Clarifying the relationship between unexplained chronic fatigue and psychiatric morbidity: results from a community survey in Great Britain

ObjectiveTo explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.DesignA quasiexperimental design. Structural equation modelling (SEM) and invariance testing.ParticipantsMales (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measuresDiagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.ResultsInvariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (p<0.05) based on five questions. Consequently, it was erroneous to conclude differences. Therefore, the Syndrome Model was created. SEM could not have tested the ACR previously, as it comprised a single data point. Thus, it was combined with these three questionnaires, increasing the data points, to create this new measurable model. Results confirmed no significant differences between groups (p=0.07 (p<0.05)).ConclusionParticipants responded in a similar manner to the questionnaire, confirming the same symptom experience. It is important to consider this in context with differing criteria and management guidelines, as this may influence diagnosis and the trajectory of patient’s management. With the biomedical cause currently unclear, it is the symptom experience and the impact on quality of life that is important. These findings are meaningful for patients, clinicians and policy development and support the requirement for future research.

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ECP02-01 - Globalisation and the impact of economic factors on psychiatric disorders

European Psychiatry ◽

10.1016/s0924-9338(11)73499-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1795-1795

Author(s):

D. Bhugra

Keyword(s):

Mental Health ◽

Cultural Identity ◽

Economic Status ◽

Psychiatric Morbidity ◽

Economic Factors ◽

Socio Economic Status ◽

Level Of Economic Development ◽

Migration Experiences ◽

The Impact ◽

The Relationship

IntroductionWith the process of globalisation in full flow, the movement of people and products across the globe has brought a series of difficulties. With migration the socio-economic status of the individuals may change with the likelihood that this status will be lower rather than higher, although depending upon the reasons for migration this may change too.ObjectivesLiterature shows that low socio-economic status is associated with a higher level of psychiatric morbidity.AimsWhether migration acts as a mediator needs to be investigated further.MethodsVarious studies have shown that rates of psychosis are elevated in migrants though these rates are differentially increased in different groups indicating that factors other than migration may be at play.ResultsIn this presentation the literature and link the acculturation and cultural identity with post-migration experiences will be reviewed.ConclusionA link exists between the perceptions within cultures and level of economic development of what constitutes mental health. The state of advancement of mental health services of a country will certainly have a large impact on prevalence rates. Further investigation should be carried out to examine in greater depth the relationship between social inequality and disorder prevalence, as distinct from income inequality.

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Psychiatric Morbidity of West Indian Immigrants in an Urban Group Practice

The British Journal of Psychiatry ◽

10.1192/bjp.111.470.51 ◽

1965 ◽

Vol 111 (470) ◽

pp. 51-56 ◽

Cited By ~ 44

Author(s):

Ari Kiev

Keyword(s):

General Practice ◽

Great Britain ◽

Psychiatric Disorders ◽

Psychiatric Morbidity ◽

West Indian ◽

Group Practice ◽

Urban Group ◽

Indian Immigrants ◽

Minor Psychiatric Disorders ◽

West Indian Immigrants

Since 1948 a number of papers published in Great Britain have demonstrated the feasibility of studying the incidence and prevalence of both major and minor psychiatric disorders in general practice (3, 4, 7, 8, 10, 11, 14, 16, 17, 18). Few, however, have focused on the health of West Indian immigrants in Great Britain, some 125,000 of whom have entered the country since that time (2, 12, 13, 20). This paper reports on the results of a six-month psychiatric morbidity survey of a group general practice in Brixton, the main purpose of which was to collect and compare data on the illness and consultation patterns of West Indian and English patients attending the same general practice.

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A controlled family study of late-onset non-affective psychosis (late paraphrenia)

The British Journal of Psychiatry ◽

10.1192/bjp.170.6.511 ◽

1997 ◽

Vol 170 (6) ◽

pp. 511-514 ◽

Cited By ~ 42

Author(s):

R. J. Howard ◽

C. Graham ◽

P. Sham ◽

J. Dennehey ◽

D. J. Castle ◽

...

