Stress-load and it’s correlation with infections in patients with myalgic encephalomyelitis/chronic fatigue syndrome

Abstract

In Sweden, a psychiatric diagnosis of Exhaustion Syndrome (ES) has been introduced in 2003. Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), so far is considered to be a neurological diagnosis. Both groups, however, suffer from overlapping symptoms such as exhaustion, fatigue, poor sleep, cognitive deficits and intolerance to stressors. This might lead to diagnostic challenges or wrong treatment. ES is associated with stress-load while ME/CFS with infection. Our clinical experience indicates that stress-load alone or in combination with infection precedes the developing of ME/CFS in many patients. To identify the prevalence and a relationship between stress-load and infection in patients refereed to ME/CFS clinic. The use of clinical data for scientific analysis was considered by the regional ethical review board in Stockholm (Ref. no. 2014/300-31) and approved by Danderyd University Hospital (DS2014-0447). Written informed consent was obtained from all participants. Records of totally 225 patients were analyzed. Approximately half of patients refereed to ME/CFS clinic (45%) suffered from a previous stress-load and/or ES. Approximately 63% of patients reported presence of infection before the start of ME/CFS symptoms. There was a week (0.2) but significantly positive correlation between the stress-load and infection. Results show that preceding stress-load and infections are quite common in patients with ME/CFS. Findings suggest an importance of identifying and treating both stress-load and/or ES in order to prevent development of ME/CFS. Theoretically, stress-load enhances the risk of infection. Therefore, patients need a tailored treatment and rehabilitation approach in order to reduce stress reactivity.