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Chronic fatigue & minor psychiatric morbidity after viral meningitis: a controlled study

  [ 54 votes ]   [ Discuss This Article ] • May 25, 1996

OBJECTIVE--To test the hypotheses that patients exposed to viral
meningitis would be at an increased risk of developing chronic
fatigue syndrome and would have an excess of neurological
symptoms and physical impairment.
METHODS--Eighty three
patients were followed up 6-24 months after viral meningitis
and a postal questionnaire was used to compare outcome with 76
controls who had had non-enteroviral, non-CNS viral
RESULTS--For the 159 patients and controls the
prevalence of chronic fatigue syndrome was 12.6%, a rate
higher than previously reported from primary care attenders,
suggesting that moderate to severe viral infections may play a
part in the aetiology of some fatigue states. Those with a
history of meningitis showed a slight, non-significant
increase in prevalence of chronic fatigue syndrome (OR 1.4;
95% CI 0.5-3.6) which disappeared when logistic regression and
analysis was used to correct for age, sex, and duration of
follow up (OR 1.0; 95% CI 0.3-2.8). Controls showed marginally
higher psychiatric morbidity measured on the general health
questionnaire-12 (adjusted OR 0.6; 95% CI 0.3-1.3) Both groups
had similar rates of neurological symptoms and physical
impairment. The best predictor of chronic fatigue was a
prolonged duration time of off work after the illness (OR
4.93, 95% CI 1.3-18.8). The best predictor of severe chronic
fatigue syndrome diagnosed by Center for Disease Control
criteria was past psychiatric illness (OR 7.82, 95% CI
1.8-34.3). Duration of viral illness, as defined by days in
hospital, did not predict chronic fatigue syndrome.
CONCLUSIONS--(1) The prevalence of chronic fatigue syndrome is
higher than expected for the range of viral illnesses
examined; (2) enteroviral infection is unlikely to be a
specific risk factor for its development; (3) onset of chronic
fatigue syndrome after a viral infection is predicted by
psychiatric morbidity and prolonged convalescence, rather than
by the severity of the viral illness itself.

Hotopf M, Noah N, Wessely S

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