Keyword(s):

At Risk ◽

Late Onset ◽

Psychiatric Morbidity ◽

Late Life ◽

Lifetime Risk ◽

First Degree Relatives ◽

Healthy Elderly ◽

Increased Risk ◽

Age Range ◽

The Relationship

BackgroundThe relationship between those schizophrenia-like conditions that have their onset in late life and early-onset schizophrenia is unclear. Very few family history studies of patients with late-onset psychosis have been reported, and it is not known whether their relatives have an increased risk of psychosis.MethodInformation was collected on the psychiatric morbidity of 269 first-degree relatives of patients with schizophrenia or delusional disorder with an onset after the age of 60 (late paraphrenia), and 272 first-degree relatives of healthy elderly control subjects, using a research diagnostic instrument.ResultsWith a narrow age range (15–50 years) at risk, the estimated lifetime risk of schizophrenia was 1.3% in the relatives of both cases and controls. With a wider age range (15–90 years) at risk, estimated lifetime risk of schizophrenia was 2.3% for the relatives of cases, and 2.2% for the relatives of controls. However, depression was significantly more common among the relatives of cases than controls.ConclusionThose schizophrenia-like psychoses with onset in late life are not genetically associated with schizophrenia.

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Aircraft noise and psychiatric morbidity

Psychological Medicine ◽

10.1017/s0033291700054337 ◽

1973 ◽

Vol 3 (4) ◽

pp. 516-520 ◽

Cited By ~ 30

Author(s):

F. Gattoni ◽

A. Tarnopolsky

Keyword(s):

Psychiatric Hospital ◽

Psychiatric Morbidity ◽

Aircraft Noise ◽

Admission Rates ◽

The Relationship

SynopsisAn earlier investigation which showed that admission rates to a psychiatric hospital were higher from the higher noise zones close to Heathrow Airport than from relatively quieter areas was repeated. The present paper could not confirm those results, although a trend in agreement with the original findings was found. The scope of the relationship between levels of aircraft noise and types of psychiatric morbidity is discussed.

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Depressive Disorder in Primary Care

The British Journal of Psychiatry ◽

10.1192/bjp.150.6.737 ◽

1987 ◽

Vol 150 (6) ◽

pp. 737-751 ◽

Cited By ~ 127

Author(s):

C. V. R. Blacker ◽

A. W. Clare

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Depressive Disorders ◽

Psychiatric Morbidity ◽

Depressive Illness ◽

Psychiatric Disturbance ◽

Collaborative Studies ◽

Effect Of Treatment ◽

Precise Relationship ◽

The Relationship

Since the pioneering study of psychiatric morbidity in primary care by Shepherdet alin 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeperet al,1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment?

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The Relationship between Trauma due to Winter Storm Alexa, PTSD, Mental Health of Palestinians in the Gaza Strip

Research in Health Science ◽

10.22158/rhs.v1n1p11 ◽

2016 ◽

Vol 1 (1) ◽

pp. 11

Author(s):

Abdelaziz M. Thabet ◽

Sanaa S. Thabet

Keyword(s):

Mental Health ◽

Political Violence ◽

Mental Health Problems ◽

Gaza Strip ◽

Psychiatric Morbidity ◽

Traumatic Events ◽

Winter Storm ◽

Social Dysfunction ◽

The Gaza Strip ◽

The Relationship

Aim: This study investigated the relationship between trauma due to winter storm Alexa, PTSD and other mental health problems of Palestinian in Gaza Strip. Method: The sample consisted of 105 males (50%) and 105 females (50%) selected from three of the most affected areas by flooding in 2014 due to Alexa storm in Gaza Strip. Participants age range was 20-65 years, with a mean age 40.88 (SD = 9.8), with a mean age of years. Mental health status was assessed by a sociodemographic scale, the Trauma Due to Flood Scale, PTSD scale, and General Health Questionnaire (28 items). Results: Mean traumatic events experienced were 7.8. There were no statistically significant differences between males and females in reporting traumatic events. Mean post-traumatic stress disorder was 18.65, re-experiences symptoms was 6.4, avoidance symptoms was 5.7 and mean arousal symptoms was 5.73. The study showed that 34.8% reported full criteria of PTSD. There were no statistically significant differences in PTSD total scores and subscales and sex of participants. Mean GHQ-28 was 12.12, somatization mean was 3.21, anxiety was 3.31, social dysfunction was 3.34, and depression was 2.27, 91% of the participants were rated as psychiatric morbidity cases and need further investigation. Males significantly scored more in social dysfunction than females. Traumatic events were significantly correlated with PTSD and general mental health and all subscales. Conclusion and implications: This study has important implications for need of establishing and implementing psychosocial intervention programs for in the Gaza Strip not only for those victims of political violence but also for people exposed to other types of traumatic events such as natural disasters.

