Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research

Borsini, Alessandra; Hepgul, Nilay; Mondelli, Valeria; Chalder, Trudie; Pariante, Carmine M.

doi:10.1017/s0033291713002468

Cited by 32 publications

(25 citation statements)

References 101 publications

(172 reference statements)

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“…Reduced efficacy was weakly related to life stress only in the sample of depressed patients. An association between life stress operationalized as childhood trauma and fatigue, which is quite similar to the emotional exhaustion component of burnout, has recently been found by Borsini, Hepgul, Mondelli, Chalder, and Pariante (2013). Similarly, Carlier, Lamberts, and Gersons (1997) found a significantly increased level of emotional exhaustion in policemen that had experienced traumatic events and suffered from PTSD.…”

Section: Discussionmentioning

confidence: 75%

Life stress as potential risk factor for depression and burnout

et al. 2015

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a b s t r a c tObjective: Depression and burnout are two psychopathological labels that have been subject to an extensive discussion over the last decades. The crucial question is whether they can be seen as conceptually equal or as two distinct syndromes. One argument for the distinction is that depression impacts on the whole life of a suffering person whereas burnout is restricted to the job context. Depression has been shown to be affected by life stress. The more stressful life events a person experiences, the more he or she is susceptible for developing a depression. As there is the widespread but controversial opinion that burnout is a prodromal syndrome of depression, the present study examined whether the number of stressful life events is also associated with an increased risk for burnout. Methods: N = 755 healthy participants and N = 397 depressed patients completed the Maslach Burnout Inventory (MBI), the Beck Depression Inventory (BDI II) and reported the extent of experienced life stress. Results: A significantly closer relation between depression and life stress than between burnout and life stress was found in the healthy (z = 3.01, p = .003) as well as in the depressed sample (z = 3.41, p = .001). This finding was supported in both samples by means of a path analytic approach where the associations between life stress, burnout, and depression were controlled for possible mediator and moderator effects, also considering the influence of age. Conclusion: By considering the influence of life stress it could be demonstrated that depression and burnout are not identical although they share substantial phenotypic variance (r = .46-.61). Most important, the trivariate associations are the same in a representative employee sample and in an inpatient clinical sample suggesting the same underlying mechanisms covering the whole range from normal behavior to psychopathology. However, only longitudinal data can show if burnout necessarily turns into depression with the consequence that the burnout -life stress association approaches the depressionlife stress association over time.

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Section: Discussionmentioning

confidence: 75%

Life stress as potential risk factor for depression and burnout

et al. 2015

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“…Previous work has also suggested an increased prevalence of childhood physical, emotional and sexual abuse in those with idiopathic chronic fatigue and chronic fatigue associated with medical and psychiatric illness [ 50 ]. Borsnini et al [ 51 ] have also confirmed childhood stressors to increase the possibility of subsequent CFS/ME. We do not routinely explore this area in detail as it seldom helps to reduce the symptoms of CFS/ME but does have the possibility of aggravating matters by raising stress and anxiety levels.…”

Section: Introductionmentioning

confidence: 96%

Investigating unexplained fatigue in general practice with a particular focus on CFS/ME

Bansal

2016

BMC Fam Pract

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Unexplained fatigue is not infrequent in the community. It presents a number of challenges to the primary care physician and particularly if the clinical examination and routine investigations are normal. However, while fatigue is a feature of many common illnesses, it is the main problem in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). This is a poorly understood condition that is accompanied by several additional symptoms which suggest a subtle multisystem dysfunction. Not infrequently it is complicated by sleep disturbance and alterations in attention, memory and mood.Specialised services for the diagnosis and management of CFS/ME are markedly deficient in the UK and indeed in virtually all countries around the world. However, unexplained fatigue and CFS/ME may be confidently diagnosed on the basis of specific clinical criteria combined with the normality of routine blood tests. The latter include those that assess inflammation, autoimmunity, endocrine dysfunction and gluten sensitivity. Early diagnosis and intervention in general practice will do much to reduce patient anxiety, encourage improvement and prevent expensive unnecessary investigations.There is presently an on-going debate as to the precise criteria that best confirms CFS/ME to the exclusion of other medical and psychiatric/psychological causes of chronic fatigue. There is also some disagreement as to best means of investigating and managing this very challenging condition. Uncertainty here can contribute to patient stress which in some individuals can perpetuate and aggravate symptoms. A simple clinical scoring system and a short list of routine investigations should help discriminate CFS/ME from other causes of continued fatigue.

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“…However, a consistent pattern of circulating cytokine or chemokine levels has not been reported (Menzies, Lyon, Elswick, Montpetit, & McCain, ; Rodriguez‐Pintó et al, ). Thus, symptoms of FM are unlikely to follow from elevations of circulating cytokines per se but might be associated with individual differences in the inflammatory response to ongoing stressful experiences (Borsini, Hepgul, Mondelli, Chalder, & Pariante, ; Feng et al, ).…”

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confidence: 99%

Stress, Inflammation and Pain: A Potential Role for Monocytes in Fibromyalgia-related Symptom Severity

et al. 2015

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The possibility that immunological changes might contribute to symptom severity in fibromyalgia (FM) prompted this proof-of-concept study to determine whether differences in monocyte subpopulations might be present in persons with FM compared with healthy controls. Relationships were assessed by comparing specific symptoms in those with FM (n = 20) and patterns of monocyte subpopulations with healthy age-matched and gender-matched controls (n = 20). Within the same time frame, all participants provided a blood sample and completed measures related to pain, fatigue, sleep disturbances, perceived stress, positive and negative affect and depressed mood (and the Fibromyalgia Impact Questionnaire for those with FM). Monocyte subpopulations were assessed using flow cytometry. No differences were observed in total percentages of circulating monocytes between the groups; however, pain was inversely correlated with percentages of circulating classical (r = -0.568, p = 0.011) and intermediate (r = -0.511, p = 0.025) monocytes in the FM group. Stress and pain were highly correlated (r = 0.608, p = 0.004) in the FM group. The emerging pattern of changes in the percentages of circulating monocyte subpopulations concomitant with higher ratings of perceived pain and the correlation between stress and pain found in the FM group warrant further investigation. Copyright © 2015 John Wiley & Sons, Ltd.

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Childhood stressors in the development of fatigue syndromes: a review of the past 20 years of research

Abstract: Our review confirms that exposure to childhood stressors is associated with the subsequent development of fatigue syndromes such as CFS and FM, and related symptoms. Further studies are needed to identify the mechanisms underlying these associations.

Cited by 32 publications

References 101 publications

Life stress as potential risk factor for depression and burnout

Life stress as potential risk factor for depression and burnout

Investigating unexplained fatigue in general practice with a particular focus on CFS/ME

Stress, Inflammation and Pain: A Potential Role for Monocytes in Fibromyalgia-related Symptom Severity

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