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Predictors of chronic "postviral" fatigue

  [ 16 votes ]   [ Discuss This Article ] • September 24, 1994

We set out to determine the relation between a general practitioner
(GP) diagnosis of viral illness and development of chronic
fatigue 6 months later. 618 subjects who attended GPs clinics
in London, south, and southwest England and who received a
diagnosis of viral illness were followed prospectively and
fatigue was assessed by questionnaire after 6 months. At
presentation, GPs recorded fatigue in 62.6% of subjects,
usually since the onset of symptoms. 502 (81.2%) subjects
completed the 6-month questionnaire, of whom 88 (17.5%) met
criteria for chronic fatigue and 65 (12.9%) had no reported
fatigue before the viral illness. Compared with a similar
group of non-postviral GP attenders, the risk ratio for
chronic fatigue in the present cohort was 1.45 (95% CI
1.14-2.04). Infective symptoms did not predict fatigue 6
months later. Psychiatric morbidity, belief in vulnerability
to viruses, and attributional style at initial presentation
were all associated with self-designated postviral fatigue.
Logistic regression showed that (1) somatic attributional
style, (2) less definite diagnosis by the GP, and (3) sick
certification were the only significant predictors of chronic
fatigue after viral infection when other factors were
controlled for. Chronic severe fatigue 6 months after
GP-diagnosed viral illness is related to symptom-attributional
style and doctor behaviour, rather than to features of the
viral illness. Some subjects with apparent postviral fatigue
had complained of tiredness before their presentation with a
viral illness.

Cope H, David A, Pelosi A, Mann A

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