Fatigue: Biomedicine, Health & Behavior - Volume 3, Issue 1, 2015

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Titles and abstracts for the journal, Fatigue: Biomedicine, Health & Behavior, Volume 3, Issue 1, 2015.

Volume 3, Issue 1, 2015[edit | edit source]

  • Chronic fatigue syndrome and co-morbid and consequent conditions: evidence from a multi-site clinical epidemiology study
    Abstract - Background: Epidemiologic data that inform our understanding of the type, frequency, and burden of co-morbidities with chronic fatigue syndrome is limited. Purpose: To elucidate co-morbid and consequent conditions, using data from a clinical epidemiology study of long-term CFS patients. Methods: Some 960 adults with CFS were identified at four sites specializing in the diagnosis and treatment of CFS. Patients reported their demographics, CFS course, other medical diagnoses, and current functioning. We determined associations between: co-morbidities and a patient's current health relative to their health when diagnosed with CFS; CFS symptom severity at onset and subsequent diagnosis with a co-morbid condition; and presence of a co-morbidity and functional ability. We also modeled the change in CFS symptom severity over time as it relates to the presence of a co-morbidity. Results: Of the sample, 84% was diagnosed with one or more co-morbid conditions after CFS onset. Fibromyalgia, depression, anxiety, and hypothyroidism were the most common diagnoses. Nearly 60% of the sample reported a mental illness. Conclusions: In general, co-morbid conditions reduced functional ability and were associated with the worsening of CFS symptoms over time. This study provides important new information on the prevalence of co-morbid conditions and their impact on the course of CFS.[1]
  • Test–retest reliability of the DePaul Symptom Questionnaire
    Abstract - Background: The DePaul Symptom Questionnaire (DSQ) was developed to provide a structured approach for collecting standardized symptomatology and health history information to allow researchers and clinicians to determine whether a patient meets the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), myalgic encephalomyelitis (ME), and/or chronic fatigue syndrome (CFS). Purpose: The purpose of this study was to examine the test–retest reliability of the DSQ. Methods: Test–retest reliability of the measure was examined with a sample of 26 adults self-identifying as having either ME/CFS, ME, and/or CFS and 25 adults who did not self-identify as having these illnesses and were otherwise healthy controls. Results: Overall, the majority of items on the DSQ exhibited good to excellent test–retest reliability, with Pearson's or kappa correlation coefficients that were 0.70 or higher. Conclusions: Thus, the present study suggests that the DSQ is a reliable diagnostic measure that can provide a standardized way of examining illness constructs and symptomatology among patients who identify as having ME/CFS, ME, and/or CFS.[2]
  • Prolonged fatigue in Ukraine and the United States: prevalence and risk factors
    Abstract - Background: Prolonged, severe, unalleviated fatigue may be disabling whether it occurs on its own or in conjunction with medical or psychiatric conditions. This paper compares the prevalence and correlates of prolonged fatigue in general population samples in Ukraine versus the US. Methods: Population surveys were conducted in 2002 in both Ukraine (Ukraine World Mental Health [WMH] Survey) and the US (National Comorbidity Survey-Replication; NCS-R). Both surveys administered the Composite International Diagnostic Interview (CIDI 3.0), which contained modules assessing: neurasthenia (prolonged fatigue); mood, anxiety, and alcohol/drug use disorders; chronic medical conditions; and demographic characteristics. Multivariable logistic regression was used to examine risk factors in each country. Results: The lifetime prevalence of prolonged fatigue was higher in Ukraine (5.2%) than the US (3.7%). In both countries, one-fifth of individuals with prolonged fatigue had no medical or DSM-IV psychiatric condition. Also in both settings, fatigue was significantly associated with socio-demographic characteristics (being female, not working, and married before) as well as early onset and adult episodes of mood/anxiety disorder. Fatigue prevalence in Ukraine increased with age, but decreased in the US at age 70. Unique risk factors for fatigue in Ukraine included lower socio-economic status, Ukrainian versus Russian ethnicity, and cardiovascular disease. Unique risk factors in the US were parental depression/anxiety, adult episodes of alcohol/drugs, pain conditions, and other health problems. Conclusions: The lifetime prevalence of prolonged fatigue in Ukraine was 40% higher than that found in US data. In addition, fatigue prevalence increased sharply with age in Ukraine perhaps due to limited social and medical resources and greater comorbidity.[3]
  • Long-term follow-up of multi-disciplinary outpatient treatment for chronic fatigue syndrome/myalgic encephalopathy
    Abstract - Aims: The current study evaluated the long-term effectiveness of a multi-disciplinary approach to chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) in a UK outpatient service. Methods: A longitudinal questionnaire survey was posted to 300 patients, incorporating measures of fatigue, physical functioning, mental health, and pain. Outcome measures administered at baseline (prior to service use) were compared to assessments at discharge, and at follow-up (average 34 months post-intervention). Results: Linear mixed modelling showed that fatigue, physical functioning, and depression significantly improved, although the improvement was reduced for fatigue, physical functioning, and pain at follow-up. Gainful employment had a significant positive association with most measures. Conclusions: The targeted multi-disciplinary service appeared to be at least somewhat effective long-term, and highly acceptable to patients. Patients appeared to benefit from individual and group approaches that combined cognitive behavioural therapy, graded exercise therapy, and pacing.[4]

