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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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References

Berelowitz, GJ, Burgess, AP, Thanabalasingham, T, Murray-Lyon, IM, Wright, DJ (1995). Post-hepatitis syndrome revisited. Journal of Viral Hepatitis 2, 133–138.CrossRefGoogle ScholarPubMed
Bjelland, I, Dahl, AA, Haug, TT, Neckelmann, D (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research 52, 69–77.CrossRefGoogle ScholarPubMed
Bruce-Jones, WDA, White, PD, Thomas, JM, Clare, AW (1994). The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever. Psychological Medicine 24, 651–659.CrossRefGoogle ScholarPubMed
Buchwald, DS, Rea, TD, Katon, WJ, Russo, JE, Ashley, RL (2000). Acute infectious mononucleosis: characteristics of patients who report failure to recover. American Journal of Medicine 109, 531–537.CrossRefGoogle ScholarPubMed
Burns, VE, Drayson, M, Ring, C, Carroll, D (2002). Perceived stress and psychological well-being are associated with antibody status after meningitis C conjugate vaccination. Psychosomatic Medicine 64, 963–970.Google ScholarPubMed
Candy, B, Chalder, T, Cleare, AJ, Peakman, A, Skowera, A, Wessely, S, Weinman, J, Zuckerman, M, Hotopf, M (2003). Predictors of fatigue following the onset of infectious mononucleosis. Psychological Medicine 33, 847–855.CrossRefGoogle ScholarPubMed
Candy, B, Chalder, T, Cleare, AJ, Wessely, S, Hotopf, M (2004). A randomised controlled trial of a psycho-educational intervention to aid recovery in infectious mononucleosis. Journal of Psychosomatic Research 57, 89–94.CrossRefGoogle ScholarPubMed
Candy, B, Chalder, T, Cleare, AJ, Wessely, S, White, PD, Hotopf, M (2002). Recovery from infectious mononucleosis: a case for more than symptomatic therapy? A systematic review. British Journal of General Practice 52, 844–851.Google ScholarPubMed
Chiu, A, Chon, SY, Kimball, AB (2003). The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Archives of Dermatology 139, 897–900.CrossRefGoogle ScholarPubMed
Cohen, S, Kamarck, T, Mermelstein, R (1983). A global measure of perceived stress. Journal of Health and Social Behavior 24, 385–396.CrossRefGoogle ScholarPubMed
Cope, H, David, A, Pelosi, A, Mann, A (1994). Predictors of chronic ‘postviral’ fatigue. Lancet 344, 864–868.CrossRefGoogle ScholarPubMed
Ebrecht, M, Hextall, J, Kirtley, L-G, Taylor, A, Dyson, M, Weinman, J (2004). Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology 29, 798–809.CrossRefGoogle ScholarPubMed
Fukuda, K, Straus, SE, Hickie, I, Sharpe, M, Dobbins, JG, Komaroff, A, International Chronic Fatigue Syndrome Study Group (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine 121, 953–959.CrossRefGoogle ScholarPubMed
Haase, AM, Prapavessis, H, Owens, R (1999). Perfectionism and eating attitudes in competitive rowers: moderating effects of body mass, weight classification and gender. Psychology and Health 14, 643–657.CrossRefGoogle Scholar
Haase, AM, Prapavessis, H, Owens, R (2002). Perfectionism, social physique anxiety and disordered eating: a comparison of male and female elite athletes. Psychology of Sport and Exercise 3, 209–222.CrossRefGoogle Scholar
Hickie, I, Davenport, T, Wakefield, D, Vollmer-Conna, U, Cameron, B, Vernon, SD, Reeves, WC, Lloyd, A (2006). Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. British Medical Journal 333, 575–580.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
Lewis, S, Cooper, CL, Bennett, D (1994). Psychosocial factors and chronic fatigue syndrome. Psychological Medicine 24, 661–671.CrossRefGoogle ScholarPubMed
Moss-Morris, R (2005). The role of illness beliefs and behaviours in the development and perpetuation of chronic fatigue syndrome. Journal of Mental Health 14, 223–235.CrossRefGoogle Scholar
