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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The psychiatric status of patients with chronic fatigue syndrome (N = 34) and muscle disease (N = 24) attending a general medical clinic was studied. Among fatigue patients 14 (41.2%) were cases and a further 9 (26.5%) were subcases of psychiatric disorder as defined by CATEGO. A variety of diagnoses was found. Significantly fewer of the muscle patients had a psychiatric disorder with 3 (12.5%) being cases and 1 (4%) a subcase. The relative risk of psychiatric disorder in patients with chronic fatigue syndrome compared to patients with muscle disease was 3.3:1.
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PMID:A comparative psychiatric assessment of patients with chronic fatigue syndrome and muscle disease. 194 50

The history of neurasthenia is discussed in the light of current interest in chronic fatigue, and in particular the illness called myalgic encephalomyelitis ('ME'). A comparison is made of the symptoms, presumed aetiologies and treatment of both illnesses, as well as their social setting. It is shown that neurasthenia remained popular as long as it was viewed as a non-psychiatric, neurological illness caused by environmental factors which affected successful people and for which the cure was rest. The decline in neurasthenia was related to the changes which occurred in each of these views. It is argued that similar factors are associated with the current interest in myalgic encephalomyelitis. It is further argued that neither neurasthenia nor 'ME' can be fully understood within a single medical or psychiatric model. Instead both have arisen in the context of contemporary explanations and attitudes involving mental illness. Future understanding, treatment and prevention of these and related illnesses will depend upon both psychosocial and neurobiological explanations of physical and mental fatigability.
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PMID:Old wine in new bottles: neurasthenia and 'ME'. 218 19

A clinical study was made on depressive state following stroke using stroke patients in the chronic stage. There were 118 stroke patients in the present study and 25 patients (21.2%) satisfied the diagnostic criteria for major depressive syndrome of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised (DSM-III-R). As for dispositional, social, and somatic factors, a tendency was observed for depressive state to develop at a high frequency among patients with a past history of mental disorder prior to development of stroke, patients residing in suburban area, patients engaged in domestic and agricultural work, and patients with a frequent history of physical disorders. A tendency was observed for depressive state to develop at a high frequency among patients showing B type in YG test and patients presenting laterality in electroencephalography. Among the 49 right stroke patients, depressive state was observed in 10 cases (20.4%), while among the 43 left stroke patients, depressive state was seen in 10 cases (23.2%) with the incidence of depressive state showing no difference by hemisphere stroke. Study of the clinical characteristics of depressive state by hemisphere stroke with the use of symptom items of Zung scale and Hamilton scale showed that patients in depressive state with right hemisphere stroke had high values in symptom items considered close to the essence of endogenous depression such as depressed mood, suicide, diurnal variation, loss of weight, and paranoid symptoms, while patients in depressive state with left hemisphere stroke had high values in symptom items having a nuance of so-called neurotic depression such as psychic anxiety, hypochondriasis, and fatigue. Comparison with endogenous depression patients indicated that right stroke patients rather than left stroke patients showed a clinical picture suggestive of endogenous depression. Antidepressant was effective in 71.4% of the cases, but no difference in effectiveness could be observed by hemisphere stroke. In stroke patients in the chronic stage the incidence of clinical depressive state was higher than 20%, and involved in its onset were not only brain organ lesions but also dispositional, social, and somatic factors and integration dysfunction in the emotional activity of the left and right hemisphere functions. As for the clinical picture, a picture considered close to endogenous depression was observed in right stroke patients, while that considered close to so-called neurotic depression was seen in left stroke patients. The therapeutic effect of antidepressant was almost equivalent to that for endogenous depression.
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PMID:[Clinical study on depressive state following stroke]. 223 45

Mental illness affected 23 (33%) of the 69 patients with von Recklinghausen neurofibromatosis (NF-1) who were the primary subjects of this report. Moderately severe or severe mental illness, that is, grade 2 and 3 according to the Comprehensive Psychopathological Rating Scale (CPRS), was found in 15 of the 69 patients (22%). The 23 mentally ill patients did not show any uniform clinical psychiatric syndrome. The most commonly occurring psychiatric diagnoses were depressive syndrome, anxiety state with vegetative dysfunction and organic brain syndrome. There was a significant positive relation between depressive syndrome and organic brain syndrome according to the CPRS rating. Half of the 69 patients complained of mental symptoms in the form of hostile feelings and autonomic disturbances and these were the most frequent psychiatric symptoms; they were also frequent among patients without mental illness. Other common symptoms were sleep difficulties, tiredness, and aches and pains. Among patients with NF-1 there was a significantly positive relation between mental illness and mental retardation, but no significant positive relation between mental illness and physical severity of NF-1. Patients with mental illness also showed a significantly increased frequency of positive neurological findings indicating central nervous manifestations of NF-1.
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PMID:Neurofibromatosis in Gothenburg, Sweden. III. Psychiatric and social aspects. 251 61

Patients with persistent fatigue are often suspected of having psychiatric illnesses, particularly depression. The authors used the Diagnostic Interview Schedule to assess the lifetime prevalence of psychiatric disorders in 28 patients who met Centers for Disease Control case definition criteria for chronic fatigue syndrome. Compared with studies of the general population and studies of chronically medically ill patients who received the same structured interview, the rates of psychiatric illness in patients with the chronic fatigue syndrome appeared high. An examination of the medical histories of the 28 patients indicated that psychiatric disorders more often preceded the chronic fatigue than followed it.
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PMID:Psychiatric diagnoses in patients who have chronic fatigue syndrome. 232 83

