The Comorbidity of Self-Reported Chronic Fatigue Syndrome, Posttraumatic Stress Disorder, and Trauma

[Dolphin]

Somebody just highlighted to me that this hadn't been posted

Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3343192/

The Comorbidity of Self-Reported Chronic Fatigue Syndrome, Posttraumatic Stress Disorder, and Traumatic Symptoms
Elizabeth Dansie,1 Pia Heppner,2 Helena Furberg,3 Jack Goldberg,4 Dedra Buchwald,5 and Niloofar Afari6,2

Psychosomatics. May 2012; 53(3): 250–257.
Published online Jan 31, 2012. doi: 10.1016/j.psym.2011.08.007


PMCID: PMC3343192
NIHMSID: NIHMS321222

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Abstract
Background
Data from primary care and community samples suggest higher rates of posttraumatic stress disorder (PTSD) among individuals with chronic fatigue syndrome (CFS).

Objective
This study investigated the co-occurrence of CFS, PTSD, and trauma symptoms and assessed the contribution of familial factors to the association of CFS with lifetime PTSD and current traumatic symptoms.

Method
Data on lifetime CFS and PTSD, as measured by self report of a doctor’s diagnosis of the disorder, and standardized questionnaire data on traumatic symptoms, using the Impact of Events Scale (IES), were obtained from 8,544 female and male twins from the community-based University of Washington Twin Registry.

Results
Lifetime prevalence of CFS was 2% and lifetime prevalence of PTSD was 4%. Participants who reported a history of PTSD were over 8 times more likely to report a history of CFS. Participants with scores ≥ 26 on the IES were over 4 times more likely to report CFS than those who had scores ≤ 25. These associations were attenuated but remained significant after adjusting for familial factors through within-twin pair analyses.

Conclusion
These results support similar findings that a lifetime diagnosis of CFS is strongly associated with both lifetime PTSD and current traumatic symptoms, although familial factors such as shared genetic and environmental contributions played a limited role in the relationship between CFS, PTSD, and traumatic symptoms. These findings suggest that future research should investigate both the familial and the unique environmental factors that may give rise to both CFS and PTSD.

 

[Dolphin]

I think a prospective study would be better to answer such questions.

When people get ill, they can look for reasons why they got ill and focus on them, while healthy people can forget about the same exposures (I recall reading some evidence on this - it was something like people who lived beside chemical plants growing up remembered this better if they got cancer than their neighbours who didn't get cancer (or something vaguely like that)).

Also, since getting ill, when I look back, minor incidents can shake me up. It's probably to do with being weak now and sensitive to stress. It doesn't necessarily mean the incidents were actually than stressful at the time (I have mentioned before remembering a neighbour complaining to us for playing ball on the road rather than the green when we were maybe nine or ten (so not young children); really not a very stressful event and something I forgot about afterwards but it has occurred to me a few times since becoming ill). People's mind may regurgitate stressful events from the past for whatever reason - I think something like that has been found in people with chronic pain.

 

[ahmo]

When I was at my worst, my nervous system out of control, I definitely was suffering from a form of PTSD. Everything in my environment triggered me, every sight of things that had once pleased or frustrated me. It's eased now that my CNS has calmed. But I still avoid engaging w/ things that represent my past.

 

[duncan]

"Self-Reported" Chronic Fatigue Syndrome ? How many were told by their GP they suffered from chronic fatigue, and conflated fatigue with CFS?

 

[JAM]

My illness caused my PTSD.

 

[alex3619]

How doctors treat us has also been claimed to cause PTSD. We have even been subjected to consistent, authority driven, enforced abusive treatment, such as in hospitals or during forced treatment during sectioning.

 

[IreneF]

A traumatic childhood is correlated with poorer health outcomes across the board.

 

[Sidereal]

In addition to the vicious social stressors PWME are subjected to, there may be plausible biological explanations for the comorbidity between PTSD and ME. For instance, Martin Pall has hypothesised that PTSD is one of the syndromes (along with ME, FM, MCS and Gulf War Illness) perpetuated by a dysfunctional NO/ONOO (nitric oxide-peroxynitrite) cycle.

Useful experimental paper here.

 

[Min]

How doctors treat us has also been claimed to cause PTSD. We have even been subjected to consistent, authority driven, enforced abusive treatment, such as in hospitals or during forced treatment during sectioning.

Yes, the authors have failed to take into account the systematic abuse and neglect we receive from the medical profession after being diagnosed with our neurological illness.

Every symptom we present with is dismissed as 'all in the mind' (I spent three years being offered antidepressants for symptoms of what turned out to be a large kidney stone) and we are patronised and sneered at rather than helped

 

[duncan]

Eh. GIGO. This is not just a poor study, imo, it's a bad one. It suggests people with our condition are typically folks easily and dramatically intimidated - or at least that's how I imagine the average layperson would translate it. So, instead of moving beyond that bullying case, we are more likely to be traumatized by it. It's not the disease, silly, it's our inability to escape our genetic predisposition to crumble under the weight of a mean and unfair environment.

 

[JAM]

How doctors treat us has also been claimed to cause PTSD. We have even been subjected to consistent, authority driven, enforced abusive treatment, such as in hospitals or during forced treatment during sectioning.

Don't forget the surgeries. I've had 4 unnecessary and unhelpful surgeries. Very traumatic.

 

[jimells]

I spent three years being offered antidepressants for symptoms of what turned out to be a large kidney stone

I grew up thinking that doctors were men and women of science. I now realize there is more science in astrology that in many clinics.

It would be interesting to see the results of a similar study conducted in a society that treats *all* sick people with respect, if indeed such a society exists today.