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The neuroendocrinology of chronic fatigue syndrome and fibromyalgia

Psychological Medicine ◽

10.1017/s0033291701004664 ◽

2001 ◽

Vol 31 (8) ◽

pp. 1331-1345 ◽

Cited By ~ 115

Author(s):

A. J. R. PARKER ◽

S. WESSELY ◽

A. J. CLEARE

Keyword(s):

Chronic Fatigue Syndrome ◽

Cochrane Collaboration ◽

Chronic Fatigue ◽

Fatigue Syndrome ◽

King's College ◽

Populations At Risk ◽

Challenge Tests ◽

Neuroendocrine Challenge ◽

The Cochrane Collaboration ◽

The Relationship

Background. Disturbance of the HPA axis may be important in the pathophysiology of chronic fatigue syndrome (CFS) and fibromyalgia. Symptoms may be due to: (1) low circulating cortisol; (2) disturbance of central neurotransmitters; or (3) disturbance of the relationship between cortisol and central neurotransmitter function. Accumulating evidence of the complex relationship between cortisol and 5-HT function, make some form of hypothesis (3) most likely. We review the methodology and results of studies of the HPA and other neuroendocrine axes in CFS.Method. Medline, Embase and Psychlit were searched using the Cochrane Collaboration strategy. A search was also performed on the King's College CFS database, which includes over 3000 relevant references, and a citation analysis was run on the key paper (Demitrack et al. 1991).Results. One-third of the studies reporting baseline cortisol found it to be significantly low, usually in one-third of patients. Methodological differences may account for some of the varying results. More consistent is the finding of reduced HPA function, and enhanced 5-HT function on neuroendocrine challenge tests. The opioid system, and arginine vasopressin (AVP) may also be abnormal, though the growth hormone (GH) axis appears to be intact, in CFS.Conclusions. The significance of these changes, remains unclear. We have little understanding of how neuroendocrine changes relate to the experience of symptoms, and it is unclear whether these changes are primary, or secondary to behavioural changes in sleep or exercise. Longitudinal studies of populations at risk for CFS will help to resolve these issues.

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Immigrant Context and Opportunity

The Annals of the American Academy of Political and Social Science ◽

10.1177/0002716215577611 ◽

2015 ◽

Vol 660 (1) ◽

pp. 175-198 ◽

Cited By ~ 15

Author(s):

Chenoa Flippen ◽

Eunbi Kim

Keyword(s):

Occupational Status ◽

The United States ◽

Community Survey ◽

National Origin ◽

Immigrant Incorporation ◽

New Destinations ◽

Socioeconomic Attainment ◽

Level Information ◽

Survey Results ◽

The Relationship

Immigrant-origin populations, once overwhelmingly concentrated in a handful of receiving gateways, have dispersed in recent decades to scores of new destinations throughout the United States. This pattern and its implications for immigrant incorporation have received a great deal of attention, but the vast majority of research has focused on Hispanics. This article examines the relationship between settlement patterns and socioeconomic attainment (income, occupational status, and homeownership) among Asians. Drawing on individual- and metro-level information from the 2009 to 2011 American Community Survey, results suggest that Asians in new destinations face an important tradeoff between income and homeownership, and that differences across contexts are largely attributable to metropolitan labor and housing market conditions, rather than the ethnic context per se. However, there are important differences in outcomes among Asians by national origin and sex, and a comparison with whites suggests that inequality differs across new and more established Asian settlement areas.

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