A longitudinal study of the relationship between psychological distress and recurrence of upper respiratory tract infections in chronic fatigue syndrome

Faulkner, Susan; Smith, Andrew Paul

doi:10.1348/135910706x171469

Cited by 23 publications

(20 citation statements)

References 24 publications

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“…The hypothesis that patterns of immune activity associated with MDD should have decreased mortality from infection in ancestral environments appears to face a challenge from data indicating that depression worsens outcome in a number of infectious processes 253, 254, 255, 256, 257, 258, 259, 260 and is associated with impairments in adaptive immune mechanisms important for protection against both viruses and bacteria. 13, 261, 262 To address this challenge, we have first to inquire whether innate immune inflammatory processes that are increased in MDD produce the patterns of infectious vulnerability and adaptive immune impairment that are apparent in depression.…”

Section: Patterns Of Immune Activation In Mdd and Protection From Infmentioning

confidence: 99%

The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

2012

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Given the manifold ways that depression impairs Darwinian fitness, the persistence in the human genome of risk alleles for the disorder remains a much debated mystery. Evolutionary theories that view depressive symptoms as adaptive fail to provide parsimonious explanations for why even mild depressive symptoms impair fitness-relevant social functioning, whereas theories that suggest that depression is maladaptive fail to account for the high prevalence of depression risk alleles in human populations. These limitations warrant novel explanations for the origin and persistence of depression risk alleles. Accordingly, studies on risk alleles for depression were identified using PubMed and Ovid MEDLINE to examine data supporting the hypothesis that risk alleles for depression originated and have been retained in the human genome because these alleles promote pathogen host defense, which includes an integrated suite of immunological and behavioral responses to infection. Depression risk alleles identified by both candidate gene and genome-wide association study (GWAS) methodologies were found to be regularly associated with immune responses to infection that were likely to enhance survival in the ancestral environment. Moreover, data support the role of specific depressive symptoms in pathogen host defense including hyperthermia, reduced bodily iron stores, conservation/withdrawal behavior, hypervigilance and anorexia. By shifting the adaptive context of depression risk alleles from relations with conspecifics to relations with the microbial world, the Pathogen Host Defense (PATHOS-D) hypothesis provides a novel explanation for how depression can be nonadaptive in the social realm, whereas its risk alleles are nonetheless represented at prevalence rates that bespeak an adaptive function.

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Section: Patterns Of Immune Activation In Mdd and Protection From Infmentioning

confidence: 99%

The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

2012

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“…A secondary aim was to compare the frequencies of health conditions and symptoms between the two groups. It was clear that the characteristic symptoms of CFS (Loblay et al, 2002;Faulkner and Smith, 2008) occurred in large percentages of the diagnosed participants, irrespective of their age and time since diagnosis. However, given that the CFS group displayed haemoglobin and erythrocyte concentrations within the respective normal ranges, it was unexpected to find a high percentage of the CFS group with either a previous or current diagnosis of iron deficiency/anaemia, and with elevated RDW and MCV.…”

Section: Discussionmentioning

confidence: 99%

“…The CFS group had a significantly lowertotal lymphocyte concentration and a lower CD4 + lymphocyte count, which may have clinical significance in terms of the ability of CFS patients to respond to infections (Lorusso et al, 2009).A high percentage of our CFS group reported recurring sore throats, indicative of upper respiratory tract infection (URTI). Recurring sore throats and inflamed lymph nodes are common symptoms of both CFS and URTI, and there is considerable evidence that CFS patients suffer from significantly more recurring episodes of URTI and other infectious illnesses compared to healthy controls (Loblay et al, 2002;Faulkner and Smith 2008). We reason that a lower CD4 + cell count might indicate an impaired Thelper lymphocyte response, as these cells produce interleukin-2 when activated and are integral to lymphocyte sub-set activation and proliferation (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…neutrophils) and in the activation of NK, T-helper (CD3 + CD4 + ) and cytotoxic (CD3 + CD8 + ) lymphocytes have been reported in individuals with CFS (Brenu et al, 2010;Peakman et al, 1997;Lorusso et al, 2009;Brenu et al, 2012) but the link between these findings and clinical status or outcomes for CFS patients is still unclear. A possible reason for immune suppression and increased susceptibility to infections in CFS individuals is psychological stress, causing alterations in the HPA-axis and autonomic nervous system (Faulkner and Smith, 2008). Alterations in leukocyte intracellular signalling may also affect immune cell function (Bowlus et al, 2003;Aluwhalia et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

