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Research: BENNETT and colleagues,
Listed in Issue 39
Abstract
BENNETT and colleagues, School of Psychiatry, University of New South Wales, Sydney Australia explored the longitudinal relationships between physical and psychological symptoms and immune factors following acute infectious illness .
Background
Methodology
The authors report preliminary data from a prospective investigation of patients with proven infectious illnesses due to Epstein- Barr virus (EBV), Ross River virus (RRV) or Q fever . Patients were assessed within 4 weeks of onset of symptoms and reviewed 2 and 4 weeks later. Physical illness data were collected at interview; psychological and somatic symptom profiles were assessed using standardised self-report questionnaires. Cell-mediated immune (CMI) function was measured using delayed-type hypersensitivity (DTH) skin responses.
Results
30 patients (17 with EBV, 5 with RRV and 8 with Q fever) were included in this analysis. The most common symptoms during the acute phase were profound fatigue and malaise . Classical depressive and anxiety symptoms were not prominent. Initially, 46% of cases had no DTH skin response, which indicated impaired cellular immunity. Over the 4-week period, there was a marked improvement in the somatic and psychological symptoms, although fatigue remained a prominent feature in 63% of patients. Reduction in reported fatigue was correlated with improvement in DTH skin response and with improvement in General Health Questionnaire (GHQ) scores.
Conclusion
Acute infectious illnesses are accompanied by a range of nonspecific somatic and psychological symptoms, especially fatigue and malaise rather than anxiety and depression. Although improvement in several symptoms occurs rapidly, fatigue often remains prominently even at 4 weeks. The resolution of fatigue is associated with improvement in cell-mediated immunity.
References
Bennett BK et al. The relationship between fatigue, psychological and immunological variables in acute infectious illness. Aust NZJ Psychiatry 32(2): 180-6 Apr 1998.
Comment
The above research studies demonstrate the incredibly advanced progress underway in elucidating the complicated biochemical, neurological and immunological changes associated with stress.
