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Depression and stress increases likelihood of chronic fatigue in later life

JULY 02, 2008

A study conducted by Dr Sam Harvey, together with Prof Hotopf and Prof Wessely, Institute of Psychiatry at King's, has demonstrated that suffering from a psychiatric illness, such as depression or anxiety, increases the likelihood of developing chronic fatigue syndrome (CFS) in later life.

This study, published in the journal Psychological Medicine, found individuals who had a psychiatric illness between ages 15 and 36 were more than two-and-a-half times more likely to report a diagnosis of CFS in later life. 

There has been a lot of debate about the role of psychological factors in CFS.  It is well established that individuals suffering with CFS have increased rates of depression and anxiety.  However, what has previously been unclear was whether the increased rates of psychiatric illness preceded the fatigue symptoms or occurred purely as a consequence of the disabling effects of a chronic illness.  This study demonstrated that individuals who reported suffering from CFS had increased rates of psychiatric disorder prior to the onset of their fatigue symptoms. 

The study used the MRC’s National Survey of Health and Development to follow more than 3000 people from birth through to age 53 years with regular assessments and access to comprehensive medical records.  Over 70% of those who reported a diagnosis of CFS had significant psychiatric symptoms prior to the onset of their fatigue symptoms.  These findings suggest that psychiatric disorders, or shared risk factors for psychiatric disorders, may have a role in the development of CFS.

It is important to point out that this does not mean that either CFS or psychiatric disorders are imaginary or all in the mind. Disorders such as depression and anxiety are well recognised genuine disorders that are also linked to abnormal neuro-biological functioning, just like CFS. Unfortunately they are also stigmatised by those who falsely conclude that such disorders are therefore imaginary, or less deserving of respect than other disorders.  It is hoped that the results of this study will help in our understanding CFS and assist in learning how to prevent and treat this debilitating and stigmatized condition.

The paper entitled: The relationship between prior psychiatric disorder and chronic fatigue.  Evidence from a national birth cohort study is authored by: Harvey SB, Wadsworth M, Wessely S, Hotopf M, Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK; MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and UCL Medical School, London, UK.  Psychological Medicine 2008;38(7):933-40.  View the paper:
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