Patients (n = 47) presenting to a neurological centre with unexplained chronic "postviral" fatigue (CFS) were studied prospectively. Controls were patients with peripheral fatiguing neuromuscular diseases and inpatients with major depression in a psychiatric hospital. Seventy-two percent of the CFS patients were cases of psychiatric disorder, using criteria that excluded fatigue as a symptom, compared with 36% of the neuromuscular group. There was no difference in subjective complaints of physical fatigue between all groups. Mental fatigue and fatigability was equally common in CFS and affective patients, but only occurred in those neuromuscular patients who were also cases of psychiatric disorder. Overall, the CFS patients more closely resembled the affective than the neuromuscular patients. Attribution of symptoms to physical rather than psychological causes was the principal difference between matched CFS and psychiatric controls. The symptoms of "postviral" fatigue had little ability to discriminate between CFS and affective disorder. The fatigue in CFS appeared central in origin, suggesting it is not primarily a neuromuscular illness. The implications for research and treatment of chronic fatigue are discussed.
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PMID:Fatigue syndromes: a comparison of chronic "postviral" fatigue with neuromuscular and affective disorders. 257 80

48 consecutive male patients of potency disorders were examined and classified as 'Dhat' syndrome, impotence or premature ejaculation. The age range of these cases was found as 20-38 years (mean 23.5 +/- 3.3 years) while age of onset was 16-24 years (mean 20.6 +/- 4.5 years). Majority of cases were unmarried (54.2%) and educated 5th class or above (79.1%). 31 cases (64.6%) had Dhat syndrome with or without impotency and/or premature ejaculation while 7 cases (14.6%) had only premature ejaculation and 10 cases (20.8%) only impotence. The cases with 'Dhat' syndrome or with impotence scored maximally on neuroticism and depression scales. Neurotic depression was the commonest associated psychiatric illness (39.5%) followed by anxiety neurosis (20.8%) while 31.3% did not have any possible diagnosis. The common presenting symptoms of 'Dhat' syndrome include weakness (70.8%), fatigue (68.7%), palpitations (68.7%), sleeplessness (62.4%) etc. Among the four groups on the basis of type of treatment (antianxiety drug, antidepressant, placebo, psychotherapy), the best response was seen in those receiving antianxiety or antidepressant drugs while those receiving psychotherapy showed minimal response. 7 cases (14.6%) dropped out of treatment and the maximum dropout (40.6%) was seen in psychotherapy group.
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PMID:'Dhat' syndrome--a useful clinical entity. 263 75

The long-term prognosis and quality of life of 201 patients admitted to hospital with reversible ischemic attacks (RIA) were estimated in a prospective study. The median follow-up time was 58 months. Further RIAs were reported by 91 patients (45%) and 48 (24%) suffered a stroke. The risk of stroke was markedly higher in the first 6 months after RIA, after which the annual stroke rate was rather constant with an average of 4.8%, about 8 times higher than expected. The average annual mortality rate for the RIA patients was 5.9%, which is significantly higher than expected. Cardiovascular deaths accounted for more than half of all deaths, stroke for one fourth. Life-table analysis of subgroups disclosed a much more favorable prognosis for women under 60 years. High systolic blood pressure, diabetes, and previous myocardial infarction were identified as risk factors. The occurrence of RIA had significantly influenced the quality of life and occupational status for the majority of the patients, even for those who did not suffer a subsequent stroke. Decreased working capacity, general asthenia and fatigue and impaired memory were the most common complaints. We conclude that RIA may be a more serious vascular event than generally believed. Apart from carrying a substantial risk of stroke and death, even a single RIA can cause permanent psychological dysfunction influencing the quality of life.
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PMID:Long-term prognosis and quality of life after reversible cerebral ischemic attacks. 271 39

The sedative or excitatory effects of drugs are difficult to evaluate in patients with depression, where sleep disturbances and tiredness in the daytime belong to the clinical manifestations of the psychiatric disorder. A refined method of vigilance measurement, based on the EEG spectra, together with proper statistical analysis of the data, is helpful for correct interpretation of the data. In two groups of patients with depression, the intensity of sleep disturbances was considered as a background variable in partial correlations, reflecting the relationships between vigilance and drug concentration in a more specific way. It was shown that the sedative effect of maprotiline interferes with the increased vigilance in the patients, with improved night sleep after treatment. As a result, the patients do not experience decreased vigilance although maprotiline has a sedative action. The results obtained in the patients treated with beta-blockers suggest that the drug itself has no sedative effect but the patients suffer from decreased vigilance in the daytime, caused by the sleep disturbances and depression.
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PMID:EEG assessment of the sedative and excitatory properties of CNS-active compounds in the patients with depression. 295 8

Seventy patients presenting to the gastroenterologist with upper abdominal pain were examined by a psychiatrist to establish the presence of psychiatric disorder, illness behaviour and to record in detail their symptom pattern. The 37 patients who had no organic cause for their abdominal complaints were subdivided into those with and without psychiatric disorder. The former (21 patients) demonstrated more illness behaviour, they complained of more abdominal symptoms and their pain was both more severe and more persistent than in the patients with organic disease and those with non-organic illness who did not have psychiatric disorder. The latter group reported no symptoms of 'psychoneurosis' and should probably be regarded as a separate group if the aetiology of functional abdominal pain is to be clarified. Those with non-organic abdominal complaints who had psychiatric illness could be distinguished by the presence of three symptoms, namely depression, anxiety and fatigue. Detection and treatment of their psychiatric disorder might lead to a decrease in their symptomatic complaints and illness behaviour.
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PMID:Symptom complaints, psychiatric disorder and abnormal illness behaviour in patients with upper abdominal pain. 327 Aug 33


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