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Unique genetic & environmental determinants of prolonged fatigue: a twin study - Chronic Fatigue Syndrome research

  [ 118 votes ]   [ Discuss This Article ] • March 15, 1999

BACKGROUND: Prolonged fatigue syndromes have been proposed as
prevalent and disabling forms of distress that occur
independently of conventional notions of anxiety and

METHODS: To investigate the genetic and
environmental antecedents of common forms of psychological and
somatic distress, we measured fatigue, anxiety, depression and
psychological distress in 1004 normal adult twin pairs (533
monozygotic (MZ), 471 dizygotic (DZ)) over 50 years of age.

RESULTS: Familial aggregation of psychological distress,
anxiety and fatigue appeared to be due largely to additive
genetic factors (MZ:DZ ratios of 2.12-2.69). The phenotypic
correlations between the psychological measures (distress,
anxiety and depression) were moderate (0.67-0.79) and higher
than that between fatigue and psychological distress (0.38).

Multivariate genetic modelling revealed a common genetic
factor contributing to the development of all the observed
phenotypes (though most strongly for the psychological forms),
a second independent genetic factor also influenced anxiety
and depression and a third independent genetic factor made a
major contribution to fatigue alone. In total, 44% (95% CI
25-60%) of the genetic variance for fatigue was not shared by
the other forms of distress. Similarly, the environmental
factor determining psychological distress made negligible
contributions to fatigue, which was underpinned largely by its
own independent environmental factor.

CONCLUSION: This study
supports the aetiological independence of prolonged fatigue
and, therefore, argues strongly for its inclusion in
classification systems in psychiatry.

Hickie I, Kirk K, Martin N

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