Twelve-Year-Old Girl with Chronic Fatigue, School Absence, and Fluctuating Somatic Symptoms

Background. Individuals with acute infections experience a range of symptoms including fatigue, malaise, muscle aches, and difficulties with concentration and memory that are usually self-limited. This cluster of symptoms is otherwise, similar to those that characterize chronic fatigue syndrome (CFS). The goal of the present study was to evaluate the cognitive and psychological functioning of CFS patients and normal controls (NCs) when they both were experiencing acute influenza-like symptoms. To induce influenza-like symptoms, we administered interleukin-6 (IL-6), a cytokine that temporarily activates the acute phase immunological and endocrine responses.Methods. Nineteen patients who met the 1994 International CFS Study Group Criteria and ten normal controls (NCs) completed routine clinical evaluations, neuropsychological tests of short-term memory, selective attention, and executive control, and self-ratings of somatic symptoms and psychological mood before, shortly following, and 1 day after IL-6 administration.Results. CFS patients consistently reported more somatic symptoms, even when both groups perceived that they were ill. Both groups somatic symptoms increased during the IL-6 challenge, but the CFS patients symptoms increased more rapidly than controls. In general, the CFS patients performed similarly to NCs on the cognitive measures before, during, and after the IL-6. In contrast to predictions, IL-6 provocation did not impair the cognitive performance of either CFS patients or NCs.Conclusions. The IL-6 provocation exacerbated the patients self-reported symptoms but did not reveal notable cognitive impairments between patients and controls during cytokine-induced acute influenza-like symptoms.

Download Full-text

Correction: unidentified chronic Fatigue Syndrome/myalgic encephalomyelitis (CFS/ME) is a major cause of school absence: surveillance outcomes from school-based clinics

BMJ Open ◽

10.1136/bmjopen-2011-000252corr1 ◽

2019 ◽

Vol 9 (11) ◽

pp. e000252corr1

Keyword(s):

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Myalgic Encephalomyelitis ◽

Fatigue Syndrome ◽

School Absence ◽

School Based

Download Full-text

Experiences Among School Personnel and School Nurses on Educational Adaptations for Students With CFS/ME: A Qualitative Interview Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.756963 ◽

2021 ◽

Vol 9 ◽

Author(s):

Wenche Ann Similä ◽

Torstein Baade Rø ◽

Torunn Hatlen Nøst

Keyword(s):

Health Care Providers ◽

Social Life ◽

Interdisciplinary Collaboration ◽

School Personnel ◽

Chronic Fatigue ◽

School Nurses ◽

Care Providers ◽

Teacher Student ◽

School Absence ◽

Qualitative Interview Study

Introduction: Chronic fatigue syndrome (CFS/ME) is a disabling disease severely impacting school attendance, education, and social life in young students. Uncertainties surrounding CFS/ME etiology may impact the interpretation of CFS/ME in schools. Thus, school personnel need information from health care providers to make adequate adaptations to education and social life at school for these students.Objectives: To explore teachers, counselors, and school nurses' experiences with adapting education for students with CFS/ME aged 13–19 in secondary and high schools.Design: A qualitative study with focus group interviews and individual interviews performed face-to-face or digitally between November 2020 and March 2021. Data were analyzed using Systematic text condensation.Participants: Six teachers, two counselors, and four school nurses in secondary and high school participated.Results: Adapting education for students with CFS/ME was challenging, especially before the students received a diagnosis. The challenges were related to identifying the students' adaptational needs, maintaining a teacher-student relationship due to school absence, difficulties in maintaining continuity of education, and uncertainty regarding the diagnosis. Successful adaptations were related to quickly reacting to school absence, early referral to educational, psychological services, a close collaboration with the school management, and the development of digital teaching for students with CFS/ME. Interdisciplinary collaboration and a clear, constructive plan with adaptive measures, including maintained teacher-student communication and educational and social adaptations, may be useful in preventing the losses, young people, with CFS/ME experience.Conclusion: Early interdisciplinary collaboration to adapt education and social life at school for students with CFS/ME, may support teachers, counselors, and school nurses in their efforts to adapt education and prevent losses related to academic and social development in students with CFS/ME.

