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The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever

Published online by Cambridge University Press:  09 July 2009

W. D. A. Bruce-Jones*
Affiliation:
Departments of Psychological Medicine and Computer Sciences, St Bartholomew's Hospital, London
P. D. White
Affiliation:
Departments of Psychological Medicine and Computer Sciences, St Bartholomew's Hospital, London
J. M. Thomas
Affiliation:
Departments of Psychological Medicine and Computer Sciences, St Bartholomew's Hospital, London
A. W. Clare
Affiliation:
Departments of Psychological Medicine and Computer Sciences, St Bartholomew's Hospital, London
*
1Address for correspondence: Dr Peter D. White, Department of Psychological Medicine, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE

Synopsis

Two hundred and fifty patients attending primary care with glandular fever or an upper respiratory tract infection were studied prospectively up to 6 months after onset. Of these patients 228 were interviewed with the Life Events and Difficulties Schedule and the Schedule for Affective Disorders and Schizophrenia, giving Research Diagnostic Criteria for psychiatric disorders. The experience of severe social adversity (provoking agents) had a significant association with psychiatric disorder at 2 months (odds ratio = 5·3) and 6 months (odds ratio = 5·8) after onset of infection. This association was especially significant for depressive illness (odds ratio = 9·1 at 2 months and 11·9 at 6 months). In contrast, social adversity had little association with the development of the post-infectious fatigue syndrome, or delayed physical recovery. Social adversity may be an important maintaining factor for psychiatric disorders, especially depressive illness, following acute infections.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

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References

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.American Psychiatric Association: Washington, DC.Google Scholar
Bock, G. R. & Whelan, J. (1993). Chronic Fatigue Syndrome. Ciba Foundation Symposium 173. John Wiley & Sons: Chichester.Google Scholar
Bonneau, R. H., Sheridan, J. F., Feng, N. G. & Glaser, R. (1991). Stress-induced suppression of herpes simplex virus (HSV)-specific cytotoxic T lymphocyte and natural killer cell activity and enhancement of acute pathogenesis following local HSV infection. Brain, Behavior and Immunology 5, 170192.CrossRefGoogle ScholarPubMed
Boyce, W. T., Cassel, J. C., Collior, A. M., Jensen, E. W., Ramey, C. T. & Smith, A. H. (1977). Influence of life events and family routines on childhood respiratory tract illness. Pediatrics 60, 609615.CrossRefGoogle ScholarPubMed
Brown, G. W. (1974). Meaning, measurement, and stress of life events. In Stressful Life Events: Their Nature and Effects (ed. Dohrenwend, B. S. and Dohrenwend, B. P.), pp. 217243. Wiley: New York.Google Scholar
Brown, G. W. & Harris, T. O. (1978). Social Origins of Depression: A Study of Psychiatric Disorder in Women. Tavistock: London.Google Scholar
Brown, G. W. & Harris, T. O. (1989). Life Events and Illness. Unwin Hyman: London.Google Scholar
Bruno, R. L. & Frick, N. M. (1987). Stress and ‘type A’ behavior as precipitants of post-polio sequelae: the Felican/Columbia Survey. Birth Defects 23, 145155.Google ScholarPubMed
Cohen, S., Tyrrell, D. A. J. & Smith, A. P. (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine 325, 606612.CrossRefGoogle ScholarPubMed
Cohen, S. & Williamson, G. M. (1991). Stress and infectious disease in humans. Psychological Bulletin 109, 524.CrossRefGoogle ScholarPubMed
Dolan, R. J., Calloway, S. P., Fonagy, P., De Souza, F. V. A. & Wakeling, A. (1985). Life events, depression and hypothalamic-pituitary-adrenal axis function. British Journal of Psychiatry 147, 429433.CrossRefGoogle ScholarPubMed
Endicott, J. & Spitzer, R. L. (1978). A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry 35, 773782.CrossRefGoogle ScholarPubMed
Evans, P. D. & Edgerton, N. (1991). Life-events and mood as predictors of the common cold. British Journal of Medical Psychology 64, 3544.CrossRefGoogle ScholarPubMed
Evans, P. D., Pitts, M. K. & Smith, K. (1988). Minor infection, minor life events and the four day desirability dip. Journal of Psychosomatic Research 32, 533539.CrossRefGoogle ScholarPubMed
Glaser, R., Kiecolt-Glaser, J. K., Speicher, C. E. & Holliday, J. E. (1985). Stress, loneliness, and changes in herpesvirus latency. Journal of Behavioral Medicine 8, 249260.CrossRefGoogle ScholarPubMed
Glaser, R., Pearson, G. R., Jones, J. F., Hillhouse, J., Kennedy, S., Mao, H. Y. & Kiecolt Glaser, J. K. (1991). Stress-related activation of Epstein-Barr virus. Brain, Behavior and Immunology 5, 219232.CrossRefGoogle ScholarPubMed
Goldmeier, D., Johnson, A., Jeffries, D., Walker, G. D., Underhill, G., Robinson, G. & Ribbans, H. (1986). Psychological aspects of recurrences of genital herpes. Journal of Psychosomatic Research 30, 601608.CrossRefGoogle ScholarPubMed
Imboden, J. B., Canter, A. & Cluff, L. E. (1961). Convalescence from influenza: A study of the psychological and clinical determinants. Archives of Internal Medicine 108, 393399.CrossRefGoogle ScholarPubMed
Irwin, I., Daniels, M., Bloom, E. T., Smith, T. L. & Weiner, H. (1987). Life events, depressive symptoms, and immune function. American Journal of Psychiatry 144, 437441.Google ScholarPubMed
Kasl, S. V., Evans, A. S. & Niederman, J. G. (1979). Psychosocial risk factors in the development of infectious mononucleosis. Psychosomatic Medicine 41, 445466.CrossRefGoogle ScholarPubMed
Kemeny, E. K., Cohen, F., Zegans, L. S. & Conant, M. A. (1989). Psychological and immunological predictors of genital herpes recurrence. Psychosomatic Medicine 51, 195208.CrossRefGoogle ScholarPubMed
Longo, D. J. & Clum, G. A. (1989). Psychosocial factors affecting genital herpes recurrences: linear vs mediating models. Journal of Psychosomatic Research 33, 161166.CrossRefGoogle ScholarPubMed
Meyer, R. J., Haggerty, R. J., Lombardi, N. & Perkins, R. (1962). Streptococcal infections in families: factors altering individual susceptibility. Pediatrics 30, 539549.CrossRefGoogle Scholar
Paykel, E. S., Myers, J. K., Dienelt, M. N., Klerman, G. L., Lindenthal, J. J. & Pepper, M. P. (1969). Life events and depression: a controlled study. Archives of General Psychiatry 21, 753760.CrossRefGoogle ScholarPubMed
Perry, S., Fishman, B., Jacobsberg, L. & Frances, A. (1992). Relationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus. Archives of General Psychiatry 49, 396401.CrossRefGoogle ScholarPubMed
Powell, R., Dolan, R. & Wessely, S. (1990). Attributions and self esteem in depression and chronic fatigue syndromes. Journal of Psychosomatic Research 34, 665673.CrossRefGoogle ScholarPubMed
Silver, P. S., Auerbach, S. M., Vishniavsky, N. & Kaplowitz, L. G. (1986). Psychological factors in recurrent genital herpes infection: stress, coping style, social support, emotional dysfunction, and symptom recurrence. Journal of Psychosomatic Research 30, 163171.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research Diagnostic Criteria: Rationale and reliability. Archives of General Psychiatry 35, 773782.CrossRefGoogle ScholarPubMed
Stricklin, A., Sewell, M. & Austad, C. (1990). Objective measurement of personality variables in epidemic neuromyasthenia patients. South African Medical Journal 77, 3134.Google ScholarPubMed
Totman, R., Kiff, J., Reed, S. E. & Craig, J. W. (1980). Predicting experimental colds in volunteers from different measures of life stress. Journal of Psychosomatic Research 24, 155163.CrossRefGoogle ScholarPubMed
White, P. D. (1990 a). Psychoimmunology. In Principles and Practice of Biological Psychiatry (ed. Dinan, T. G.), pp. 153182. CNS (Clinical Neuroscience) Publishers: London.Google Scholar
White, P. D. (1990 b). Fatigue and chronic fatigue syndromes. In Somatization: Physical Symptoms and Psychological Illness (ed. Bass, C. M.), pp. 104140. Blackwell: 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
Wilder, R. M., Hubble, J. & Kennedy, C. E. (1971). Life changes and infectious mononucleosis. Journal of the American College Health Association 20, 115119.Google Scholar
World Health Organization (1990). 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