Tag: stress

Evidence that abnormalities of central neurohormonal systems are key to understanding fibromyalgia and chronic fatigue syndrome

Abstract:

Fibromyalgia (FM) and chronic fatigue syndrome (CFS) fall into the spectrum of what might be termed stress-associated syndromes by virtue of frequent onset after acute or chronic stressors and apparent exacerbation of symptoms during periods of physical or emotional stress. These illnesses also share perturbation of the hypothalamic-pituitary-adrenal axis and sympathetic stress response systems. In this article, the authors discuss the specific neurohormonal abnormalities found in FM and CFS and potential mechanisms by which dysfunction of neurohormonal stress-response systems could contribute to vulnerability to stress-associated syndromes and to the symptoms of FM and CFS.

 

Source: Crofford LJ, Demitrack MA. Evidence that abnormalities of central neurohormonal systems are key to understanding fibromyalgia and chronic fatigue syndrome. Rheum Dis Clin North Am. 1996 May;22(2):267-84. http://www.ncbi.nlm.nih.gov/pubmed/8860799

 

The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever

Abstract:

Two hundred and fifty patients attending primary care with glandular fever or an upper respiratory tract infection were studied prospectively up to 6 months after onset. Of these patients 228 were interviewed with the Life Events and Difficulties Schedule and the Schedule for Affective Disorders and Schzophrenia, giving Research Diagnostic Criteria for psychiatric disorders.

The experience of severe social adversity (provoking agents) had a significant association with psychiatric disorder at 2 months (odds ratio = 5.3) and 6 months (odds ratio = 5.8) after onset of infection. This association was especially significant for depressive illness (odds ratio = 9.1 at 2 months and 11.9 at 6 months).

In contrast, social adversity had little association with the development of the post-infectious fatigue syndrome, or delayed physical recovery. Social adversity may be an important maintaining factor for psychiatric disorders, especially depressive illness, following acute infections.

 

Source: Bruce-Jones WD, White PD, Thomas JM, Clare AW. The effect of social adversity on the fatigue syndrome, psychiatric disorders and physical recovery, following glandular fever. Psychol Med. 1994 Aug;24(3):651-9. http://www.ncbi.nlm.nih.gov/pubmed/7991747

 

Self help organization’s advice on myalgic encephalomyelitis

Comment on: Outcome in the chronic fatigue syndrome. [BMJ. 1992]

 

EDITOR,-I should like to assure Simon Wessely that neither the ME Association nor ME Action regards Michael Sharpe and colleagues’ findings in patients with chronic fatigue’ as another attack on its credibility. Nor do we see why the paper should “further sour relations between the organisations and the profession.”

As Wessely points out, the apparent relation between functional impairment and membership of a self help organisation at follow up does not mean that membership of such an organisation is responsible for the impairment. Aside from the fact that the study did not focus on myalgic encephalomyelitis, or on the work the ME Association does, Sharpe reassured us that there was no evidence of a causal relation between membership of a patient group and level of disability.

As regards the potential damage resulting from inaccurate information about myalgic encephalomyelitis, it is worth emphasising that the quote that illustrates this came from Nursing Standard and not from a magazine for patients. The British organisations have long been unhappy with the way the media have portrayed the illness and reviewed existing research, and it is often extremely difficult to get erroneous or biased information corrected. Sometimes we get a right of reply, but usually we don’t.

Finally, I wish to make clear that our current advice on exercise and stress is based on sound scientific research, the recommendations of our medical advisers, and 50 years’ experience. Since our aim is to help patients it would be ridiculous for us to ignore good research and to stick instead to outdated explanations, speculation, or even prejudice. No one gains from such a narrow minded approach, least of all us.

You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1883373/pdf/bmj00091-0063a.pdf

 

Source: Hume MC. Self help organization’s advice on myalgic encephalomyelitis. BMJ. 1992 Sep 12;305(6854):649. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1883373/

 

Objective measurement of personality variables in epidemic neuromyasthenia patients

Abstract:

The psychological symptoms of patients diagnosed as having epidemic neuromyasthenia were investigated using the Minnesota Multiphasic Personality Inventory, the Social Readjustment Rating Scale, the Mehrabian Achieving Tendency Scale for Females, a personal data questionnaire, and a subjective anxiety rating.

Twenty-five women with epidemic neuromyasthenia were compared with 25 women who were not ill. Multivariate analysis using the Hotelling T-test on the group data indicated that the patient and non-patient groups differed significantly (P less than 0.001) in respect of psychological characteristics. Stress as a possible predisposing factor in the illness was supported (P less than 0.001).

The data do not support the concept of epidemic neuromyasthenia as being ‘mass hysteria’ as mentioned by McEvedy and Beard, but rather seem to support the suggestion that diagnosis can be made by use of a combination of logical, objective medical and physiological measures. The use of biofeedback as a possible treatment is also proposed.

 

Source: Stricklin A, Sewell M, Austad C. Objective measurement of personality variables in epidemic neuromyasthenia patients. S Afr Med J. 1990 Jan 6;77(1):31-4. http://www.ncbi.nlm.nih.gov/pubmed/2294610