Abstract
History of traumatic exposure in primary care and epidemiological studies suggest increased risks of chronic fatigue syndrome. The objective of this study is to examine the relationship between post-traumatic disorder (PTSD) and chronic fatigue syndrome (CFS) diagnosis among twins. We also examined the impact of sex and birth weight discordance on CFS and PTSD outcomes among twins. A cross-sectional study design was used to analyze the data of twins registered with the Washington State Twin Registry (“n” =18,398). Sociodemographic characteristics such as age, sex, race, and ethnicity were compared between twin pairs with and without CFS. Generalized estimating equation (GEE) and linear regression was used to measure the correlation between twins’ health background. Twins diagnosed with PTSD were 4.1 times more likely to develop CFS compared with those without PTSD (95% CI: 2.52-6.52) and the odds of female twins being diagnosed with CFS is 2.26 times more than male (95%CI: 1.74-2.93). Findings of our study identify PTSD, age, being a female twin, separation from a twin before the age of 18, and being victim to traumatic event such as assault and fire as significant predictors of CFS. We did not find sex discordance or birth weight discordance to be significant predictors of CFS. Results of this research requires a holistic approach to treatment and management. Keywords: Chronic Fatigue Syndrome; Post-traumatic stress disorders; Birth weight discordance; Sex discordance; Stress Coping DOI: 10.7176/JHMN/91-01 Publication date: July 31 st 2021
Highlights
Chronic Fatigue Syndrome (CFS) known as myalgic encephalomyelitis (ME) is a debilitating long-term illness that is characterized by persistent fatigue not alleviated by rest or induced by exhausting activity, not explained by other conditions, and results in meaningful activity reduction(Collin et al 2018)
post-traumatic disorder (PTSD) is defined by eight diagnostic criteria in the DSM-5 which include; 1) exposure to actual or threatened death, serious injury or sexual violence, 2) presence of one or more intrusive symptoms beginning after traumatic event occurred, 3) persistent avoidance of stimuli associated with traumatic event, 4) negative alterations in cognition and mood associated with traumatic event, 5) marked alterations in arousal and reactivity beginning or worsening after traumatic event, 6) duration of disturbance must be more than one month, 7) clinically significant distress or social and occupational impairment, and 8) the disturbance must not be attributable to substance use or another mental disorder (Psychiatry and American Psychiatric 2013)
Due to the contributions of genes seen in both chronic fatigue syndrome (CFS) and PTSD manifestations, we find it important to study the relationship between CFS and PTSD in the light of twin data where the role of genes and shared intrauterine environment is taken into consideration
Summary
Chronic Fatigue Syndrome (CFS) known as myalgic encephalomyelitis (ME) is a debilitating long-term illness that is characterized by persistent fatigue not alleviated by rest or induced by exhausting activity, not explained by other conditions, and results in meaningful activity reduction(Collin et al 2018). PTSD is defined by eight diagnostic criteria in the DSM-5 which include; 1) exposure to actual or threatened death, serious injury or sexual violence, 2) presence of one or more intrusive symptoms beginning after traumatic event occurred, 3) persistent avoidance of stimuli associated with traumatic event, 4) negative alterations in cognition and mood associated with traumatic event, 5) marked alterations in arousal and reactivity beginning or worsening after traumatic event, 6) duration of disturbance must be more than one month, 7) clinically significant distress or social and occupational impairment, and 8) the disturbance must not be attributable to substance use or another mental disorder (Psychiatry and American Psychiatric 2013). The estimated prevalence of PTSD in the United States is about 8%
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