Download Full-text

Comorbid Somatic Symptoms and Functional Status in Patients With Fibromyalgia and Chronic Fatigue Syndrome: Sensory Amplification as a Common Mechanism

Psychosomatics ◽

10.1176/appi.psy.49.3.235 ◽

2008 ◽

Vol 49 (3) ◽

pp. 235-242 ◽

Cited By ~ 61

Author(s):

Michael E. Geisser ◽

Cathy Strader Donnell ◽

Frank Petzke ◽

Richard H. Gracely ◽

Daniel J. Clauw ◽

...

Keyword(s):

Chronic Fatigue Syndrome ◽

Functional Status ◽

Somatic Symptoms ◽

Chronic Fatigue ◽

Common Mechanism ◽

Fatigue Syndrome

Download Full-text

Chronic Fatigue and Fibromyalgia Symptoms are Key Components of Deficit Schizophrenia and are Strongly Associated with Activated Immune-Inflammatory Pathways

10.20944/preprints201907.0262.v1 ◽

2019 ◽

Author(s):

Abbas Almulla ◽

Hussein Al-Hakeim ◽

Mokhlad Abed ◽

André Carvalho ◽

Michael Maes

Keyword(s):

Convergent Validity ◽

Rating Scale ◽

Somatic Symptoms ◽

Internal Consistency Reliability ◽

Chronic Fatigue ◽

Psychomotor Retardation ◽

Deficit Schizophrenia ◽

Thought Disorders ◽

Symptom Domains

A subset of patients with schizophrenia experience physio-somatic symptoms reminiscent of chronic fatigue and fibromyalgia. In schizophrenia, these symptoms contribute to impaired quality of life, and are strongly related to neuro-cognitive deficits, and increased IgA responses to tryptophan catabolites. Negative and PHEM (psychosis, hostility, excitation, mannerism) symptoms, psychomotor retardation (PMR) and formal thought disorders, appear to be manifestations of a single trait reflecting overall severity of schizophrenia (OSOS). In this study, 120 patients with deficit schizophrenia (DEFSCZ) and 54 healthy subjects were assessed with the FibroFatigue (FF) rating scale, and the above-mentioned symptom domains as well as neuro-cognitive tests and biomarkers were measured. In DEFSCZ, there were robust associations between the FF score and all above-mentioned symptom domains, and impairments in semantic and episodic memory and executive functions. Furthermore, the FF score loaded highly on an OSOS latent vector (LV), which showed adequate convergent validity, internal consistency reliability and predictive relevance and fitted a reflective model. Soft Independent Modelling of Class Analogy (SIMCA) showed that the FF items discriminated DEFSCZ from controls with an overall accuracy of 100%. Interleukin IL-1β, IL-1 receptor antagonist (sIL-1RA), tumour necrosis factor (TNF)-α and CCL-11 (eotaxin) explained 66.8% of the variance in the FF score and 59.4% of the variance in OSOS. In conclusion, these data show that physio-somatic symptoms are a core component of the phenomenology of DEFSCZ and are largely mediated by neurotoxic effects of activated immune pathways, including aberrations in CCL-11, IL-1β and TNF-α signalling.

Download Full-text

In End-Stage Renal Disease, the Effects of Hemodialysis on Chronic Fatigue Syndrome- and Fibromyalgia-Like Symptoms are Mediated via Inflammatory Biomarkers, Copper and Wnt/Catenin Pathway Proteins

10.20944/preprints202103.0336.v1 ◽

2021 ◽

Author(s):

Halah Asad ◽

Hussein Al-Hakeim ◽

Shatha Moustafa ◽

Michael Maes

Keyword(s):

