Tag: 1989

Psychiatric diagnoses in patients who have chronic fatigue syndrome

Abstract:

Patients with persistent fatigue are often suspected of having psychiatric illnesses, particularly depression. The authors used the Diagnostic Interview Schedule to assess the lifetime prevalence of psychiatric disorders in 28 patients who met Centers for Disease Control case definition criteria for chronic fatigue syndrome. Compared with studies of the general population and studies of chronically medically ill patients who received the same structured interview, the rates of psychiatric illness in patients with the chronic fatigue syndrome appeared high. An examination of the medical histories of the 28 patients indicated that psychiatric disorders more often preceded the chronic fatigue than followed it.

 

Source: Kruesi MJ, Dale J, Straus SE. Psychiatric diagnoses in patients who have chronic fatigue syndrome. J Clin Psychiatry. 1989 Feb;50(2):53-6.  http://www.ncbi.nlm.nih.gov/pubmed/2536690

 

Post-viral fatigue syndrome: evidence for underlying organic disturbance in the muscle fibre

Abstract:

Ten patients with post-viral fatigue syndrome and abnormal serological, virological, immunological and histological studies were examined by the single-fibre electromyographic (EMG) technique after excluding concurrent problems in the neuromuscular system. No abnormality of fibre density was noted but all patients had abnormal jitter values. Very high jitter values were not associated with impulse or concomitant blocking. The findings confirm the organic nature of the disease. A muscle membrane disorder probably arising from defective myogenic enzymes is the likely mechanism for the fatigue and the single-fibre EMG abnormalities. This muscle membrane defect may be due to the effects of a persistent viral infection.

 

Source: Jamal GA, Hansen S. Post-viral fatigue syndrome: evidence for underlying organic disturbance in the muscle fibre. Eur Neurol. 1989;29(5):273-6.  http://www.ncbi.nlm.nih.gov/pubmed/2792146

 

Management of chronic (post-viral) fatigue syndrome

Abstract:

Simple rehabilitative strategies are proposed to help patients with the chronic fatigue syndrome. A model is outlined of an acute illness giving way to a chronic fatigue state in which symptoms are perpetuated by a cycle of inactivity, deterioration in exercise tolerance and further symptoms. This is compounded by the depressive illness that is often part of the syndrome. The result is a self-perpetuating cycle of exercise avoidance. Effective treatment depends upon an understanding of the interaction between physical and psychological factors. Cognitive behavioural therapy is suggested. Cognitive therapy helps the patient understand how genuine symptoms arise from the frequent combination of physical inactivity and depression, rather than continuing infection, while a behavioural approach enables the treatment of avoidance behaviour and a gradual return to normal physical activity.

 

Source: S Wessely, A David, S Butler, and T Chalder. Management of chronic (post-viral) fatigue syndrome. J R Coll Gen Pract. 1989 Jan; 39(318): 26–29. PMCID: PMC1711569 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1711569/ (Full article)