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The validity and reliability of the fatigue syndrome that follows glandular fever

Published online by Cambridge University Press:  09 July 2009

P. D. White ,
S. A. Grover ,
H. O. Kangro ,
J. M. Thomas ,
J. Amess  and
A. W. Clare
P. D. White*
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
S. A. Grover
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
H. O. Kangro
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
J. M. Thomas
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
J. Amess
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
A. W. Clare
Affiliation:
St Bartholomew's Hospital Medical College and St George's Medical School, London
*
1Address for correspondence: Dr Peter D. White, Department of Psychological Medicine, St Bartholomew's Hospital Medical College, London, EC1A 7BE.
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Synopsis

The validity and reliability of an empirically defined fatigue syndrome were tested in a prospective cohort study of 245 primary care patients, with glandular fever or an upper respiratory tract infection. Subjects were interviewed three times in the 6 months after onset. Subjects with the empirically defined fatigue syndrome were compared with those who were well and those who had a psychiatric disorder.

The validity of the fatigue syndrome was supported, separate from psychiatric disorders in general and depressive disorders in particular. Only 16% of subjects with the principal component derived fatigue factor also met criteria for a psychiatric disorder (excluding pre-morbid phobias). Compared with subjects with psychiatric disorders, subjects with the operationally defined fatigue syndrome reported more severe physical fatigue, especially after exertion, were just as socially incapacitated, had fewer mental state abnormalities, and showed little overlap on independent questionnaires. A more mild fatigue state also existed. Both the fatigue syndrome and state were more reliable diagnoses over time than depressive disorders. The empirically defined fatigue syndrome probably is a valid and reliable condition in the 6 months following glandular fever.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 5 , September 1995 , pp. 917 - 924
Copyright
Copyright © Cambridge University Press 1995

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References

American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. (DSM-III). American Psychiatric Association: Washington, DC.Google Scholar
Bakheit, A. M., Behan, P. O., Dinan, T. G., Gray, C. E. & O'Keane, V. (1992). Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome. British Medical Journal 304, 1010–1012.CrossRefGoogle ScholarPubMed
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 & Sons: Chichester.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.CrossRefGoogle ScholarPubMed
David, A. S. (1991). Postviral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.Google Scholar
Davidson, J. R. T., Miller, R. D., Turnbull, C. D. & Sullivan, J. L. (1982). Atypical depression. Archives of General Psychiatry 39, 527–534.Google Scholar
Demitrack, M. A., Dale, J. K., Straus, S. E., Laue, L., Listwak, S. J., Kruesi, M. J., Chrousos, G. P. & Gold, P. W. (1991). Evidence for impaired activation of the hypothalamic–pituitary–adrenal axis in patients with chronic fatigue syndrome. Journal of Clinical Endocrinology & Metabolism 73, 1224–1234.CrossRefGoogle ScholarPubMed
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
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventive & Social Medicine 24, 18–23.Google Scholar
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of the Society of Clinical Psychology 6, 278–296.Google Scholar
Katon, W. J. & 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 & Sons: Chichester.Google Scholar
Kendell, R. E. (1989). Clinical validity. Psychological Medicine 19, 45–55.Google Scholar
Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C. & Eaves, L. J. (1994). The clinical characteristics of major depression as indices of the familial risk to illness. British Journal of Psychiatry 165, 66–72.Google Scholar
Kroenke, K., Wood, D. R., Mangelsdorff, A. D., Meier, N. J. & Powell, J. B. (1988). Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome. Journal of the American Medical Association 260, 929–934.Google Scholar
Lane, T. J., Manu, P. & Matthews, D. A. (1991). Depression and somatization in the chronic fatigue syndrome. American Journal of Medicine 91, 335–344.Google Scholar
Lloyd, G. G. & Cawley, R. H. (1983). Distress or illness? A study of psychological symptoms after myocardial infarction. British Journal of Psychiatry 142, 120–125.Google Scholar
Manu, P., Matthews, D. A. & Lane, T. J. (1988). The mental health of patients with a chief complaint of chronic fatigue. A prospective evaluation and follow-up. Archives of Internal Medicine 148, 2213–2217.CrossRefGoogle ScholarPubMed
Manu, P., Matthews, D. A. & Lane, T. J. (1991). Panic disorder among patients with chronic fatigue. Southern Medical Journal 84, 451–456.CrossRefGoogle ScholarPubMed
Robins, E. & Guze, S. B. (1979). Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. American Journal of Psychiatry 126, 983–987.Google Scholar
Schluederberg, A., Straus, S. E., Peterson, P., Blumenthal, S., Komaroff, A. L., Spring, S. B., Landay, A. & Buchwald, D. (1992). Chronic fatigue syndrome research; definition and medical outcome assessment. Annals of Internal Medicine 117, 325–331.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773–782.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. 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
White, P. D., Thomas, J. M., Amess, J., Crawford, D., Grover, S. A. & Kangro, H. (1995 a). The incidence, prevalence and prognosis of the fatigue syndrome which follows Epstein-Barr virus infection. (Submitted.)Google Scholar
White, P. D., Thomas, J. M., Kangro, H., Amess, J., Grover, S. A. & Clare, A. W. (1995 b). The incidence, prevalence and prognosis of psychiatric disorders which follow glandular fever. (Submitted.)Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). Description and Classification of Psychiatric Symptoms, 9th edn.Cambridge University Press: London.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67, 361–370.Google Scholar