Een onderzoek van Jason,
Katz en collega's toont,
net als dat van Lloyd en collega's, aan dat
±12-15% van de mensen met een Pfeiffer/
EBV-infectie na een half jaar aan de diagnose CVS voldoet.
De onderzoekers bestudeerden tevens in hoeverre autonome dysfunctie, familiaire stress,
schoolafwezigheid/dagen in bed en psychiatrische diagnosen bij aanvang van de ziekte
de einduitkomst van de infectie bepaalden (wel of niet CVS-patiënt na 6 maanden).
Stapsgewijze lineaire regressieanalyse, een statistische methode
waarbij berekend wordt welke factoren andere factoren beïnvloeden,
leerde de onderzoekers dat veel van die factoren invloed hebben,
maar dat autonome disfunctie (orthostatische intolerantie etc.) en het aantal dag in bed,
dé factoren waren die de einduitkomst bepaalden: wel of geen diagnose CVS.
Eenvoudiger gesteld,
uiteindelijk bepaalt (alleen) de ernst van de EBV-infectie de "einduitkomst",
en niet psychiatrische factoren of familiaire stress, zoals gesteld door
Heijnen en collega's.
De studies van Jason en Hickie lijken me zinvolle informatie voor huisartsen
die in hun praktijk geconfronteerd worden met ze ziekte van Pfeiffer.
Enkele relevante citaten uit de studie:
According to this study,
significant baseline predictors in the stepwise logistic regression
included autonomic symptoms and days spent in bed since the onset of IM.
This suggests that
indices of illness severity are the best predictors for
adolescents destined to develop CFS following IM.
...
Our findings are thus comparable to those of Hickie et al. (2006),
who followed patients with mononucleosis (glandular fever), Q fever, and Ross River virus
who later met criteria for CFS.
Development of CFS in their cohort
was predicted largely by the severity of the acute illness
rather than by demographic, psychological, or microbiological factors.
...
Several studies have identified family stress as a precursor to CFS
(Carter et al., 1999; Van Middendorp, Geenen, Kuis, Heijnen, & Sinnema, 2001).
The studies by van Middendorp and Carter were of children referred to psychologists,
in whom one would anticipate a higher rate of behavioral factors.
In these studies, along with a potential for referral bias,
these adolescents most likely are not representative of the CFS population as a whole.
...
Our study also did not show
a relationship between familial stress and the development of post-infectious CFS.
Predictors of post-infectious chronic fatigue syndrome in adolescents.
Health Psychology and Behavioral Medicine. 2014 Jan 2. (2)1: 41-51.
doi: 10.1080/21642850.2013.869176
Jason LA, Katz BZ, Shiraishi Y, Mears CJ, Im Y, Taylor RA.
Abstract
This study focused on
identifying risk factors for
adolescent post-infectious chronic fatigue syndrome (CFS),
utilizing a prospective, nested case-control longitudinal design
in which
over 300 teenagers with infectious mononucleosis (IM)
were identified
through primary care sites and
followed.
Baseline variables that were gathered
several months following IM,
included
autonomic symptoms,
days in bed since IM,
perceived stress,
stressful life events,
family stress,
difficulty functioning and attending school,
family stress, and
psychiatric disorders.
A number of variables
were predictors of
post-infectious CFS at six months;
however,
when autonomic symptoms
were used as
a control variable,
only days spent in bed since mono
was a significant predictor.
Step-wise logistic regression findings indicated that
baseline autonomic symptoms
as well as
days spent in bed since mono,
which reflect the severity of illness,
were
the only significant predictors of
those who met CFS criteria at six months.
Keywords
mononucleosis, chronic fatigue syndrome, risk factors, autonomic symptoms, longitudinal
http://www.tandfonline.com/doi/pdf/10.1080/21642850.2013.869176
Met dank aan Rob.
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