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Jason/Katz:

alleen de ernst van

de EBV-infectie

bepaalt of iemand

CVS-patiŽnt wordt.

 

 

 

 


 

 

 

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-patiŽnt na 6 maanden).

 

Stapsgewijze lineaire regressieanalyse, een statistische methode

waarbij berekend wordt welke factoren andere factoren beÔnvloeden,

leerde de onderzoekers dat veel van die factoren invloed hebben,

maar dat autonome disfunctie (orthostatische intolerantie etc.) en het aantal dag in bed,

dť 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.