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Cited by 199Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Psychosomatic Disorders and Their Treatments

Follow up of patients presenting with fatigue to an infectious diseases clinic.

Open access
Sharpe, M., Hawton, K., Seagroatt, V., Pasvol, G.·1992·BMJ
DOI 10.1136/bmj.305.6846.147PMC PMC1883193
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Abstract

OBJECTIVES: To determine the symptomatic and functional status during follow up of patients referred to hospital with unexplained fatigue and to identify patient variables associated with persistent functional impairment. DESIGN: Follow up by postal questionnaire six weeks to four years (median 1 year) after initial clinical assessment of patients referred to hospital during 1984-8. SETTING: Infectious diseases outpatient clinic in a teaching hospital. PATIENTS: 200 consecutive patients with fatigue of uncertain cause for at least six weeks; 177 fulfilled the inclusion criteria. MAIN OUTCOME MEASURES: Findings at initial assessment; current symptoms, beliefs about the cause of illness, coping behaviours emotional disorder, social variables including membership of self help organizations, and degrees of recovery and functional impairment from questionnaire responses. RESULTS: 144 (81%) patients returned completed questionnaires. Initial assessment did not indicate the cause of fatigue, other than preceding infection. The proportion of patients with functional impairment was significantly smaller with longer follow up (33% (11/33) at two to four years, 73% (29/40) at six weeks to six months; chi 2 for trend = 12.5, df = 1; p less than 0.05). Functional impairment was significantly associated with belief in a viral cause of the illness (odds ratio = 3.9; 95% confidence interval 1.5 to 9.9), limiting exercise (3.2; 1.5 to 6.6), avoiding alcohol (4.5; 1.8 to 11.3), changing or leaving employment (3.1; 1.4 to 6.9), belonging to a self help organization (7.8; 2.5 to 23.9), and current emotional disorder (4.4; 2.0 to 9.3). CONCLUSIONS: Short term prognosis for recovery of function was poor but improved with time. Most patients had made a functional recovery by two years after initial clinic attendance. Impaired functioning was more likely with certain patient characteristics. Prospective studies are required to clarify whether these associations are the consequences of a more disabling illness or indicate factors contributing to impaired function.

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  • Previous research has found anxiety and depression as measured by the HADS to be related to poor treatment outcome, and more functional impairment at follow-up.

    “Previous research has also found anxiety and depression as measured by the HADS to be related to poor treatment outcome (Bentall et al., 2002), and more functional impairment at follow-up (Sharpe et al., 1992).”

    From The relationship between improvement in insomnia severity and long-term outcomes in the treatment of chronic fatigue (2018) · cites this paper as Sharpe et al., 1992

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Authors
Sharpe, M., Hawton, K., Seagroatt, V., & Pasvol, G.
Affiliations
University of Oxford (GB)
ORCID
Venue
BMJ
Publisher
BMJ
Published
1992-07-18
Volume
305
Issue
6846
Pages
147-152
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.305.6846.147
PMC
PMC1883193
OpenAlex
W2050766951
Cited by
198
References
30
Citations by year
2026: 2 · 2023: 10 · 2022: 1 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 2
FWCI
11.48
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
unexplained fatigue, functional disability, functional recovery, prognosis, illness beliefs, self-help organizations, emotional disorders, coping behaviour, employment change, alcohol avoidance, exercise limitation, infectious disease clinic
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Affective Symptoms, Aged, Attitude to Health, Female, Follow-Up Studies, Humans, Infections, Male, Middle Aged, Outpatient Clinics, Hospital, Prognosis, Referral and Consultation, Fatigue Syndrome, Chronic

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