989). Psychiatric diagnoses in patients who have chronic fatigue syndrome. Journal of Clinical Psychiatry 50, 53–56.Google Scholar
Lewandowski, D. & Graham, J. R. (1972). Empirical correlates of frequently occurring two-point code types: a replicated study. Journal of Clinical Psychology 39, 467–472.Google Scholar
Little, K. B. & Fisher, J. (1958). Two new experimental scales of the MMPI. Journal of Consulting and Clinical Psychology 22, 305–306.CrossRefGoogle ScholarPubMed
Love, A. W. & Peck, C. L. (1987). The MMPI and psychological factors in chronic low back pain: a review. Pain 28, 1–12.Google Scholar
McKenzie criteria (1988). Myalgic Encephalomyelitis Syndrome. Therapeutic Notes No. 205, New Zealand Department of Health Circulation.Google Scholar
Manu, P., Mathews, D. A. & Lane, T. J. (1988). The mental health of patients with a chief complaint of chronic fatigue. Archives of Internal Medicine 148, 2213–2217.Google Scholar
Mathew, R. J., Maxine, L. W. & Mirabi, M. (1981). Physical symptoms of depression. British Journal of Psychiatry 139, 293–296.Google Scholar
Millon, C., Salvato, F., Blaney, N., Morgan, R., Mantero-Atienza, E., Klimas, N. & Fletcher, M. (1989). A psychological assessment of chronic fatigue syndrome/chronic Epstein-Barr virus patients. Psychology and Health 3, 131–141.Google Scholar
Moore, J. E., McFall, M. E., Kivlahan, D. R. & Capestany, F. (1988). Risk of misinterpretation of MMPI schizophrenia scale elevations in chronic pain patients. Pain 32, 207–213.Google Scholar
Murdoch, J. C. (1989). Myalgic encephalomyelitis syndrome. New Zealand Medical Journal 102, 372–373.Google Scholar
Rabins, P. V. & Brooks, B. R. (1981). Emotional disturbances in multiple sclerosis patients: validity of the General Health Questionnaire. Psychological Medicine 11, 425–427.Google Scholar
Rosenhan, D. L. & Seligman, M. E. P. (1988). Abnormal Psychology (2nd edn.). Norton: New York.Google Scholar
Stout, A. L. & Steege, J. F. (1985). Psychological assessment of women seeking treatment for premenstrual syndrome. Journal of Psychosomatic Research 29, 621–629.Google Scholar
Taerk, G. S., Toner, B. B., Salit, I. S., Garfinkel, P. E. & Ozersky, S. (1987). Depression in patients with neuromyasthenia (benign myalgic encephalomyelitis). International Journal of Psychiatric Medicine 17, 49–56.Google Scholar
Watson, D. (1982). Neurotic tendencies among chronic pain patients: an MMPI item analysis. Pain 14, 365–385.Google Scholar
Welsh, G. S. (1956). Factor dimensions A and R. In Basic Readings on the MMPI in Psychology and Medicine (ed. Welsh, G. S. and Dahlstrom, W. G.), pp. 264–281. University of Minnesota Press: Minneapolis.Google Scholar
Wessely, S. & Powell, R. (1989). Fatigue syndromes: a comparison of chronic ‘Postviral’ fatigue with neuromuscular and affective disorders. Journal of Neurology, Neurosurgery and Psychiatry 52, 940–948.Google Scholar
White, P. (1989). Fatigue syndrome: neurasthenia revived. British Medical Journal 298, 1199–1200.Google Scholar
World Health Organization, Division of Mental Health (1988). International Classification of Disorders, 10: September 1988 draft. WHO: Geneva.Google Scholar