End Stage Renal Disease ◽

Muscle Tension ◽

Somatic Symptoms ◽

Chronic Fatigue ◽

Beta Catenin ◽

Fatigue Syndrome ◽

Gi Symptoms ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

End-stage renal disease (ESRD) is associated with fatigue and physio-somatic symptoms. The aims of this study are to delineate the associations between severity of fatigue and physio-somatic symptoms and glomerular filtration rate, inflammatory biomarkers, and Wnt/catenin-pathway proteins. The Wnt-pathway related proteins β-catenin, Dickkopf-related protein 1 (DKK1), R-spondin-1, and sclerostin were measured by ELISA technique in 60 ESRD patients and 30 controls. The Fibromyalgia and Chronic Fatigue Syndrome (FF) Rating Scale was used to assess severity of FF symptoms. ESRD is characterized by a significant increase in the total FF score, muscle tension, fatigue, sadness, sleep disorders, GI symptoms, and a flu-like malaise. The total FF score was significantly correlated with serum levels of urea, creatinine, phosphate, and copper (positively), and β-catenin, eGFR, hemoglobin, albumin, and zinc (inversely). The total FF score was associated with the number of total dialysis and weekly dialysis sessions, and these dialysis characteristics were more important in predicting FF scores than eGFR measurements. Partial Least Squares analysis showed that the FF score comprised two factors which are differently associated with biomarkers: a) 43.0% of the variance in fatigue, GI symptoms, muscle tension, sadness, and insomnia is explained by hemoglobin, albumin, zinc, β-catenin, and R-spondin-1; and b) 22.3% of the variance in irritability, concentration and memory impairments by increased copper and cations/chloride ratio, and male sex. ESRD patients show high levels of fatigue and physio-somatic symptoms which are associated with hemodialysis and mediated by dialysis-induced changes in inflammatory pathways, the Wnt/catenin pathway, and copper.

Download Full-text

Cognitive–behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a randomised controlled trial

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000797 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000797

Author(s):

Sadaf Malik ◽

Tarjei Tørre Asprusten ◽

Maria Pedersen ◽

Julie Mangersnes ◽

Gro Trondalen ◽

...

Keyword(s):

Music Therapy ◽

Intervention Group ◽

Chronic Fatigue ◽

Behavioural Therapy ◽

Control Group ◽

Barr Virus ◽

School Absence ◽

Cognitive Behavioural ◽

Epstein Barr ◽

Randomised Controlled

BackgroundCognitive–behavioural therapy (CBT) is effective in chronic fatigue (CF) syndrome. However, CBT has not been investigated in postinfectious CF, nor is it known whether addition of therapeutic elements from other disciplines might be useful. We explored combined CBT and music therapy intervention for CF following Epstein-Barr virus (EBV) infection in adolescents.MethodsAdolescents (12–20 years old) participating in a postinfectious cohort study who developed CF 6 months after an acute EBV infection were eligible for the present study. A combined CBT and music therapy programme (10 therapy sessions and related homework) was compared with care as usual in a randomised controlled design. Therapists and participants were blinded to outcome evaluation. Endpoints included physical activity (steps/day), symptom scores, recovery rate and possible harmful effects, but the study was underpowered regarding efficacy. Total follow-up time was 15 months. Power analyses suggested that 120 participants would be needed in order to detect a moderate effect size.ResultsA total of 91 individuals with postinfectious CF were eligible, and a total of 43 were included (21 intervention group, 22 control group). Concern regarding school absence due to therapy sessions was the main reason for declining participation. Seven individuals left the study during the first 3 months, leaving 15 in the intervention group and 21 in the control group at 3 months follow-up. No harmful effects were recorded, and compliance with appointment was high. In intention-to-treat analyses, the primary endpoint (number of steps/day) did not differ significantly between the intervention group and the control group (difference (95% CI) =–1298 (–4874 to 2278)). Secondary outcome measures were also not significantly different among the two groups.ConclusionAn intervention study of combined CBT and music therapy in postinfectious CF is feasible. A fully powered trial is needed to evaluate efficacy; participants’ concern regarding school absence should be properly addressed to secure recruitment.Trial registration numberClinicalTrials ID: NCT02499302, registered July 2015.

Download Full-text