Psychologic Outcome, Fatigue, and QoL after Infection with Shiga Toxin-producing Escherichia coli O1

[Firestormm]

Ring any bells? I wonder if any of these poor unfortunates subsequently met a diagnosis for Me/CFS?

14 march 2014

Psychologic Outcome, Fatigue, and Quality of Life after Infection with Shiga Toxin-producing
Escherichia coli O104

Abstract
Backgrounds & Aims
From May through July 2011, in northern Germany, there was a large outbreak of hemolytic-uremic syndrome (HUS) and bloody diarrhea, related to infections from Shiga toxin-producing Escherichia coli O104 (STEC).

We investigated the depression, post-traumatic symptoms, fatigue, and health-related quality of life among patients within the first 6 months after STEC infection and aimed to identify factors associated with poor outcome.

Methods
In a cohort study, we performed baseline assessments of 389 patients (69% female) 3 months after STEC infection (82±36 days) and follow-up assessments of 308 of the patients 6 months afterward (199±17 days).

Data were collected at 13 hospitals in northern Germany. Patients completed validated self-report scales and a diagnostic interview (SCID).

Results
At baseline, HUS was diagnosed in 31% of the patients.

Six months after the infection, mean self-reported severity of depression and post-traumatic symptoms and fatigue were significantly greater than in the general population, and the mean score from the mental component of health-related quality of life survey was significantly lower than average.

For depression, the change in effect size was 0.58. Post-traumatic stress disorder had recently developed in 3% of patients (95% confidence interval [CI], 1%–5%) and 43% of patients had clinically relevant fatigue (95% CI, 41%–45%).

The most important baseline factors associated with poor psychological health 6 months after STEC infection were previous traumatic events, neuroticism, and low social support (all P<.05).

Conclusions
Six months after the major outbreak of STEC infection in northern Germany, a substantial number of patients had poor psychological health, persistent fatigue, and impaired quality of life.

For future outbreaks, patients’ premorbid risk factors should be considered, which might minimize the long-term effects of infections on mental health.

Tate Mitchell via Co-cue said:

Yet another infection which results in a prolonged, post-infectious (aka 'chronic') fatigue syndrome. While the study
abstract states that:

"The most important baseline factors associated with poor psychological health 6 months after STEC infection were previous traumatic events, neuroticism, and low social support", the questionnaires used for these diagnoses are generally completely and blatantly inappropriate to be used with populations suffering from ill health.

I can't remember the exact wording, but negative responses to questions similar to 'Are you able to enjoy the activities you once did?', 'Do you feel confident in your abilities?', 'Do you go out as often as you used to?', etc. are taken to mean that the individual suffers from depression, neuroticism, etc.

IMO there needs to be a study entitled 'Neuroticism in patients suffering from acute influenza' which asks people who have the flu to fill out these same questionnaires.

Of course the infection would still be present in those people, and like it or not, that is what makes all the difference to modern medicine.

 

[Ren]

From this thread* and posted by Roy S (post 13):

"...Baseline variables that were gathered several months following IM [infectious mononucleosis], 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."

The full paper is here: http://www.tandfonline.com/doi/full/10.1080/21642850.2013.869176

And I added (post 15):
"...a 2006 study that's been posted by CDC which also determined, "The syndrome [PVFS] was predicted largely by the severity of the acute illness rather than by demographic, psychological, or microbiological factors." http://www.bmj.com/content/333/7568/575


Am I right in understanding that the German Escherichia coli O104 (STEC) study didn't look at (rate) acute-illness severity?


*http://forums.phoenixrising.me/inde...n-chronic-fatigue-syndrome.28446/#post-433085