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Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: a case–control study

Published online by Cambridge University Press:  09 July 2009

H. Cope ,
A. Mann ,
A. Pelosi  and
A. David
H. Cope*
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. Mann
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. Pelosi
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
A. David
Affiliation:
Section of Epidemiology and General Practice, Institute of Psychiatry, the Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London; Hairmyres Hospital, East Kilbride
*
1Address for correspondence: Dr Helen Cope, Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

This study investigated psychosocial morbidity, coping styles and health locus of control in 64 cases with and without chronic fatigue identified from a cohort of primary care patients recruited 6 months previously with a presumed, clinically diagnosed viral illness. A significant association between chronic fatigue and psychosocial morbidity, somatic symptoms and escape-avoidance coping styles was shown. Chronic fatigue cases were significantly more likely to have a past psychiatric history and a current psychiatric diagnosis based on a standardized clinical interview. Twenty-three of the cases fulfilled criteria for chronic fatigue syndrome (CFS). Such cases were significantly more fatigued than those not fulfilling criteria, but had little excess psychiatric disorder. A principal components analysis provided some evidence for chronic fatigue being separable from general psychosocial morbidity but not from the tendency to have other somatic complaints. Past psychiatric history and psychological distress at the time of the viral illness were risk factors for psychiatric ‘caseness’ 6 months later, while presence of fatigue, psychologising attributional style and sick certification were significant risk factors for CFS. These findings extend a previous questionnaire study of predictors of chronic ‘post-viral’ fatigue.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 6 , November 1996 , pp. 1197 - 1209
Copyright
Copyright © Cambridge University Press 1996

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