Moss-Morris, R, Spence, M (2006). To ‘lump’ or to ‘split’ the functional somatic syndromes: can infectious and emotional risk factors differentiate between the onset of chronic fatigue syndrome and irritable bowel syndrome? Psychosomatic Medicine 68, 463–469.CrossRefGoogle ScholarPubMed
Moss-Morris, R, Weinman, J, Petrie, KJ, Horne, R, Cameron, LD, Buick, D (2002). The revised illness perception questionnaire (IPQ-R). Psychology and Health 17, 1–16.CrossRefGoogle Scholar
Petersen, I, Thomas, JM, Hamilton, WT, White, PD (2006). Risk and predictors of fatigue after infectious mononucleosis in a large primary-care cohort. QJM: Monthly Journal of the Association of Physicians 99, 49–55.CrossRefGoogle Scholar
Schwarz, KA, Dunphy, G (2003). An examination of perceived stress in family caregivers of older adults with heart failure. Experimental Ageing Research 29, 221–235.CrossRefGoogle ScholarPubMed
Sharpe, M (1997). Cognitive behavior therapy for functional somatic complaints. The example of chronic fatigue syndrome. Psychosomatics 38, 356–362.CrossRefGoogle ScholarPubMed
Sharpe, M, Peveler, R, Mayou, R (1992). The psychological treatment of patients with functional somatic symptoms: a practical guide. Journal of Psychosomatic Research 36, 515–529.CrossRefGoogle ScholarPubMed
Sharpe, MC, Archard, LC, Banatvala, JE, Borysiewicz, LK, Clare, AW, David, A, Edwards, RH, Hawton, KE, Lambert, HP, Lane, RJ, et al. (1991). A report – chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine 84, 118–121.CrossRefGoogle ScholarPubMed
Slade, PD, Owens, R (1998). A dual process model of perfectionism based on reinforcement theory. Behavior Modification 22, 372–390.CrossRefGoogle ScholarPubMed
Spence, M, Moss-Morris, R (2007). The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of gastroenteritis patients. Gut 56, 1066–1071.CrossRefGoogle Scholar
Spence, MJ, Moss-Morris, R, Chalder, T (2005). The Behavioural Responses to Illness Questionnaire (BRIQ): a new predictive measure of medically unexplained symptoms following acute infection. Psychological Medicine 35, 583–593.CrossRefGoogle ScholarPubMed
Surawy, C, Hackmann, A, Hawton, K, Sharpe, M (1995). Chronic fatigue syndrome: a cognitive approach. Behaviour Research Therapy 33, 535–544.CrossRefGoogle ScholarPubMed
Tabachnick, BG, Fidell, LS (1989). Using Multivariate Statistics, 2nd edn. Harper Collins Publishers: Northridge, CA.Google Scholar
Terry-Short, LA, Owens, RG, Slade, PD, Dewey, ME (1995). Positive and negative perfectionism. Personality and Individual Differences 18, 663–668.CrossRefGoogle Scholar
Wessely, S, Butler, S, Chalder, T, David, AS (1991). The cognitive behavioural management of the post-viral fatigue syndrome. In Post-viral Fatigue Syndrome (ed. Jenkins, R. and Mowbray, J.), pp. 305–334. John Wiley & Sons Ltd: Chichester.Google Scholar
Wessely, S, Chalder, T, Hirsch, S, Pawlikowska, T, Wallace, P, Wright, DJM (1995). Postinfectious fatigue: prospective cohort study in primary care. Lancet 345, 1333–1338.CrossRefGoogle ScholarPubMed
White, PD, Thomas, JM, Amess, J, Crawford, DH, Grover, SA, Kangro, HO, Clare, AW (1998). Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever. British Journal of Psychiatry 173, 475–481.CrossRefGoogle ScholarPubMed
White, PD, Thomas, JM, Amess, J, Grover, SA, Kangro, HO, Clare, AW (1995). The existence of a fatigue syndrome after glandular fever. Psychological Medicine 25, 907–916.CrossRefGoogle ScholarPubMed
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
Wildman, MJ, Smith, EG, Groves, J, Beattie, JM, Caul, EO, Ayres, JG (2002). Chronic fatigue following infection by Coxiella burnetii (Q fever): ten-year follow-up of the 1989 UK outbreak cohort. QJM: Monthly Journal of the Association of Physicians 95, 527–538.CrossRefGoogle ScholarPubMed
Zigmond, AS, Snaith, RP (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed