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1.
BMC Neurol ; 19(1): 275, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699051

RESUMO

BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease, whose exact cause remains unclear. A wide range of risk factors has been proposed that helps understanding potential disease pathogenesis. However, there is little consistency for many risk factor associations, thus we undertook an exploratory study of risk factors using data from the UK ME/CFS Biobank participants. We report on risk factor associations in ME/CFS compared with multiple sclerosis participants and healthy controls. METHODS: This was a cross-sectional study of 269 people with ME/CFS, including 214 with mild/moderate and 55 with severe symptoms, 74 people with multiple sclerosis (MS), and 134 healthy controls, who were recruited from primary and secondary health services. Data were collected from participants using a standardised written questionnaire. Data analyses consisted of univariate and multivariable regression analysis (by levels of proximity to disease onset). RESULTS: A history of frequent colds (OR = 8.26, P <= 0.001) and infections (OR = 25.5, P = 0.015) before onset were the strongest factors associated with a higher risk of ME/CFS compared to healthy controls. Being single (OR = 4.41, P <= 0.001), having lower income (OR = 3.71, P <= 0.001), and a family history of anxiety is associated with a higher risk of ME/CFS compared to healthy controls only (OR = 3.77, P < 0.001). History of frequent colds (OR = 6.31, P < 0.001) and infections before disease onset (OR = 5.12, P = 0.005), being single (OR = 3.66, P = 0.003) and having lower income (OR = 3.48, P = 0.001), are associated with a higher risk of ME/CFS than MS. Severe ME/CFS cases were associated with lower age of ME/CFS onset (OR = 0.63, P = 0.022) and a family history of neurological illness (OR = 6.1, P = 0.001). CONCLUSIONS: Notable differences in risk profiles were found between ME/CFS and healthy controls, ME/CFS and MS, and mild-moderate and severe ME/CFS. However, we found some commensurate overlap in risk associations between all cohorts. The most notable difference between ME/CFS and MS in our study is a history of recent infection prior to disease onset. Even recognising that our results are limited by the choice of factors we selected to investigate, our findings are consistent with the increasing body of evidence that has been published about the potential role of infections in the pathogenesis of ME/CFS, including common colds/flu.


Assuntos
Síndrome de Fadiga Crônica , Adulto , Estudos Transversais , Síndrome de Fadiga Crônica/epidemiologia , Síndrome de Fadiga Crônica/etiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
2.
BMC Public Health ; 19(1): 840, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31253111

RESUMO

BACKGROUND: Few reports have examined the association between unemployment and work disability in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This study explored the key determinants of work disability in a CFS/ME cohort. METHODS: A community-based prospective study included 1086 CFS/ME patients aged 18-65 years. Demographic and clinical characteristics and outcome measures were recorded. Multiple linear regression analysis was performed to identify key risk indicators of work disability. RESULTS: Four hundred and fifty patients with CFS/ME were employed (41.4%) and 636 were unemployed (58.6%). Older age at pain onset (OR: 1.44; 95% CI: 1. 12-1.84, autonomic dysfunction (OR: 2.21; 95% CI: 1.71-2.87), neurological symptom (OR: 1.66; 95% CI: 1. 30-2.13) and higher scores for fatigue (OR: 2.61; 95% CI: 2.01-3.39), pain (OR: 2.09; 95% CI: 1.47-2.97), depression (OR: 1.98; 95% CI: 1. 20-3.26), psychopathology (OR: 1.98; 95% CI: 1.51-2.61) and sleep dysfunction (OR: 1.47; 95% CI: 1. 14-1.90) were all associated with a higher risk of work disability due to illness. CONCLUSIONS: Using an explanatory approach, our findings suggest that unemployment is consistently associated with an increased risk of work disability due to CFS/ME, although further more rigorous research is now needed to help in targeting interventions at the workplace.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Síndrome de Fadiga Crônica/epidemiologia , Desemprego/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia
3.
Clin Child Psychol Psychiatry ; 24(3): 580-592, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30945566

RESUMO

INTRODUCTION: Previous research has indicated that co-morbid depression is common in adolescents with chronic fatigue syndrome (CFS). OBJECTIVES: We sought to compare the characteristics of depressive symptoms in adolescents with CFS to those of healthy controls (HCs) and illness controls (adolescents with asthma). DESIGN: Case-control study nested within a prospective clinical cohort. METHODS: A total of 121 adolescents with CFS who attended an initial assessment at two specialist CFS units completed the Children's Depression Inventory (CDI). Their responses were compared to 80 HCs and 27 adolescents with asthma (illness controls). The clinical cohort of adolescents with CFS completed questionnaires at assessment, and those who were seen subsequently for treatment at the CFS unit (68%) completed the measures again at their first treatment session. RESULTS: CFS participants scored significantly higher on all the depression subscales than participants with asthma and HCs. Depression score explained 11% of the variance in subsequent fatigue, but only 1.9% of the variance in physical functioning. Depression score also explained most (68%) of the variance in subsequent depression. CONCLUSION: Depressive symptoms are more prominent in adolescents with CFS than in HCs or illness controls. These symptoms also appear to remain over time during a naturalistic follow-up where no treatment was provided. This highlights the need for further research into depression in CFS, including stratifying treatment outcomes by depression status to determine what is effective at addressing these symptoms.


Assuntos
Depressão/epidemiologia , Síndrome de Fadiga Crônica/epidemiologia , Adolescente , Asma/epidemiologia , Asma/psicologia , Estudos de Casos e Controles , Comorbidade , Depressão/psicologia , Síndrome de Fadiga Crônica/psicologia , Feminino , Humanos , Masculino , Prevalência , Inquéritos e Questionários
4.
Psychol Health ; 34(7): 850-866, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30821511

RESUMO

Objectives: To investigate perfectionism and beliefs about emotions in adolescents with chronic fatigue syndrome (CFS) and their parents. Design: Case-control comparing adolescents (age 11-18) with CFS (N = 121), asthma (N = 27) and healthy controls (N = 78) with a 3-month follow up for CFS participants. Main outcome measures: Adolescents: Chalder Fatigue Questionnaire, physical functioning, Beliefs about Emotions scale (BES), Child and Adolescent Perfectionism Scale, Frost Multidimensional Perfectionism Scale (FMPS). Parents: BES, FMPS, Self-sacrificing scale, Affective styles questionnaire. Results: Adolescents with CFS did not consistently report higher levels of perfectionism and unhelpful beliefs about emotions than adolescents with asthma or healthy adolescents. Mothers' and adolescents' beliefs about emotions and unhelpful perfectionism were significantly associated (p = .007). Linear regression found that neither adolescent perfectionism nor beliefs about emotions accounted for variance in subsequent fatigue or physical functioning. Conclusion: Parental perfectionism and emotion regulation style may contribute to perfectionism in adolescents with CFS. Parental representations could contribute to fatigue maintenance.


Assuntos
Emoções , Síndrome de Fadiga Crônica/psicologia , Pais/psicologia , Perfeccionismo , Adolescente , Estudos de Casos e Controles , Criança , Estudos de Coortes , Síndrome de Fadiga Crônica/epidemiologia , Feminino , Humanos , Masculino , Inquéritos e Questionários
5.
Int J Occup Med Environ Health ; 32(1): 75-85, 2019 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-30855100

RESUMO

Objectives: Over the last 20 years, tertiary institutions have been subjected to several changes. This has resulted in increased workloads for academics. Some academics have started to experience symptoms that are related to chronic fatigue syndrome and burnout. Researchers, however, cannot agree whether the 2 syndromes are two sides of the same coin or actually 2 separate constructs. This study that was conducted at a tertiary institution in South Africa therefore aimed to determine if these constructs accounted for the evidence of the same syndrome within an academic setting or if they were 2 separate, distinguishable constructs. However, since job satisfaction and social support play a role in the poor physical and psychological health experienced by individuals with chronic fatigue syndrome or burnout, it was decided to also include these 2 constructs into the investigation. Age was also incorporated because it had dissimilar relationships with burnout and chronic fatigue syndrome. Material and Methods: The participants completed the following questionnaires via an online survey: The Centers for Disease Control and Prevention Chronic Fatigue Syndrome Symptom Inventory, the Oldenburg Burnout Inventory, the Overall Job Satisfaction Scale and the Social Support Scale. The data was used for constructing a structural equation model. Results: Job satisfaction was found to be a strong predictor of burnout. The number of symptoms indicative of chronic fatigue syndrome reported by the participants proved to be a relatively strong significant predictor of burnout. Age did not yield any significant relationship with any of the constructs. Conclusions: The results indicated that chronic fatigue and burnout should be perceived as 2 distinguishable constructs in the academic context. It should be noted, however, that some overlap exists between them. Int J Occup Med Environ Health. 2019;32(1):75 ­ 85


Assuntos
Esgotamento Profissional/epidemiologia , Docentes/psicologia , Síndrome de Fadiga Crônica/epidemiologia , Satisfação no Emprego , Apoio Social , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , África do Sul , Inquéritos e Questionários
6.
J Adv Nurs ; 75(8): 1667-1677, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30666686

RESUMO

AIMS: To identify the prevalence of work-related musculoskeletal disorders, levels of chronic occupational fatigue, and how they vary with individual and work organization factors. DESIGN: A multi-hospital cross-sectional survey. METHODS: Nurses from 39 hospitals completed self-reported questionnaires from June to September 2015. Descriptive statistics were used to summarize hospitals and nurses' characteristics, fatigue levels and prevalence, and type of musculoskeletal disorders. Linear and logistic regression analyses were used to identify correlational factors. RESULTS: The results revealed that 71.3% of participants reported a work-related musculoskeletal disorder in the previous 12 months, mainly back pain. The reported musculoskeletal disorders were significantly correlated with years of experience, nurse to patient ratios, and chronic occupational fatigue. Higher chronic occupational fatigue levels were associated with education, age, years of experience, nurse to patient ratio, and model of care. CONCLUSION: Preventive work organization strategies are needed to ensure healthier occupational environment for nurses.


Assuntos
Síndrome de Fadiga Crônica/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Local de Trabalho/organização & administração , Local de Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Administração Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
7.
Acta Oncol ; 58(5): 753-762, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30696351

RESUMO

Background: Chronic fatigue (CF) is scarcely explored among young adult cancer survivors (YACSs), and more knowledge is needed to develop targeted interventions for YACSs with CF. The present study aimed to investigate the prevalence of CF and associated factors in YACSs. Also, the change of fatigue with time was explored. Material and methods: The present cross-sectional study is part of a nation-wide population based survey of Norwegian survivors of cancer in childhood, adolescence, and young adulthood (The NOR-CAYACS study).YACSs diagnosed at the age of 19-39 years with breast cancer stage ≤ III (BC), colorectal cancer (CRC), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia, or non-metastatic malignant melanoma (MM) were included 5-30 years after diagnosis. Survivors of MM treated with limited surgery were included as a reference group. CF was assessed by the Fatigue Questionnaire. Logistic regression analyses were performed to identify factors associated with CF. Results: In total, 1488 survivors completed the questionnaire (a response rate of 42%), of which 1088 were eligible for the present study. Overall, 25% reported CF. CF was significantly more prevalent among survivors of BC (29%) (p < .001), CRC (29%) (p = .001) and NHL (27%) (p = .003) than among survivors of MM (15%). CF was associated with systemic treatment combined with surgery and/or radiotherapy (p = .018), comorbidity (p = .038), pain (p = .002), numbness in hands/feet (p = .046), and depressive symptoms (p < .001) in the multivariable model. Among survivors with CF, 60% reported that they had been tired since cancer treatment, and among these, 65% reported worsening or no change of fatigue with time. Conclusion: One of four YACSs reported CF 15 years from diagnosis (mean). CF was associated with several possibly treatable factors. Health professionals involved in the follow-up of YACSs should have knowledge of CF and approaches to manage it.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Síndrome de Fadiga Crônica/epidemiologia , Sobreviventes/estatística & dados numéricos , Adulto , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/terapia , Estudos Transversais , Exercício , Síndrome de Fadiga Crônica/etiologia , Feminino , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Noruega/epidemiologia , Prevalência , Autorrelato
8.
Int Urogynecol J ; 30(3): 483-488, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29974141

RESUMO

INTRODUCTION AND HYPOTHESIS: Patients in gynecology outpatient clinics (GOPDs) may present with symptoms that do not correlate well with the observed pathology and are usually labelled as having a functional disorder or medically unexplained symptoms (MUS). Underlying central sensitivity syndrome (CSS) with central sensitization (CS) as a potential mechanism may be responsible for some of their symptoms. The aim of this study is to identify the proportion of women with central sensitivity syndrome attending GOPDs. METHODS: This was a prospective study. All women attending a GOPD included in the study were asked to complete a validated Central Sensitization Inventory (CSI). The responses were graded on a Likert scale from 0 (never) to 4 (always). The total score ranges from 0 to 100. For screening purposes, a single CSI cutoff score of 40 was used to identify the group of women who may have central sensitization syndrome. RESULTS: Three hundred twenty-six women participated in the study. Overall, 123 (37%) women achieved a score above 40. This could be interpreted as these patients having increased risk of underlying central sensitization. Of these, 43 had a previously confirmed diagnosis of migraine, 55 (44%) depression, 39 (31.7%) anxiety, 11 fibromyalgia (FM), 34 irritable bowel syndrome (IBS) and 16 chronic fatigue syndrome (CFS/ME). CONCLUSIONS: Managing patients and their expectations in gynecological outpatient departments when symptoms are inconsistent with observable pathological findings is challenging. This is further complicated when patients have a concomitant central sensitivity syndrome, which can also influence the surgical outcome. Identifying these patients is a key factor for appropriate management.


Assuntos
Ansiedade/epidemiologia , Sensibilização do Sistema Nervoso Central , Depressão/epidemiologia , Doenças dos Genitais Femininos/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Prolapso de Órgão Pélvico/epidemiologia , Assistência Ambulatorial , Comorbidade , Síndrome de Fadiga Crônica/epidemiologia , Feminino , Fibromialgia/epidemiologia , Ginecologia , Humanos , Síndrome do Intestino Irritável/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Prevalência , Estudos Prospectivos , Escócia/epidemiologia , Síndrome
9.
J Transl Med ; 16(1): 342, 2018 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-30518392

RESUMO

BACKGROUND: The overlapping symptoms and pathophysiological similarities between burn injury and chronic fatigue syndrome (CFS) are noteworthy. Thus, this study explores the possible association between burn injury and the subsequent risk of CFS. METHOD: We used data from the Taiwan National Health Insurance system to address the research topic. The exposure cohort comprised of 17,204 patients with new diagnoses of burn injury. Each patient was frequency matched according to age, sex, index year, and comorbidities with four participants from the general population who did not have a history of CFS (control cohort). Cox proportional hazards regression analysis was conducted to estimate the relationship between burn injury and the risk of subsequent CFS. RESULT: The incidence of CFS in the exposure and control cohorts was 1.61 and 0.86 per 1000 person-years, respectively. The exposure cohort had a significantly higher overall risk of subsequent CFS than did the control cohort (adjusted hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.41-1.56). The risk of CFS in patients with burn injury in whichever stratification (including sex, age, and comorbidity) was also higher than that of the control cohort. CONCLUSION: The findings from this population-based retrospective cohort study suggest that thermal injury is associated with an increased risk of subsequent CFS and provided a point of view suggesting burn injuries in sun- exposed areas such as the face and limbs had greater impact on subsequent development of CFS compared with trunk areas. In addition, extensively burned areas and visible scars were predictors of greater physiological and psychosocial that are needed to follow-up in the long run.


Assuntos
Queimaduras/complicações , Síndrome de Fadiga Crônica/epidemiologia , Síndrome de Fadiga Crônica/etiologia , Idoso , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
10.
Endocrinol Diabetes Nutr ; 65(10): 564-570, 2018 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30309810

RESUMO

BACKGROUND AND OBJECTIVE: Multiple chemical sensitivity (MCS) is a complex, acquired, chronic syndrome of multifactorial etiology with multiple symptoms. The aim of the study was to assess the nutritional habits, dietary characteristics and physical activity, as well as their determinants, of a population diagnosed with MCS, which may allow for a more precise approach to nutritional improvement. PATIENTS AND METHOD: A descriptive, cross-sectional study in patients diagnosed with MCS. Information was collected using adapted questionnaires. Data included presence of comorbidities, nutritional (use of supplements, types of diet) and food purchasing habits. Dietary intake, food intolerances, and physical activity were also recorded. RESULTS: The study included of 52 patients (48 female) aged 50.9±10.3 years. Diagnosis of MCS was commonly associated to chronic fatigue syndrome (70.1%), fibromyalgia (65.4%), or electrosensitivity (51.9%). The most common comorbidities were irritable bowel, gastroesophageal reflux, and depression/anxiety-depressive disorder. Exclusion diets were followed by 57.7%, 52.1% commonly used supplements (6.4±5.2 per person), and 16.0% took more than 10 daily. A high proportion of volunteers did not take the recommended amounts of dairy products (84.3%), fruit (82.3%), and cereals (64.7%), the foods to which intolerance was greatest. As regards physical activity, active subjects only represented 12.5%. CONCLUSIONS: The data collected support the need to improve food pattern and to perform physical activity according to individual characteristics. Nutritional education and diet personalization could prevent incomplete, monotonous, and unbalanced diets which impair quality of life and physiological status.


Assuntos
Dieta , Exercício , Sensibilidade Química Múltipla/epidemiologia , Adulto , Idoso , Asma/epidemiologia , Comorbidade , Estudos Transversais , Laticínios , Depressão/epidemiologia , Suplementos Nutricionais , Grão Comestível , Síndrome de Fadiga Crônica/epidemiologia , Síndrome de Fadiga Crônica/etiologia , Comportamento Alimentar , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Hipersensibilidade/epidemiologia , Hipotireoidismo/epidemiologia , Síndrome do Intestino Irritável/epidemiologia , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/etiologia , Espanha/epidemiologia , Inquéritos e Questionários
11.
BMJ Open ; 8(9): e020775, 2018 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-30232103

RESUMO

OBJECTIVES: To define the prevalence of severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and its clinical characteristics in a geographically defined area of Northern England. To understand the feasibility of a community-based research study in the severely affected CFS/ME group. DESIGN: A two-phase clinical cohort study to pilot a series of investigations in participants own homes. SETTING: Participants were community living from the area defined by the Northern clinical network of the UK. PARTICIPANTS: Adults with either a medical or a self-reported diagnosis of CFS/ME. Phase 1 involved the creation of a database. Phase 2: five participants were selected from database, dependent on their proximity to Newcastle. INTERVENTIONS: The De Paul fatigue questionnaire itemised symptoms of CFS/ME, the Barthel Functional Outcome Measure and demographic questions were collected via postal return. For phase 2, five participants were subsequently invited to participate in the pilot study. RESULTS: 483 questionnaire packs were requested, 63 were returned in various stages of completion. 56 De Paul fatigue questionnaires were returned: all but 12 met one of the CFS/ME criteria, but 12 or 22% of individuals did not fulfil the Fukuda nor the Clinical Canadian Criteria CFS/ME diagnostic criteria but 6 of them indicated that their fatigue was related to other causes and they barely had any symptoms. The five pilot participants completed 60% of the planned visits. CONCLUSIONS: Severely affected CFS/ME individuals are keen to participate in research, however, their symptom burden is great and quality of life is poor. These factors must be considered when planning research and methods of engaging with such a cohort.


Assuntos
Síndrome de Fadiga Crônica/epidemiologia , Qualidade de Vida , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Projetos Piloto , Prevalência , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários , Avaliação de Sintomas , Adulto Jovem
12.
BMJ Open ; 8(9): e020817, 2018 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-30181183

RESUMO

INTRODUCTION: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease involving central nervous system and immune system disorders, as well as cardiovascular abnormalities. ME/CFS is characterised by severe chronic fatigue lasting for at least 6 months, including clinical symptoms such as tender cervical or axillary lymph nodes, muscle pain, joint pain without swelling or redness, post-exertional malaise for more than 24 hours and unrefreshing sleep. Studies on the epidemiology of ME/CFS in Europe only include single countries and, therefore, the prevalence and incidence of ME/CFS in Europe (as a whole) is unknown. One of the purposes of the European Network on ME/CFS (EUROMENE; European Union-funded COST Action; Reference number: 15111) is to address this gap in knowledge. We will systematically review the literature reporting figures from European countries to provide a robust summary and identify new challenges. METHODS AND ANALYSIS: We will systematically search the literature databases Scopus, PubMed and Web of Science for studies published in the last 10 years (ie, after 2007). No language restriction will be applied. Two independent reviewers will search, screen and select studies as well as extract data about their main characteristics and evaluate their methodological and reporting quality. When disagreements emerge, the reviewers will discuss to reach a consensus. We plan to produce a narrative summary of our findings as we anticipate that studies are scarce and heterogeneous. The possibility of performing meta-analyses will be discussed in a EUROMENE meeting. ETHICS AND DISSEMINATION: Ethical approval is not required as only publicly available data will be included. Findings will be described in EUROMENE reports, published in peer-reviewed journal(s) and presented at conferences. The findings will be also communicated to policy-makers, healthcare providers, people with ME/CFS and other sections of society through regular channels including the mass-media. PROSPERO REGISTRATION NUMBER: CRD42017078688.


Assuntos
Síndrome de Fadiga Crônica/epidemiologia , Revisão Sistemática como Assunto , Europa (Continente)/epidemiologia , Humanos , Incidência , Prevalência , Projetos de Pesquisa
13.
BMC Public Health ; 18(1): 1014, 2018 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-30111291

RESUMO

BACKGROUND: Group-based transdiagnostic occupational rehabilitation programs including participants with mental and somatic disorders have emerged in clinical practice. Knowledge is sparse on subsequent participation in competitive work. This study aimed to investigate trajectories for (re)entry to work for predefined subgroups in a diagnostically heterogeneous sample of sick-listed participants after completing occupational rehabilitation. METHODS: A cohort of 212 participants aged 18-69 on long-term sick leave (> 8 weeks) with chronic pain, chronic fatigue and/or common mental disorders was followed for one year after completing a 3½-week rehabilitation intervention based on Acceptance and Commitment Therapy. Self-reported, clinical and registry data were used to study the associations between predefined biopsychosocial predictors and trajectories for (re)entry to competitive work (≥ 1 day per week on average over 8 weeks). Generalized estimating equations analysis was used to investigate trajectories. RESULTS: For all biopsychosocial subgroups (re)entry to work increased over time. Baseline employment, partial sick leave and higher expectation of return to work (RTW) predicted higher probability of having (re)entered work at any given time after discharge. The odds of increasing reentry over time (statistical interaction with time) was weaker for the group receiving the benefit work assessment allowance compared with those receiving sickness benefit (OR = 0.92, p = 0.048) or for those on partial sick leave compared with full sick leave (OR 0.77, p < 0.001), but higher for those who at baseline had reported having a poor economy versus not (OR 1.16, p = 0.010) or reduced emotional functioning compared with not (OR 1.11, p = 0.012). Health factors did not differentiate substantially between trajectories. CONCLUSIONS: Work participation after completing a transdiagnostic occupational rehabilitation intervention was investigated. Individual and system factors related to work differentiated trajectories for (re)entry to work, while individual health factors did not. Having a mental disorder did not indicate a worse prognosis for (re)entry to work following the intervention. Future trials within occupational rehabilitation are recommended to pivot their focus to work-related factors, and to lesser extent target diagnostic group.


Assuntos
Dor Crônica/reabilitação , Síndrome de Fadiga Crônica/reabilitação , Transtornos Mentais/reabilitação , Reabilitação Vocacional , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Terapia de Aceitação e Compromisso , Adolescente , Adulto , Idoso , Dor Crônica/epidemiologia , Estudos de Coortes , Síndrome de Fadiga Crônica/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Licença Médica/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
14.
Actas esp. psiquiatr ; 46(4): 125-132, jul.-ago. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-174679

RESUMO

Introducción. Los Trastornos de Personalidad (TP) resultan altamente prevalentes entre pacientes con Síndrome de Fatiga Crónica (SFC), pero los estudios basados en el DSM-5 resultan escasos. Aún no han sido usados Instrumentos validados específicamente en pacientes SFC. Por este motivo, nuestro objetivo fue analizar las diferencias en las facetas de la personalidad y perfiles de dominios entre los pacientes con SFC con y sin un TP utilizando el Inventario de Personalidad para DSM-5 (PID-5). Además, se analizó la capacidad de este instrumento para predecir la presencia de TP en una muestra de pacientes con SFC. Método. Un total de 84 pacientes con SFC fueron evaluados mediante entrevista clínica y realizaron evaluación psicopatológica con las entrevistas SCID I y SCID II. Las facetas y dominios dimensionales de la personalidad se evaluaron con el PID-5, de acuerdo con DSM-5. Ese instrumento ha sido validado para TPs, pero no en CFS. Resultados. De la muestra, 54 (64%) de los pacientes cumplieron con los criterios de un TP. Las facetas más frecuentes en SFC con TP, en comparación con aquellos pacientes sin TP, fueron: Inseguridad de Separación, Perseveración, Aislamiento, Depresividad, Perfeccionismo Rígido, Creencias y Experiencias Inusuales. La Afectividad Negativa y el Desapego fueron los dos dominios significativos en pacientes con SFC-TP. En los análisis de regresión, sólo el Desapego y Perfeccionismo Rígido constituyen un factor pronóstico que conduce a una alta probabilidad de padecer un TP. Conclusión. De acuerdo con estos resultados, los dominios y facetas PID-5 podrían ser adecuados y útiles para diferenciar entre los pacientes con TP de los no-TP en muestras clínicas y sugieren un perfil de personalidad dimensional más frecuente en pacientes con SFC


Introduction. Personality Disorders (PD) are highly prevalent among Chronic Fatigue Syndrome (CFS) patients, but studies based on the DSM-5 are still scarce. Validated instruments have not yet been specifically used in CFS patients. Therefore, our aim was to analyze the differences in personality facets and domains profiles among CFS patients with and without a PD using the Personality Inventory for DSM-5 (PID-5). Additionally, we analyzed the ability of this instrument to predict PD in a sample of CFS patients. This instrument is validated for PDs, but not for CFS.Methods. All of the 84 CFS patients were evaluated through a clinical interview and underwent psychopathological evaluation with the SCID I and SCID II. Dimensional personality facets and domains were evaluated with the PID-5, according to DSM-5. Results. In our sample, 54 (64%) of the patients fulfilled the criteria of a PD. The most significant facets in CFS with PD in comparison to those patients without a PD were Separation Insecurity, Perseveration, Withdrawal, Depressivity, Rigid Perfectionism, Unusual Beliefs and Experiences. Negative Affectivity and Detachment were the two significant domains in CFS-PD patients. In the regression analyses, only Detachment and Rigid Perfectionism constituted a prognostic factor leading to high probability of an endorsed PD. Conclussion. According to these results, the PID-5 domains and facets could be adequate and useful to differentiate between PD and non-PD patients in clinical samples and suggest a more frequent dimensional personality profile in CFS patients


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Síndrome de Fadiga Crônica/epidemiologia , Determinação da Personalidade , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade/estatística & dados numéricos , Síndrome de Fadiga Crônica/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Personalidade/psicologia , Estudos Transversais , Modelos Logísticos
16.
J Immunol Res ; 2018: 1060421, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29854827

RESUMO

In the course of pSS, inflammatory cell infiltration consists mainly of lymphocytes infiltrating exocrine glands, which leads to their impaired function. The characteristic feature is generalized dryness. The aim of this study was to attempt to answer the question whether it is possible to distinguish between patients with pSS and individuals with dryness caused by other pathologies without applying invasive studies. The study included 68 patients with pSS and 43 healthy controls with dryness. FS ≥ 1 was observed in 90% of patients with pSS (with or without dryness), and only in 23% of the control group (only with xerostomia). In the pSS group, anaemia (p = 0.0085), lymphocytopenia (p = 0.0006), elevated ERS (p = 0.001), higher RF titer, and ANA antibodies were noted. Configuration of anti-SSA + SSB + Ro52 antibodies was characteristic for the pSS group. Considering the clinical symptoms, statistically significant differences were noted between pSS patients and the control group in frequency (p = 0.02) and severity (p = 0.042) of fatigue, lymphadenopathy, major salivary gland involvement, and photosensitivity to UV light. In conclusion, invasive methods are pivotal in pSS diagnosis in this salivary gland biopsy. Chronic fatigue syndrome is more common in pSS patients and can be subjective distinguishing factor in the group of people with dryness.


Assuntos
Desidratação/diagnóstico , Síndrome de Fadiga Crônica/epidemiologia , Glândulas Salivares/patologia , Síndrome de Sjogren/diagnóstico , Xerostomia/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antinucleares/sangue , Biópsia , Desidratação/epidemiologia , Fadiga , Feminino , Humanos , Linfadenopatia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Síndrome de Sjogren/epidemiologia , Xerostomia/epidemiologia , Adulto Jovem
17.
Sleep Med Rev ; 41: 255-265, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29759891

RESUMO

Sleep and circadian abnormalities are prevalent and burdensome manifestations of diverse neuro-immune diseases, and may aggravate the course of several neuropsychiatric disorders. The underlying pathophysiology of sleep abnormalities across neuropsychiatric disorders remains unclear, and may involve the inter-play of several clinical variables and mechanistic pathways. In this review, we propose a heuristic framework in which reciprocal interactions of immune, oxidative and nitrosative stress, and mitochondrial pathways may drive sleep abnormalities across potentially neuroprogressive disorders. Specifically, it is proposed that systemic inflammation may activate microglial cells and astrocytes in brain regions involved in sleep and circadian regulation. Activated glial cells may secrete pro-inflammatory cytokines (for example, interleukin-1 beta and tumour necrosis factor alpha), nitric oxide and gliotransmitters, which may influence the expression of key circadian regulators (e.g., the Circadian Locomotor Output Cycles Kaput (CLOCK) gene). Furthermore, sleep disruption may further aggravate oxidative and nitrosative, peripheral immune activation, and (neuro) inflammation across these disorders in a vicious pathophysiological loop. This review will focus on chronic fatigue syndrome, bipolar disorder, and multiple sclerosis as exemplars of neuro-immune disorders. We conclude that novel therapeutic targets exploring immune and oxidative & nitrosative pathways (p.e. melatonin and molecular hydrogen) hold promise in alleviating sleep and circadian dysfunction in these disorders.


Assuntos
Transtorno Bipolar/epidemiologia , Síndrome de Fadiga Crônica/epidemiologia , Inflamação/fisiopatologia , Esclerose Múltipla/epidemiologia , Estresse Oxidativo/fisiologia , Transtornos do Sono-Vigília/fisiopatologia , Encéfalo/fisiopatologia , Humanos
18.
J Sleep Res ; 27(6): e12703, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29770505

RESUMO

Non-restorative sleep is a hallmark symptom of chronic fatigue syndrome/myalgic encephalomyelitis. However, little is known about self-reported sleep disturbances in these subjects. This study aimed to assess the self-reported sleep quality and its impact on quality of life in a Spanish community-based chronic fatigue syndrome/myalgic encephalomyelitis cohort. A prospective cross-sectional cohort study was conducted in 1,455 Spanish chronic fatigue syndrome/myalgic encephalomyelitis patients. Sleep quality, fatigue, pain, functional capacity impairment, psychopathological status, anxiety/depression and health-related quality of life were assessed using validated subjective measures. The frequencies of muscular, cognitive, neurological, autonomic and immunological symptom clusters were above 80%. High scores were recorded for pain, fatigue, psychopathological status, anxiety/depression, and low scores for functional capacity and quality of life, all of which correlated significantly (all p < 0.01) with quality of sleep as measured by the Pittsburgh Sleep Quality Index. Multivariate regression analysis showed that after adjusting for age and gender, the pain intensity (odds ratio, 1.11; p <0.05), psychopathological status (odds ratio, 1.85; p < 0.001), fibromyalgia (odds ratio, 1.39; p < 0.05), severe autonomic dysfunction (odds ratio, 1.72; p < 0.05), poor functional capacity (odds ratio, 0.98; p < 0.05) and quality of life (odds ratio, 0.96; both p < 0.001) were significantly associated with poor sleep quality. These findings suggest that this large chronic fatigue syndrome/myalgic encephalomyelitis sample presents poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index, and that this poor sleep quality is associated with many aspects of quality of life.


