Differences in adrenal steroid profile in chronic fatigue syndrome, in depression and in health. Scott LV, Salahuddin F, Cooney J, Svec F, Dinan TG Department of Psychiatry, Trinity College Medical School, Dublin, Ireland.
BACKGROUND: Hyperactivity and hypoactivity of the HPA have been forwarded as of pathophysiological relevance in major depressive disorder and chronic fatigue syndrome (CFS), respectively. METHODS: This study examines cortisol levels in the two disorders, and also assesses levels of the adrenal androgens, dehydroepiandrosterone (DHEA) and its sulphate derivative (DHEA-S), and 17-alpha-hydroxyprogesterone; 15 subjects with CFS diagnosed according to CDC criteria, 15 subjects with DSM III-R major depression and 11 healthy subjects were compared. RESULTS: DHEA and DHEA-S levels were significantly lower in the CFS compared to the healthy group; DHEA-S levels, but not DHEA, were lower in the depressives; cortisol and 17-alpha-hydroxyprogesterone did not differ between the three groups. CONCLUSIONS: A potential role for DHEA, both therapeutically and as a diagnostic tool, in CFS, is suggested.
PMID: 10403156, UI: 99329950
[The chronic fatigue and neurasthenia in the student population]. [Article in Spanish]
Mojarro Praxedes MD, Benjumea Pino P Servicio de Psiquiatria,Hospital Clinico Universitario, Sevilla, Sevilla, 41009,Espana.
INTRODUCTION: Fatigue is one of the most common symptoms in community studies, primary care and other medical setting. In spite of a high frequency of fatigue, the incidence of chronic fatigue syndrome is very low. In this paper, we want to know the frequency of chronic fatigue syndrome and neurasthenia; we want to know the association between fatigue and depressive symptoms in students. METHODS: We studied 277 medical student, administering: 1. a center for disease control questionnaire to assess major criteria and minor criteria of chronic fatigue syndrome, 2. ICD 10 criteria for the diagnoses of neurasthenia and 3. Beck depression inventory. RESULTS AND CONCLUSIONS: We found that the 37,55% of the subjects suffer fatigue. 9 subjects (3,25% of the total) meet the criteria of neurasthenia. 2 subjects (0,72% of the total) meet the chronic fatigue syndrome criteria. The depressive symptoms are most frequent in the subjects with fatigue, but we don't know if they are the cause or the consequence of the fatigue. With the factorial analyses, we find that symtoms of physical fatigue, mental fatigue and cognitive difficulties are factor independent of each other.
PMID: 10380143
The authors studied the spontaneous
production of interleukin-6 in CFS
patients during both "natural fatigue"
and "experimental [induced]
fatigue". A significant increase
was seen during natural fatigue but
not during experimental fatigue,
leading the authors to suggest a role
of IL-6 in the natural symptomatology
and perhaps in the pathogenesis
of CFS. In addition,
the authors believe these findings show that
laboratory-induced fatigue may
not be a good model to study
immunological changes in CFS and
that instead they should be studied
during the natural course of the
disease.
Dr Jones stated that: ?A number
of the CFS patients said they feel worse when
they have allergies,?in a recently
completed a CFS study looking at four
groups of people--one with CFS,
one with allergies, one with depression and a
control group.
CFS is defined as six months of
fatigue that interferes with daily functioning
with no other disease being identified.
(Depending on the way CFS is defined,
between 13 and 300 people in every
100,000 have the disease.)
Researchers have looked at a number
of chemical changes in the body as a
signal of CFS, but Dr.Jones found
that ?the only consistent finding is
allergy.? Seventy-five percent
of people with CFS have allergies; 10 to 20
percent of the general population
have allergies.
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