See also[edit | edit source]

References[edit | edit source]

  1. Bateman, L.; Darakjy, S.; Klimas, N.; Peterson, D.; Levine, S.M.; Allen, A.; Carlson, S.A.; Balbin, E.G.; Gottschalk, G.; March, D. (2015), "Chronic fatigue syndrome and co-morbid and consequent conditions: evidence from a multi-site clinical epidemiology study", Fatigue: Biomedicine, Health & Behavior, 3 (1): 1-15, doi:10.1080/21641846.2014.978109
  2. Jason, Leonard A.; So, Suzanne; Brown, Abigail A.; Sunnquist, Madison; Evans, Meredyth (2015), "Test–retest reliability of the DePaul symptom questionnaire.", Fatigue: Biomedicine, Health & Behavior, 3 (1): 16-32, doi:10.1080/21641846.2014.978110
  3. Friedberg, F., Tintle, N., Clark, J., & Bromet, E. (2015). Prolonged fatigue in Ukraine and the United States: prevalence and risk factors. Fatigue: Biomedicine, Health & Behavior, 3 (1), 33-46. doi:10.1080/21641846.2014.993829
  4. Houlton, A., Christie, M. M., Smith, B., & Gardiner, E. (2015). Long-term follow-up of multi-disciplinary outpatient treatment for chronic fatigue syndrome/myalgic encephalopathy. Fatigue: Biomedicine, Health & Behavior, 3 (1), 47-58. doi:10.1080/21641846.2014.993873

T2 hyperintensity An unusual bright spot on a T2-weighted MRI of the brain. Also known as an Unidentified Bright Object (UBO). T2 hyperintensities are often found in the periventricular region, where they may be referred to as "white matter hyperintensities" or "leukoaraiosis". They may also be found in the basal ganglia or brainstem, where they are sometimes referred to as "gray matter hyperintensities", or "subcortical hyperintensities". T2 hyperintensities can represent different things: lesions, dilated Virchow-Robin spaces, or demyelination. They are commonly found in elderly individuals and in neurological disorders. (Learn more: www.ncbi.nlm.nih.gov)

Diagnostic and Statistical Manual of Mental Disorders (DSM) - A psychiatric reference book published by the American Psychiatric Association, often referred to as "the psychiatrist's Bible". Although the most recent version (DSM-5) purports to be the authoritative guide to the diagnosis of mental disorders, the editors of both previous versions of the manual have heavily criticized the current version due to the climate of secrecy that shrouded the development of the latest version. 69% of the people who worked on DSM-5 reported having ties to the pharmaceutical industry. Dr. Allen Frances, who headed the development of the previous version, warned of dangerous unintended consequences such as new false 'epidemics'. The British Psychological Society criticized DSM-5 diagnoses as "clearly based largely on social norms, with 'symptoms' that all rely on subjective judgements" and expressed a major concern that "clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences". A petition signed by over 13,000 mental health professionals stated that the lowered diagnostic thresholds in DSM-5, combined with entirely subjective criteria based on western social norms, would "lead to inappropriate medical treatment of vulnerable populations". The director of the US National Institute of Mental Health, Dr. Thomas R. Insel, pointed out that the diagnoses in DSM-5 had no scientific validity whatsoever. (Learn more: www.scientificamerican.com)

myalgic encephalopathy An alternate term that is sometimes used for myalgic encephalomyelitis, by people who believe the evidence for inflammation in ME is insufficient. This terminology reflects the belief that the "-itis" suffix implies inflammation.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

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