Assuntos
Síndrome de Fadiga Crônica/epidemiologia , Síndrome de Fadiga Crônica/psicologia , Qualidade de Vida/psicologia , Autorrelato , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/psicologia , Adulto , Estudos de Coortes , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/psicologia , Síndrome de Fadiga Crônica/diagnóstico , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autorrelato/normas , Sono/fisiologia , Transtornos do Sono-Vigília/diagnóstico , Adulto Jovem
19.
Sleep Med ; 46: 26-36, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29773208

RESUMO

OBJECTIVE/BACKGROUND: Sleep abnormalities are characteristic of chronic fatigue syndrome (CFS, also known as 'ME'), however it is unknown whether sleep might be a causal risk factor for CFS/ME. PATIENTS/METHODS: We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. We describe sleep patterns of children aged 6 months to 11 years, who were subsequently classified as having (or not having) 'chronic disabling fatigue' (CDF, a proxy for CFS/ME) between the ages 13 and 18 years, and we investigated the associations of sleep duration at age nine years with CDF at age 13 years, as well as sleep duration at age 11 years with CDF at age 16 years. RESULTS: Children who had CDF during adolescence had shorter night-time sleep duration from 6 months to 11 years of age, and there was strong evidence that difficulties in going to sleep were more common in children who subsequently developed CDF. The odds of CDF at age 13 years were 39% lower (odds ratio (OR) = 0.61, 95% CI = 0.43, 0.88) for each additional hour of night-time sleep at age nine years, and the odds of CDF at age 16 years were 51% lower (OR = 0.49, 95% CI = 0.34, 0.70) for each additional hour of night-time sleep at age 11 years. Mean night-time sleep duration at age nine years was 13.9 (95% CI = 3.75, 24.0) minutes shorter among children who developed CDF at age 13 years, and sleep duration at age 11 years was 18.7 (95% CI = 9.08, 28.4) minutes shorter among children who developed CDF at age 16 (compared with children who did not develop CDF at 13 and 16 years, respectively). CONCLUSIONS: Children who develop chronic disabling fatigue in adolescence have shorter night-time sleep duration throughout early childhood, suggesting that sleep abnormalities may have a causal role in CFS/ME or that sleep abnormalities and CFS/ME are associated with a common pathophysiological cause.


Assuntos
Síndrome de Fadiga Crônica/epidemiologia , Sono/fisiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Síndrome de Fadiga Crônica/etiologia , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Fatores de Risco , Fatores de Tempo , Reino Unido/epidemiologia
20.
Epidemiol Infect ; 146(5): 633-641, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29486812

RESUMO

Prolonged fatigue is increasingly reported among chikungunya virus (CHIKV)-infected populations. We investigated the relationships between CHIKV exposure, long-lasting rheumatic musculoskeletal pain (LRMSP) and chronic fatigue. 1094 participants (512 CHIKV seropositive and 582 seronegative) of the TELECHIK population-based cohort were analysed considering the duration of the manifestations throughout an average 2-year follow-up. Weighted prevalence rates and prevalence ratios for LRMSP, idiopathic chronic fatigue (ICF), and chronic fatigue syndrome (CFS)-like illness, both latter syndromes adapted from Centers for Disease Control (CDC)-1994/Fukuda criteria, were compared. Population attributable fractions (PAF) were estimated to assess the contribution of CHIKV infection to each of the three phenotypes. Among 362 adult subjects who had reported either rheumatic pain or fatigue at the onset of the infection, weighted prevalence rates of LRMSP, ICF and CFS-like illness were respectively of 32.9%, 38.7% and 23.9%, and of 8.7%, 8.5% and 7.4% among initially asymptomatic peers (P < 0.01, respectively). Each of the three outcomes was highly attributable to chikungunya (PAF of 43.2%, 36.2% and 41.0%, respectively). In the sub-cohort of CHIKV-infected subjects, LRMSP, ICF and CFS-like illness, which overlapped in 70%, accounted for 53% of the chronic manifestations. In addition to rheumatic disease, chronic fatigue could be considered in caring for patients with chronic chikungunya disease.


Assuntos
Febre de Chikungunya/epidemiologia , Síndrome de Fadiga Crônica/epidemiologia , Doenças Reumáticas/epidemiologia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Febre de Chikungunya/complicações , Vírus Chikungunya/fisiologia , Doença Crônica/epidemiologia , Estudos de Coortes , Síndrome de Fadiga Crônica/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Reunião/epidemiologia , Doenças Reumáticas/virologia , Adulto Jovem
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