PREDICTORS OF CHRONIC POSTVIRAL FATIGUE
PREDICTORS OF CHRONIC POSTVIRAL FATIGUE
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DOI：
10.1016/s0140-6736(94)92833-9
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发表时间：
1994-09-24
期刊：
影响因子：
168.9
通讯作者：
MANN, A
中科院分区：
文献类型：
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作者：
COPE, H;DAVID, A;MANN, A
我们开始确定全科医生(GP)诊断的病毒疾病和6个月后慢性疲劳的发展之间的关系。对618名在伦敦、英格兰南部和西南部的全科医生诊所就诊并被诊断为病毒性疾病的受试者进行前瞻性跟踪，并在6个月后通过问卷评估疲劳感。502人(81.2%)完成了为期6个月的问卷调查，其中88人(17.5%)符合慢性疲劳标准，65人(12.9%)在患病前没有报告疲劳。与类似的非病毒后GP患者组相比，本队列中慢性疲劳的风险比为1.45(95%可信区间为1.14-2.04)。感染症状不能预示6个月后的疲劳。精神病发病率、对病毒易感性的信念以及最初出现时的归因方式都与自我指定的病毒后疲劳有关。Logistic回归分析显示，在控制其他因素的情况下，躯体归因方式、GP诊断不明确、疾病证明是病毒感染后慢性疲劳的唯一有意义的预测因素；GP诊断为病毒病后6个月的慢性重度疲劳与症状归因方式和医生行为有关，而与病毒病的特征无关。一些有明显的病毒后疲劳的受试者在出现病毒疾病之前就抱怨过疲倦。
We set out to determine the relation between a general practitioner (GP) diagnosis of viral illness and development of chronic fatigue 6 months later. 618 subjects who attended GPs clinics in London, south, and southwest England and who received a diagnosis of viral illness were followed prospectively and fatigue was assessed by questionnaire after 6 months.At presentation, GPs recorded fatigue in 62.6% of subjects, usually since the onset of symptoms. 502 (81.2%) subjects completed the 6-month questionnaire, of whom 88 (17.5%) met criteria for chronic fatigue and 65 (12.9%) had no reported fatigue before the viral illness. Compared with a similar group of non-postviral GP attenders, the risk ratio for chronic fatigue in the present cohort was 1.45 (95% CI 1.14-2.04). Infective symptoms did not predict fatigue 6 months later. Psychiatric morbidity, belief in vulnerability to viruses, and attributional style at initial presentation were all associated with self-designated postviral fatigue. Logistic regression showed that somatic attributional style, less definite diagnosis by the GP, and sick certification were the only significant predictors of chronic fatigue after viral infection when other factors were controlled for.Chronic severe fatigue 6 months after GP-diagnosed viral illness is related to symptom-attributional style and doctor behaviour, rather than to features of the viral illness. Some subjects with apparent postviral fatigue had complained of tiredness before their presentation with a viral illness.