Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis
Predictions and associations of fatigue syndromes and mood disorders that occur after infectious mononucleosis
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DOI：
10.1016/s0140-6736(01)06961-6
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发表时间：
2001-12-08
期刊：
影响因子：
168.9
通讯作者：
Clare, AW
中科院分区：
文献类型：
--
作者：
White, PD;Thomas, JM;Clare, AW
背景某些感染可在少数感染者中引发慢性疲劳综合征（CFS），但原因尚不清楚。我们描述了一些因素，预测或与长期疲劳后传染性单核细胞增多症和对比这些因素与那些预测情绪障碍后，相同infection.Methods我们前瞻性研究了一个队列的250名初级保健患者传染性单核细胞增多症或普通上呼吸道感染，直到6个月后临床发病。我们寻求急性和慢性疲劳综合征和情绪障碍的预测因素，从临床，实验室和心理社会measurements.Findings经验定义的疲劳综合征发病后6个月，排除共病精神障碍，发病时单点试验阳性（优势比2.1 [95%CI 1.4-3.3]）和较低的身体素质（0.35 [0.15-0.8]）是最可靠的预测指标。颈部淋巴结肿大和最初的卧床休息与疲劳综合征有关，或可预测疲劳综合征发作后2个月。相比之下，心境障碍的预测因素是病前精神病史（2.3 [1.4-3.9]）、情绪人格评分（1.21 [1.11-1.35]）和社会逆境（1.7 [1.0-2.9]）。CFS的定义，包括共病的情绪障碍预测的混合物，这些因素预测的经验定义的疲劳综合征或mood disorders.Interpretation感染后的长期疲劳综合征的预测因子不同的定义和时间，特别是取决于是否存在共病的情绪障碍。特定的感染及其随之而来的免疫反应可能具有早期作用，但身体失调也可能很重要。相比之下，情绪障碍是由一般情绪障碍的预测因素预测的。
Background Certain infections can trigger chronic fatigue syndromes (CFS) in a minority of people infected, but the reason is unknown. We describe some factors that predict or are associated with prolonged fatigue after infectious mononucleosis and contrast these factors with those that predicted mood disorders after the same infection.Methods We prospectively studied a cohort of 250 primary-care patients with infectious mononucleosis or ordinary upper-respiratory-tract infections until 6 months after clinical onset. We sought predictors of both acute and chronic fatigue syndromes and mood disorders from clinical, laboratory, and psychosocial measures.Findings An empirically defined fatigue syndrome 6 months after onset, which excluded comorbid psychiatric disorders, was most reliably predicted by a positive Monospot test at onset (odds ratio 2.1 [95% CI 1.4-3.3]) and lower physical fitness (0.35 [0.15-0.8]). Cervical lymphadenopathy and initial bed rest were associated with, or predicted, a fatigue syndrome up to 2 months after onset. By contrast, mood disorders were predicted by a premorbid psychiatric history (2.3 [1.4-3.9]), an emotional personality score (1.21 [1.11-1.35]), and social adversity (1.7 [1.0-2.9]). Definitions of CFS that included comorbid mood disorders were predicted by a mixture of those factors that predicted either the empirically defined fatigue syndrome or mood disorders.Interpretation The predictors of a prolonged fatigue syndrome after an infection differ with both definition and time, depending particularly on the presence or absence of comorbid mood disorders. The particular infection and its consequent immune reaction may have an early role, but physical deconditioning may also be important. By contrast, mood disorders are predicted by factors that predict mood disorders in general.