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Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection
Prospective cohort studies following individuals from acute infections have documented a prevalent post-infective fatigue state meeting diagnostic criteria for chronic fatigue syndrome (CFS) – that is, a post-infective fatigue syndrome (PIFS). The Dubbo Infection Outcomes Study (DIOS) was a prospect...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359311/ https://www.ncbi.nlm.nih.gov/pubmed/35959390 http://dx.doi.org/10.3389/fneur.2022.935442 |
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author | Sandler, Carolina X. Cvejic, Erin Valencia, Braulio M. Li, Hui Hickie, Ian B. Lloyd, Andrew R. |
author_facet | Sandler, Carolina X. Cvejic, Erin Valencia, Braulio M. Li, Hui Hickie, Ian B. Lloyd, Andrew R. |
author_sort | Sandler, Carolina X. |
collection | PubMed |
description | Prospective cohort studies following individuals from acute infections have documented a prevalent post-infective fatigue state meeting diagnostic criteria for chronic fatigue syndrome (CFS) – that is, a post-infective fatigue syndrome (PIFS). The Dubbo Infection Outcomes Study (DIOS) was a prospective cohort following individuals from acute infection with Epstein-Barr virus (EBV), Ross River virus (RRV), or Q fever through to assessment of caseness for CFS designated by physician and psychiatrist assessments at 6 months. Previous studies in DIOS have revealed that functional genetic polymorphisms in both immunological (pro- and anti-inflammatory cytokines) and neurological (the purinergic receptor, P2X7) genes are associated with both the severity of the acute infection and subsequent prolonged illness. Principal components analysis was applied to self-report data from DIOS to describe the severity and course of both the overall illness and concurrent mood disturbance. Associations between demographics and acute infection characteristics, with prolonged illness course as well as the PIFS outcome were examined using multivariable statistics. Genetic haplotype-driven functional variations in the neuropeptide Y (NPY) gene previously shown to be associated with brain responses to stress, and to trait anxiety were also examined as predictors. The sample included 484 subjects (51% female, median age 32, IQR 19–44), of whom 90 (19%) met diagnostic criteria for CFS at 6 months. Participants with greater overall illness severity and concurrent mood disturbance in the acute illness had a more prolonged illness severity (HR = 0.39, 95% CI: 0.34–0.46, p < 0.001) and mood disturbance (HR = 0.36, 95% CI: 0.30–0.42, p < 0.001), respectively. Baseline illness severity and RRV infection were associated with delayed recovery. Female gender and mood disturbance in the acute illness were associated with prolonged mood disturbance. Logistic regression showed that the odds of an individual being diagnosed with PIFS increased with greater baseline illness severity (OR = 2.24, 95% CI: 1.71–2.94, p < 0.001). There was no association between the NPY haplotypes with overall illness severity or mood disturbance either during the acute illness phase or with prolonged illness (p > 0.05). Severe acute infective illnesses predicted prolonged illness, prolonged mood disturbance and PIFS. These factors may facilitate early intervention to manage both PIFS and mood disturbances. |
format | Online Article Text |
id | pubmed-9359311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93593112022-08-10 Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection Sandler, Carolina X. Cvejic, Erin Valencia, Braulio M. Li, Hui Hickie, Ian B. Lloyd, Andrew R. Front Neurol Neurology Prospective cohort studies following individuals from acute infections have documented a prevalent post-infective fatigue state meeting diagnostic criteria for chronic fatigue syndrome (CFS) – that is, a post-infective fatigue syndrome (PIFS). The Dubbo Infection Outcomes Study (DIOS) was a prospective cohort following individuals from acute infection with Epstein-Barr virus (EBV), Ross River virus (RRV), or Q fever through to assessment of caseness for CFS designated by physician and psychiatrist assessments at 6 months. Previous studies in DIOS have revealed that functional genetic polymorphisms in both immunological (pro- and anti-inflammatory cytokines) and neurological (the purinergic receptor, P2X7) genes are associated with both the severity of the acute infection and subsequent prolonged illness. Principal components analysis was applied to self-report data from DIOS to describe the severity and course of both the overall illness and concurrent mood disturbance. Associations between demographics and acute infection characteristics, with prolonged illness course as well as the PIFS outcome were examined using multivariable statistics. Genetic haplotype-driven functional variations in the neuropeptide Y (NPY) gene previously shown to be associated with brain responses to stress, and to trait anxiety were also examined as predictors. The sample included 484 subjects (51% female, median age 32, IQR 19–44), of whom 90 (19%) met diagnostic criteria for CFS at 6 months. Participants with greater overall illness severity and concurrent mood disturbance in the acute illness had a more prolonged illness severity (HR = 0.39, 95% CI: 0.34–0.46, p < 0.001) and mood disturbance (HR = 0.36, 95% CI: 0.30–0.42, p < 0.001), respectively. Baseline illness severity and RRV infection were associated with delayed recovery. Female gender and mood disturbance in the acute illness were associated with prolonged mood disturbance. Logistic regression showed that the odds of an individual being diagnosed with PIFS increased with greater baseline illness severity (OR = 2.24, 95% CI: 1.71–2.94, p < 0.001). There was no association between the NPY haplotypes with overall illness severity or mood disturbance either during the acute illness phase or with prolonged illness (p > 0.05). Severe acute infective illnesses predicted prolonged illness, prolonged mood disturbance and PIFS. These factors may facilitate early intervention to manage both PIFS and mood disturbances. Frontiers Media S.A. 2022-07-25 /pmc/articles/PMC9359311/ /pubmed/35959390 http://dx.doi.org/10.3389/fneur.2022.935442 Text en Copyright © 2022 Sandler, Cvejic, Valencia, Li, Hickie and Lloyd. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Sandler, Carolina X. Cvejic, Erin Valencia, Braulio M. Li, Hui Hickie, Ian B. Lloyd, Andrew R. Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title | Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title_full | Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title_fullStr | Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title_full_unstemmed | Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title_short | Predictors of Chronic Fatigue Syndrome and Mood Disturbance After Acute Infection |
title_sort | predictors of chronic fatigue syndrome and mood disturbance after acute infection |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9359311/ https://www.ncbi.nlm.nih.gov/pubmed/35959390 http://dx.doi.org/10.3389/fneur.2022.935442 |
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