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Irregularities in red cell distribution width and lymphocyte concentration in individuals with Chronic Fatigue Syndrome

Broadbent

Coutts²

2015

IJHS

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Background: Chronic Fatigue Syndrome is a complex condition with no clear aetiology. There are inconsistent reports of abnormal red cell indices and variations in some immune cell subsets in CFS patients. Aim: Toexaminehaemato logical and immunological indices and the frequency of irregularities. Methods: Full blood counts and immune cell subsets of 24 Chronic Fatigue Syndrome individuals and 18 healthy, sedentary controls were analysed by cell sorter and flow cytometer. The frequencies of abnormal blood count and immunological indices, and health conditions in both groups were also recorded. Results: Total lymphocyte concentration was below-normal in 33.3% of CFS participants, with mean values significantly lower than the non-CFS group. CFS participants also had a lower CD3 + CD4 + lymphocyte count (p < 0.05). Compared to non-CFS, the CFS group had significantly higher frequencies of above-normal red cell distribution width (RDW), above-normal erythrocyte mean cell volume (MCV), previous/current iron deficiency, cardiac symptoms, recurring sore throats and headaches, poor sleep, joint and back pain. Conclusion: Significantly higher frequencies of abnormal RDW, MCV and lymphocyte concentrations in CFS participants may be associated with iron deficiency and immune cell dysfunction.

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“…Having coping resources (optimism and social support) predicted less relapses (Lutgendorf et al, 1995). In a diary study of CFS patients, Faulkner and Smith (2008) found that daily ratings of psychological distress predicted greater physical fatigue during the following week. Together, these findings suggest that emotional distress reactions (to environmental challenges and daily life stress) may trigger physical symptoms in CFS.…”

Section: Introductionmentioning

confidence: 99%

Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome

Lattie

Antoni

Fletcher

et al. 2012

Brain, Behavior, and Immunity

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Objectives Stressors and emotional distress responses impact chronic fatigue syndrome (CFS) symptoms, including fatigue. Having better stress management skills might mitigate fatigue by decreasing emotional distress. Because CFS patients comprise a heterogeneous population, we hypothesized that the role of stress management skills in decreasing fatigue may be most pronounced in the subgroup manifesting the greatest neuroimmune dysfunction. Methods In total, 117 individuals with CFS provided blood and saliva samples, and self-report measures of emotional distress, perceived stress management skills (PSMS), and fatigue. Plasma interleukin-1-beta (IL-1β, IL-2, IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α), and diurnal salivary cortisol were analyzed. We examined relations among PSMS, emotional distress, and fatigue in CFS patients who did and did not evidence neuroimmune abnormalities. Results Having greater PSMS related to less fatigue (p = .019) and emotional distress (p < .001), greater diurnal cortisol slope (p = .023) and lower IL-2 levels (p = .043). PSMS and emotional distress related to fatigue levels most strongly in CFS patients in the top tercile of IL-6, and emotional distress mediated the relationship between PSMS and fatigue most strongly in patients with the greatest circulating levels of IL-6 and a greater inflammatory (IL-6):anti-inflammatory (IL-10) cytokine ratio. Discussion CFS patients having greater PSMS show less emotional distress and fatigue, and the influence of stress management skills on distress and fatigue appear greatest among patients who have elevated IL-6 levels. These findings support the need for research examining the impact of stress management interventions in subgroups of CFS patients showing neuroimmune dysfunction.

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A longitudinal study of the relationship between psychological distress and recurrence of upper respiratory tract infections in chronic fatigue syndrome

Abstract: CFS patients reported more frequent URTIs than healthy controls and these recurrences were preceded by high levels of psychological stress. High levels of stress were also associated with greater subsequent fatigue. Possible explanations of these results are discussed.

Cited by 23 publications

References 24 publications

The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

The evolutionary significance of depression in Pathogen Host Defense (PATHOS-D)

Irregularities in red cell distribution width and lymphocyte concentration in individuals with Chronic Fatigue Syndrome

Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome

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