In een overzichtsartikel, dat onlangs in Current Psychiatry Reports verschenen is, laten
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 .
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
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.
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.
Chronic fatigue syndrome, CFS, Depression, Generalised anxiety disorder,
Neuropsychological, Major depressive disorder, MDD,
Somatoform disorder, Personality disorder, Attention, Memory, Reaction time