Post-hepatitis syndrome revisited.

To examine the role of acute hepatitis A and B infection in the aetiology of chronic fatigue syndrome and psychiatric morbidity we studied 40 patients with acute viral hepatitis A or B consecutively admitted to an infectious diseases unit and studied at least 6 months after recovery. Liver function tests (LFT) had returned to normal in each case. Forty-seven patients with other infectious diseases, of which 12 were presumed viral, admitted immediately after each hepatitis patient during the same period acted as controls. The main outcome measures were scores on a fatigue and muscle pain questionnaire, general health questionnaire (GHQ-12) and supplementary questions. The hepatitis cases scored significantly higher fatigue scores, GHQ-12 scores and muscle pain scores. Length of time since recovery from illness, age and sex were not confounding factors. Hepatitis cases were also less energetic, had greater weight change, had altered alcohol tolerance, had less exercise tolerance and felt less fit than the control group and compared with their premorbid state. Hence fatigue is more common after recovery in patients hospitalized for hepatitis A and B up to 30 months post-infection compared with matched controls hospitalized for other infectious diseases. Hepatitis A and B infection is a risk factor for post-infection fatigue, intermittent fatigue, as well as for psychiatric morbidity.

The use of drugs for physical conditions in adults with mental retardation.

A survey of the drugs given for physical complaints in two mental handicap hospitals is described. Thirty-six per cent of 537 adults in hospital A and 43% of 944 adults in hospital B received medications and, of those who did, over half in each hospital received only one drug. The hospital populations differed significantly but both showed a significant increase in total drug usage with increasing age in both sexes, higher among females in every group. This increase was greatest with C.V.S. drug usage, but it did not reach significance for the three most frequently prescribed groups, which were gastrointestinal drugs (to 13% of the total patients), vitamins and nutritional supplements (11%), dermatological (10%) and cardiovascular (10%) drugs. Mental level was significantly indirectly related to usage of gastrointestinal drugs, drugs for anaemia, and vitamins and nutritional supplements, and directly to usage of cardiovascular drugs.