Moods Play Bigger Role in Fatigue
Chronic fatigue--the seventh most common complaint heard by family physicians--is associated more with emotional factors than with physical disease, researchers suggest in the current issue of the Journal of the American Medical Assn.
In a study of 102 chronically fatigued patients and 26 control subjects, 80% of the fatigued group had abnormally high scores for depression or anxiety, compared to 12% of the control subjects. Diagnostic tests showed fatigued patients had no more medical problems than control subjects.
Researchers from Brooke Army Medical Center in Ft. Sam Houston, Tex., also concluded that most cases of chronic fatigue are probably not caused by Epstein-Barr, a herpes-like virus thought to cause infectious mononucleosis and implicated in chronic fatigue syndrome. Previously called chronic Epstein-Barr virus syndrome, chronic fatigue syndrome also has been dubbed “yuppie flu.”
In another study reported in the same issue, researchers conclude that one test commonly used to help diagnose chronic fatigue syndrome--antibody to Epstein-Barr early antigen--”was found not to be helpful,” said Dr. Robert E. Van Scoy, a consultant in infectious disease and internal medicine at Mayo Clinic, Rochester, Minn.
In the last few years, doctors have relied more on three or four other diagnostic blood tests, said Orvalene Prewitt, co-director of the Chronic Fatigue Syndrome Society Central Regional Office in Kansas City, Kan. But the choice of tests “should be left up to a patient’s own physician,” she added.
Said Van Scoy: “A certain amount of fatigue is part of normal living. The most important thing is to be carefully examined by a physician to see if he or she can find causes--both physical illness or emotional strain--for the chronic fatigue. In the large majority of patients, it probably isn’t the E-B virus causing chronic fatigue.”
Hurting? Think Happy
If you’ve got a headache, being in a bad mood might make it worse, a team of Australian researchers report in the journal Behaviour Research and Therapy. A happier state of mind, they said, can lessen a headache’s intensity.
In the study, the researchers played seven minutes of “mood suggestive” music to 63 headache sufferers and 60 control subjects. Half of each group listened to music designed to induce despondency while the other half listened to music meant to induce a happy state of mind.
Mood induction had no effect on the headache status of control subjects, who remained headache-free throughout. Headache sufferers who listened to happy music reported a decrease in headache intensity while those who listened to depressing music reported an increase.
In other studies, the Australian researchers have found that about two-thirds of headache sufferers have hard-driving, competitive Type-A personalities and have difficulty managing time effectively, said Paula R. Nathan, a professor of psychology at the University of Western Australia and one of the study authors. She recommends that headache sufferers learn to manage time, stress and pain more effectively.
Lesbians and Stress
Many lesbians suffer from extreme stress, and more than one in five has considered suicide, a new nationwide survey shows.
The survey of 2,000 lesbians, ages 17 to 80, conducted by the nonprofit National Lesbian and Gay Health Foundation in Washington, found that 21% had considered suicide “sometimes” or “often,” and 18% of those had attempted it (most often by drug overdose).
Nearly all respondents reported wanting help for psychological problems at some time, and three-quarters said they were either currently or previously in psychological counseling, said Caitlin Ryan, co-investigator of the six-year project with Judy Bradford, a health policy researcher at Virginia Commonwealth University in Richmond.
Among the sources of stress: lack of personal support, job discrimination and the perceived need to keep personal relationships hidden from co-workers and family.
Seventeen percent said their sexual orientation was known by co-workers, Ryan said, while 13% reported losing a job because they are gay. One-third had problems at work or school and one in five reported problems with family members. About the same number said their sexual orientation was not known by any family member.
Based on the findings, Ryan emphasizes the need for health care practitioners to assess these problems in known lesbian patients. She also recommends that lesbians seek out physicians they feel comfortable with, using referrals from friends or gay clinics.
To control stress, she suggests becoming involved in gay community activities. “The (survey respondents) who had less stress appeared to be regularly involved in community activities,” she said.
