Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T07:24:14.900Z Has data issue: false hasContentIssue false
  • English
  • Français

Incidence, risk and prognosis of acute and chronic fatigue syndromes and psychiatric disorders after glandular fever

Published online by Cambridge University Press:  03 January 2018

P. D. White ,
J. M. Thomas ,
J. Amess ,
D. H. Crawford ,
S. A. Grover ,
H. O. Kangro  and
A. W. Clare
P. D. White*
Affiliation:
St Bartholomew's and the Royal London Medical and Dental School, London
J. M. Thomas
Affiliation:
St Bartholomew's and the Royal London Medical and Dental School, London
J. Amess
Affiliation:
St Bartholomew's and the Royal London Medical and Dental School, London
D. H. Crawford
Affiliation:
Department of Virology, Royal Postgraduate Medical School, London
S. A. Grover
Affiliation:
Department of Virology, St Georges Hospital Medical School, London
H. O. Kangro
Affiliation:
St Bartholomew's and the Royal London Medical and Dental School, London
A. W. Clare
Affiliation:
St Bartholomew's and the Royal London Medical and Dental School, London
*
P. D. White, Department of Psychological Medicine. St Bartholomew's and the Royal London Medical and Dental School, London EC1A 7BE
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The role of viruses in the aetiology of both chronic fatigue syndrome (CFS) and depressive illness is uncertain.

Method

A prospective cohort study of 250 primary care patients, presenting with glandular fever or an ordinary upper respiratory tract infection (URTI).

Results

The incidence of an acute fatigue syndrome was 47% at onset, after glandular fever, compared with 20% with an ordinary URTI (relative risk 2.3, 95% CI 1.3–4.1). The acute fatigue syndrome lasted a median (interquartile range) of eight weeks (4–16) after glandular fever, but only three weeks (2–4) after an URTI. The prevalence of CFS was 9–22% six months after glandular fever, compared with 0–6% following an ordinary URTI, with relative risks of 2.7–5.1. The most conservative measure of the incidence of CFS was 9% after glandular fever, compared with no cases after an URTI. A conservative estimate is that glandular fever accounts for 3113 (95% C11698–4528) new cases of CFS per annum in England and Wales. New episodes of major depressive disorder were triggered by infection, especially the Epstein – Barr virus, but lasted a median of only three weeks. No psychiatric disorder was significantly more prevalent six months after onset than before.

Conclusions

Glandular fever is a significant risk factor for both acute and chronic fatigue syndromes. Transient new major depressive disorders occur close to onset, but are not related to any particular infection if they last more than a month.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 6 , December 1998 , pp. 475 - 481
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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

Armitage, P. & Berry, G. (1994) Statistical Methods in Medical Research. Oxford: Blackwell Scientific.Google Scholar
Berelowitz, G. J., Burgess, A. P., Thanabalasingham, T., et al (1995) Post-hepatitis syndrome revisited. Journal of Viral Hepatitis, 2, 133–138.Google Scholar
Blacker, C. V. R. (1988) Depression in General Practice. MD thesis. London: University of London.Google Scholar
Bruce-Jones, W. D. A., White, P. D., Thomas, J. M., et al (1994) The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever. Psychological Medicine, 24, 651–659.Google Scholar
Cope, K., David, A., Pelosi, A., et al (1994) Predictors of chronic “postviral” fatigue. Lancet, 344, 864–868.Google Scholar
Communicable Disease Surveillance Centre (1995) Communicable Disease Statistics (England and Wales). Series MB2, no. 22. London: HMSO.Google Scholar
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
Fukuda, K., Straus, S. E., Hickie, I., et al (1994) The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953–959.Google Scholar
Goldberg, D. P. & Huxley, P. (1980) Mental Illness in the Community: The Pathway to Psychiatric Care. London: Tavistock.Google Scholar
Hotopf, M. H. & Wessely, S. (1994) Viruses, neurosis and fatigue. Journal of Psychosomatic Research, 38, 499–514.Google Scholar
Hotopf, M. H., Noah, N. & Wessely, S. (1996) Chronic fatigue and psychiatric morbidity following viral meningitis: a controlled study. Journal of Neurology, Neurosurgery and Psychiatry, 60, 495–503.Google Scholar
Lambore, S., McSherry, J. & Kraus, A. S. (1991) Acute and chronic symptoms of mononucleosis. Journal of Family Practice, 33, 33–37.Google Scholar
Office of Population Censuses and Surveys (1995) Population Trends, 79. London: HMSO.Google Scholar
Regier, D. A., Boyd, J. H., Burke, J. D. Jr., et al (1988) One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. Archives of General Psychiatry, 45, 977–986.Google Scholar
Sharpe, M. C., Archard, L. C., Banatvala, J. et al (1991) A report – chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine, 84, 118–121.Google Scholar
Spitzer, R. L., Endiott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Wessely, S., Chalder, T., Hirsch, S., et al (1995) Postinfectious fatigue: prospective cohort study in primary care. Lancet, 345, 1333–1338.Google Scholar
Wessely, S., Hotopf, M. & Sharpe, M. (1998) Chronic Fatigue and its Syndromes. Oxford: Oxford University Press.CrossRefGoogle Scholar
White, P. D. (1993) A Prospective Study of Fatigue and Psychiatric Illness Following Glandular Fever. MD thesis. London: University of London.Google Scholar
White, P. D. Thomas, J. M., Amess, J., et al (1995a) The existence of a fatigue syndrome after glandular fever. Psychological Medicine, 25, 907–916.Google Scholar
White, P. D., Grow, S. A., Kangro, H. O., et al (1995b) The validity and reliability of the fatigue syndrome which follows glandular fever. Psychological Medicine, 25, 917–924.Google Scholar
White, P. D., Dash, A. R. & Thomas, J. M. (1998) Poor concentration and the ability to process information after glandular fever. Journal of Psychosomatic Research, 44, 269–278.Google Scholar
Zigmond, A. S. & Snaith, R. P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.