The relationship between fatigue, psychological and immunological variables in acute infectious illness
The relationship between fatigue, psychological and immunological variables in acute infectious illness
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DOI：
10.3109/00048679809062727
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发表时间：
1998-04-01
影响因子：
4.6
通讯作者：
Lloyd, AR
中科院分区：
文献类型：
--
作者：
Bennett, BK;Hickie, IB;Lloyd, AR
目的：本文的目的是探讨纵向关系的生理和心理症状和免疫因素以下急性infectiveillustration.Method：从前瞻性调查的患者血清学证实的急性传染病由于EB病毒（EBV），罗斯河病毒（RRV）或Q热的初步数据。在症状发作后4周内对患者进行评估，然后在2周和4周后进行审查。身体疾病的数据收集在采访。通过标准化自我报告问卷对心理和躯体症状进行评估。细胞介导的免疫（CMI）功能进行了评估迟发型超敏反应（DTH）的皮肤responses.Results：30例患者进行了评估，并在4周的时间内（包括17例EBV，5个RRV和8个Q热）被列入本分析。在急性期，深度疲劳和不适是最常见的症状。典型的抑郁和焦虑症状并不突出。最初，46%的病例没有DTH皮肤反应（即皮肤无反应性），表明细胞免疫受损。在4周的时间内，躯体和心理症状都有明显改善，尽管疲劳仍然是63%受试者的突出特征。报告疲劳的减少与DTH皮肤反应的改善（p = 0.001）和一般健康问卷（GHQ）评分的改善（p < 0.01）相关。结论：急性感染性疾病伴随着一系列非特异性的躯体和心理症状，特别是疲劳和不适，而不是焦虑和抑郁。尽管几种症状的改善很快，但疲劳通常在4周时仍然是一个突出的主诉。疲劳的缓解与细胞介导的免疫力的改善有关。
Objective: The aim of this paper is to explore the longitudinal relationships between physical and psychological symptoms and immunological factors following acute infective illnesses.Method: Preliminary data from a prospective investigation of patients with serologically proven acute infectious illnesses due to Epstein-Barr virus (EBV), Ross River virus (RRV) or Q fever are reported. Patients were assessed within 4 weeks of onset of symptoms and then reviewed 2 and 4 weeks later. Physical illness data were collected at interview. Psychological and somatic symptom profiles were assessed by standardised self-report questionnaires. Cell-mediated immune (CMI) function was assessed by measurement of delayed-type hypersensitivity (DTH) skin responses.Results: Thirty patients who had been assessed and followed over the 4-week period (including 17 patients with EBV, five with RRV and eight with Q fever) were included in this analysis. During the acute phase, profound fatigue and malaise were the most common symptoms. Classical depressive and anxiety symptoms were not prominent. Initially, 46% of cases had no DTH skin response (i.e. cutaneous anergy) indicative of impaired cellular immunity Over the 4-week period, there was a marked improvement in both somatic and psychological symptoms, although fatigue remained a prominent feature in 63% of subjects. The reduction in reported fatigue was correlated with improvement in the DTH skin response (p = 0.001) and with improvement in General Health Questionnaire (GHQ) scores (p < 0.01).Conclusions: Acute infectious illnesses are accompanied by a range of nonspecific somatic and psychological symptoms, particularly fatigue and malaise rather than anxiety and depression. Although improvement in several symptoms occurs rapidly, fatigue commonly remains a prominent complaint at 4 weeks. Resolution of fatigue is associated with improvement in cell-mediated immunity.