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Christley:

psychiatrische en

cognitieve symptomen

in ME/CVS

 

 

 

 


 

 

 

In een overzichtsartikel, dat onlangs in Current Psychiatry Reports verschenen is, laten

Christley, Duffy, Martin (University of West of Scotland)en Everall (University of Melbourne)

een aantal psychiatrische aspecten en kenmerkende cognitieve klachten de revue passeren.

 

De psychische aspecten die in het artikel aan de orde komen, zijn:

  • depressie (oorzaak of gevolg, biologische overeenkomsten, zoals inflammatie en oxidatieve/nitrosatieve stress, en verschillen, zoals HPA as en RNase-L dysfunctie),
  • persoonlijkheidsstoornissen (niet afwijkend van die in andere ziekten)
  • angststoornissen (lijken vaker voor te komen in ME en CVS), en
  • somatisatie (cijfers zijn afhankelijk van de visie m.b.t. de oorzaak van symptomen).

Tevens vat het artikel de drie meest in het oog springende cognitieve klachten samen:

problemen met de concentratie, het geheugen en de reactiesnelheid (zie ook hier).

 

 


 

Enkele relevante citaten uit het artikel:

 

 

The symptoms of MDD and CFS overlap significantly and

as such it is not surprising that that

the CFS literature indicates that

MDD is the single most frequently occurring psychiatric disorder

associated with CFS [23].

 

Although high rates of MDD are linked with CFS,

as many as 30 to 50 percent of CFS patients

do not experience psychiatric symptoms.

 

...

 

As is evident, the aetiological relationship

between CFS and MDD is complex and not fully understood.

 

Despite the complexity there is an emerging body of evidence suggesting that

the link between CFS and MDD might be explained

through shared oxidative and nitrosative stress (IO&NS) pathways.

 

...

 

[T]he Johnson et al. and Demitrack studies demonstrate that

the diagnosis of somatisation in CFS

depends upon

patient reports of physical symptoms and

the assumption by the researcher that

there is no physical cause for the symptoms.

 

...

 

These studies indicate that there are

higher rates of personality disorder

amongst CFS patients than in non-clinical populations,

which are estimated to range

between nine and six percent in the general population.

 

However, these high rates of personality disorder in CFS

are similar to

those found in patients with other chronic medical conditions.

 

...

 

[O]bjective evidence of cognitive disturbance has been demonstrated

with deficits in attention, memory and reaction time

being the most problematic for CFS patients.

 

 


 

 

The neuropsychiatric and neuropsychological features of chronic fatigue syndrome: revisiting the enigma.

Curr Psychiatry Rep. 2013 Apr;15(4):353. doi: 10.1007/s11920-013-0353-8.

Christley Y, Duffy T, Everall IP, Martin CR.

 

 

Abstract

 

The aim of this article is to provide

a comprehensive and updated review of

the key neuropsychiatric and neuropsychological complaints

associated with chronic fatigue syndrome (CFS).

 

Neuropsychiatric and neuropsychological difficulties are common in CFS

and are linked primarily to disorders of mood, affect and behaviour.

 

The neuropsychiatric complaint

most frequently encountered amongst CFS patients

is depression and in particular major depressive disorder (MDD).

 

Despite decades of research,

the precise aetiological relationship between CFS and MDD remains poorly understood.

 

This has resulted in the development of

a number of interesting and polarised hypotheses

regarding the aetiological nature of CFS.

 

Recent scientific advances have however begun to unravel

a number of interesting inflammatory and immunological explanations

that suggest CFS and MDD are distinct yet interrelated conditions.

 

The possibility that the overlap between CFS and MDD

might be explained

in terms of shared oxidative and nitrosative (IO&NS) pathways

is an area of intense research interest and

is reviewed in detail in this article.

 

The overlap between CFS and MDD is further differentiated by

variations in HPA axis activity between the two disorders.

 

Important immunological differences between MDD and CFS are also reviewed

with particular emphasis on antiviral RNase L pathways in CFS.

 

In addition to the presence of neuropsychiatric complaints,

CFS is also associated with neuropsychological symptoms

such as impaired attention, memory and reaction time.

 

The key neuropsychological problems reported by CFS patients

are also included in the review

in an effort to understand the significance of cognitive impairment in CFS.

 

 

PMID: 23440559

 

 

Keywords

 

Chronic fatigue syndrome, CFS, Depression, Generalised anxiety disorder,

Neuropsychiatric, Neuropsychological, Major depressive disorder, MDD,

Somatoform disorder, Personality disorder, Attention, Memory, Reaction time

 

 

http://link.springer.com/article/10.1007%2Fs11920-013-0353-8

http://www.ncbi.nlm.nih.gov/pubmed/23440559