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Gimeno et al: Stressful Events in the Onset of Chronic Fatigue Syndrome

Discussion in 'Latest ME/CFS Research' started by mango, Aug 19, 2016.

  1. mango

    mango Senior Member

    Stressful Events in the Onset of Chronic Fatigue Syndrome.

    Gimeno Pi I1, Guitard Sein-Echaluce ML2, Rosselló Aubach L3, Torres Puig-Gros J4, Fernández Solà J5.

    Author information
    1. Centro de Atención Primaria 1er de Maig. Institut Català de la Salut. Lleida, España
    2. Facultad de Enfermería y Fisioterapia. Universidad de Lleida, Lleida. España.
    3. Unidad de Reumatología. Hospital Universitario Santa María. Lleida. España.
    4. Servicio de Vigilancia Epidemiológica. Departamento de Salud. Lleida. España.
    5. Unidad de Fatiga Crónica. Hospital Clínic. Universidad de Barcelona. España.
    Rev Esp Salud Publica. 2016 Aug 18;90:e1-e7.
    [Article in English, Spanish]

    Chronic Fatigue Syndrome (CFS) is a complex and multifactorial disease. Stressful situations experienced could be related to the presentation of the disease. Few studies have determined which factors could trigger CFS. The main objective of this study was to explore the stressful situations which can be associated with CFS presentation.

    Retrospective observational case-control study with CFS diagnosed patients according to the Fukuda's criteria. Controls were matched to cases by sex, age and educational level with a 1:1 ratio. Participants aged between 18 and 75 years from the province of Lleida. Information was obtained through personal questionnaires. The measure of association was the odds ratio.

    In total, 77 cases and 77 controls were included. Association found between stressful life events and presentation of disease were pregnancy ORa=31.7 (CI95%:2.2-456.7), spousal abuse ORa= 10.2 (CI95%:1.2-88.4) and mobbing ORa=6.9 (CI95%:1.3-36.9), eating disorders=7.5 (CI95%:1.3-42.1), car accident ORa=5.5 (CI95%:1.7-17 9), economic problems ORa=5.1 (CI95%:2.1-12.6) and changes in sleep habits ORa=2.8 (CI95%:1.1-7.5).

    Stressful life events as pregnancy, spousal abuse, mobbing, eating disorders, car accident, economic problems and changes in sleep habits felt by those affected must be taken into consideration when compiling background information related to the onset of Chronic Fatigue Syndrome. Adequate identification of these stressful life events in risk people could contribute to early diagnosis of Chronic Fatigue Syndrome.

    KEYWORDS: Accidents; Chronic Fatigue Syndrome; Dyssomnias; Early Diagnosis; Feeding and Eating Disorders; Logistic Regression; Poverty; Precipitating factors; Pregnancy; Spain; Spouse Abuse; Stressful events
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  2. Woolie

    Woolie Senior Member

    Nasty stuff.

    Pretty clear just from the abstract where they're going with this - one of the article keywords is “precipitating factors” - a reference to the bipsychosocial model, which identifies predisposing, precipitating, and perpetuating factors in psychosomatic illnesses. Predisposing factors are generally things like being anxious and overly focused on your body sensations. Perpetuating factors are usually psychological stressors - this is obviously what they’re trying to go for here. Perpetuating factors things like believing you have an organic disease, or receiving sympathy and attention from relatives.

    It’s hard to say just from this abstract, but I would wager that the questionnaire was loaded so that participants would only mention psychological precipitating factors. Most of us wouldn't mention these - we'd mention the very obvious episode of mono/glandular fever, other acute illness, etc. It is also unclear how they compared these events in the control sample, who of course have no specific illness onset to use as a reference point.

    There is also no consideration of the important issue of recall bias. Research has shown that even those with well documented organic illnesses are likely to identify more stressful events in period preceding their illness than completely healthy controls (when the controls are questioned about events occurring within a specific timeframe of some major event). It is likely that people who suddenly become ill are more likely to pay attention to aspects of their life around the time they first got ill. Perhaps they do that to try and make sense of it all.

    The only real way to do this kind of research is prospectively, with a big cohort. You need to question a large population about the stresses in their current life, and then examine the number that develop your illnes within a specific time period afterwards.

    There's just this industry that keeps churning out this bullshit, eh? With no consideration of the pitfalls.
    Last edited: Aug 20, 2016
    Webdog, Mij, Marky90 and 7 others like this.
  3. A.B.

    A.B. Senior Member

    Or the harm that arises from trying to treat a disease with psychotherapy: patients being blamed, time and money being wasted, unreasonable expectations being set, prejudices being fueled, doctor-patient relationships breaking down.
    Webdog, Jennifer J, Valentijn and 4 others like this.
  4. Valentijn

    Valentijn Senior Member

    There was a prospective study, and it showed there was no connection between such factors and developing ME. I don't know why researchers insist on producing poorer-quality research when their hypothesis has already been disproven with higher-quality research.
    TiredSam, mermaid, Woolie and 14 others like this.
  5. Effi

    Effi Senior Member

    I'm pretty sure this is coming from the same place where they recently added 'mindfulness' as a viable, 'succesful' treatment for ME/CFS and FM.
    Woolie and OhShoot like this.
  6. adreno

    adreno PR activist

    Just about covers all, doesn't it? Did anyone in life not experience one of these "stressful life events"?
    halcyon, Woolie, OhShoot and 7 others like this.
  7. TiredSam

    TiredSam The wise nematode hibernates


    So they haven't read any literature outside their own narrow field then. They probably call themselves experts.
    Woolie, Solstice and Valentijn like this.
  8. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

  9. mermaid

    mermaid Senior Member

    Cornwall, UK
    I love the way that pregnancy is on that list - that's an awful lot of women then at a stroke. And why is pregnancy assumed to be stressful? Surprised that the menopause isn't on there to catch the rest of us ;)
    Solstice, Webdog, Woolie and 5 others like this.
  10. Snowdrop

    Snowdrop Rebel without a biscuit

    More ivory tower nonsense. I'd like to see a paper where the word 'stress' is clearly and fully discussed not just described (as in spousal abuse--yes that would be stressful).

    As an example--and this comes from an inadequate ability to think things through--there is physical stress in the same way a building might be stressed there are to me at least two kinds of psychologic stress (which we all experience) those situations that present a difficulty or obstacle but that we can find solutions for and resolve albeit with difficulty and that should be separate from what I'd term toxic stress. These are situations where all the power resides on one side and the person experiencing stress can do nothing to effect meaningful change.

    These all have different effects on people and in relation to illness.

    And as for pregnancy--I never felt better or more relaxed. This shows a real lack of actually getting to know the people they are studying--they just make assumptions and then make shit up.

    I'm hoping the age of tolerance for this kind of blarney is coming to an end.
    Last edited: Aug 21, 2016
    Solstice and Woolie like this.
  11. Woolie

    Woolie Senior Member

    Nice point, @Valentijn. I do remember that.
    mermaid likes this.

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