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

Fatigue, pain, and emotional upset remain the most common problems affecting humanity and for which we still know so very little. Chronic fatigue syndrome is most likely a number of as yet unproven various undifferentiated illnesses that are exceedingly difficult to distinguish from depression. There probably is a subset of patients with CFS who do have true immune dysfunction and persistent viral infection, and this particular group of patients should be further investigated. This group is the minority of patients who present with chronic fatigue. Although chronic fatigue syndrome may be the result of an organic illness in psychologically susceptible individuals, it remains most important to assess underlying psychologic factors that then need to be addressed. These factors may very likely have a profound effect on immune function, but more research is needed in this area. The diagnostic evaluation of patients with chronic fatigue syndrome should initially focus on causes for fatigue other than Epstein-Barr viral infection. Significant underlying medical conditions should be ruled out, and extensive inquiry into symptoms suggestive of depression and anxiety should be aggressively pursued. Treatment should include psychiatric support and counseling, good nutrition, adequate rest, and a gradual increase in activity. Anti-inflammatory agents and serotonin-replenishing antidepressants are helpful when muscle pain and tenderness are a major part of the patient's symptoms. Psychoactive drugs are useful when indicated. Low doses of antidepressants such as doxepin (10-25 mg at night) are generally well tolerated and have shown efficacy in numerous patients, although there are no reports of controlled trials.
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PMID:Chronic fatigue and depression in the ambulatory patient. 187 21

This chapter has reviewed some of the methodological and theoretical issues in research linking the social environment to medical illnesses. The second part of the chapter has focused on three specific neurological entities to examine evidence for a possible association between neurological illness and life stress. There is some suggestion that certain vulnerable epileptic patients can experience convulsions in response to acute emotional upheaval or certain types of cognitive challenges. More commonly, it is probable that social stress and emotional tension can produce lowering of seizure threshold by increasing levels of fatigue and disrupting sleep. The latter factor, in particular, is known to lower seizure threshold. In the case of stroke, several dramatic cases of intracranial hemorrhage have been related to disastrous life circumstances. A general association between life stress and stroke has yet to be established. The case for a link between life events and onset of exacerbation of multiple sclerosis seems stronger. Events which produce emotional upset seem capable of worsening symptoms in patients with existing disease, and several studies have reported unusual life stresses in the period preceding onset of symptoms in this disorder.
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PMID:The social environment and neurological disease. 389 69

One hundred and fifteen electronics factory employees completed questionnaires relevant to work stress, and gave unstimulated saliva samples. As previously found, Perceived Coping Incapacity correlated very significantly with self-reported emotional upset and psychosomatic complaints. Salivary [Na+] correlated significantly with Perceived Coping Incapacity (rho = -0.30, p < 0.01), and also with emotional upset (rho = -0.19, p < 0.05). Raised [K+] tended to be associated with reduced fatigue (rho = -0.21, p < 0.05) and lower self-medication (rho = -0.21, p < 0.05) together with a greater perceived personal work responsibility (rho = 0.19, p < 0.05)-all consistent with the perception of work demands as positive challenges rather than stressors. Self-reported fatigue and emotional upset at work gave higher correlations with [K+] and [Na+] than either did on its own. Salivary [cortisol] was uncorrelated with self-reported work stress indices, and with [K+] and [Na+].
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PMID:Concentrations of sodium, potassium and cortisol in saliva, and self-reported chronic work stress factors. 865 57

It is widely accepted that Shakespeare was unique in the range of his insights into the human mind, but the way his characters reveal their mental states through bodily sensations has not been systematically explored. The author has searched for these phenomena in the 42 major works of Shakespeare and in 46 genre-matched works by his contemporaries, and in this paper the author focuses on sensory changes other than those involving vision, taste, the heart and the alimentary tract (all considered in other papers). Vertigo is experienced by five distressed Shakespearean characters, all men, but not at all by the other writers' characters. Breathlessness, probably representing hyperventilation, occurs eleven times in Shakespeare's works but only twice in the other writers' works. Fatigue, expressing grief, is articulated by several Shakespearean characters including Hamlet. It features less often in the others' works. Deafness at a time of high emotion is mentioned by Shakespeare several times but usually by a character 'turning a deaf ear', consciously or unconsciously. To the other writers, ears show emotion only by burning or itching. Blunting of touch and pain and their opposites of hypersensitivity to touch and pain are all to be found in Shakespeare's works when a character is distressed or excited, but not so with his contemporaries' works. Faint feelings and cold feelings are also more common in the works of Shakespeare. Overall, therefore, Shakespeare was exceptional in his use of sensory disturbances to express emotional upset. This may be a conscious literary device or a sign of exceptional awareness of bodily sensations.
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PMID:Body-conscious Shakespeare: sensory disturbances in troubled characters. 2167 16