Correlates of Somatic Causal Attributions in Primary Care Patients with Fatigue

Abstract

Researchers in the field of chronic fatigue in tertiary care found that patients’ somatic (e.g. viral) explanations for their condition may lead to chronicity of symptoms. We studied the influence of a somatic attributional bias on outcome and reported symptoms in primary care patients with fatigue. We compared fatigue scores on a specific scale, and number of presented symptoms, in two groups of primary care patients with ‘functional’ fatigue: 75 with a high score on the somatic subscale of the Fatigue Attribution Scale (S-FAS), and 95 with a low score on the S-FAS. At the index visit, patients with low and high scores on the S-FAS were not different for age, sex, fatigue scores, and levels of depressive symptoms. Patients with high scores on the S-FAS presented significantly more somatic and psychological symptoms – a total of 36 symptoms for 24 patients (25.3%) in the low-score group, and a total of 52 symptoms for 31 patients (41.3%) in the high-score group. Forty-two days later, at the follow-up visit, the fatigue scores were similar in both groups. In primary care patients with fatigue not due to somatic illnesss or major depression, the tendency to attribute fatigue to somatic causes is not associated with a worse outcome, but with a higher number of reported symptoms.

Alexithymia, Neurovegetative Arousal and Neuroticism

“…In this study, the alexithymie trait is not a categorical concept connected only to certain nosographie structures, but is a dimensional factor having an etiopathogenetic role in somatization [2][3][4], Alexithymia is the result of the interaction between the neurovegetative component (exasperation of sympathetic reactivity) [12,13] and the cognitive component (deficit in the cognitive processing of emotions experienced somatically) [3,4,10,11]. Therefore, the theoretic and psychometric applica tions of the alexithymie concept to the field of somatiza tion represents a reliable operative instrument for the detection of these pathologies [40][41][42][43][44], Nevertheless, its application to a specific nosographie area (e.g. somato form disorders) cannot provide a complete explanation for the etiopathogenesis of these syndromes.…”

Chronic fatigue syndrome: a qualitative investigation of young patient's beliefs and coping strategies

“…These beliefs have been correlated with poor prognosis [20], increased symptoms [21] and a greater loss of functional ability [22]. It has also been suggested that this attribution style might be a vulnerability factor in developing CFS/ME [15].…”

Patient Expectations Did Not Predict Outcome of Drug and Behavioral Treatment of Urgency Urinary Incontinence

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