Background/Objectives: Fibromyalgia is a chronic pain syndrome influenced by both physical and psychological factors, but their interaction remains unclear. We evaluated tools combining physical and emotional dimensions to characterise fibromyalgia and assess associations with persistent physical symptoms (PPS) and the emotional distress in its clinical interpretation. Methods: This cross-sectional study included 1588 patients referred to the Pain Management Unit, Complejo Asistencial Universitario de León. Fibromyalgia cases had a prior diagnosis to referral using the 2019 ACTTION–American Pain Society Pain Taxonomy diagnostic criteria. At the first consultation, participants completed a standardized protocol including sociodemographic variables, a Central Sensitization Inventory Part B checklist of previously physician-diagnosed physical and psychological conditions, and the visual analogue scale for pain, the Modified Somatic Perception Questionnaire (MSPQ), and the Zung Self-Rating Depression Scale. The Distress and Risk Assessment Method (DRAM) was used to integrate MSPQ and Zung data. Results: Women had higher odds of fibromyalgia (p = 0.003). Fibromyalgia was associated with PPS (p < 0.001), with chronic fatigue predominating in women (p < 0.001) and neck injury/whiplash in men (p = 0.005). The MSPQ had the highest OR among the instruments evaluated (overall: p < 0.001; women: p < 0.001; men: p = 0.005). Fibromyalgia status differed by DRAM category (nominal model, p < 0.001), suggesting higher odds in the Depressive and Somatic categories compared with Normal. Conclusions: In our sample, sex was associated with fibromyalgia and PPS profiles; PPS profiles were also associated with fibromyalgia. The MSPQ appeared to be among the most informative instruments, and its integration with Zung through the DRAM may have potential utility for psychosomatic risk profiling in fibromyalgia, warranting further study.

The paper has particularly focused on the role of married women in household chores and how it impacts their mental health. Several factors have been taken into consideration; like verbal aggression, social isolation, and Internalization of blame , respectively. All these factors have hurt the mental health of women. The issue of women has been described with the help of ‘labelling theory’, where the person tries to withdraw from all the social events and activities due to consistent devaluation and rejection from people. The withdrawal has thereby resulted in constricting social networks with minimal attempts to seek jobs. This study examines the association between unpaid domestic work and the mental health of married women. Unpaid domestic labour, including cooking, cleaning, childcare, eldercare, and emotional management within the household, remains disproportionately performed by women across socio-economic groups. Despite variations in education, employment status, and income, domestic responsibilities continue to be structured around traditional gender norms, positioning women as primary caregivers and household managers. The study investigates how the intensity and distribution of unpaid domestic work influence psychological well-being, stress levels, and burnout risk among married women. The paper has adhered to both primary and secondary data. The sampling technique is purposive, where participants have been selected deliberately. The primary data has been collected through in-depth interviews, which have helped gain deeper insight into the problem. While the secondary data has been effective in gathering the existing problem, with giving shape and an idea about the problem. The findings reveal a significant positive association between hours spent on unpaid domestic work and elevated levels of perceived stress, emotional exhaustion, and reduced life satisfaction. Women engaging in longer hours of domestic labour reported chronic fatigue, irritability, sleep disturbances, and limited personal time. Employed women experienced role conflict and time-based stress due to balancing paid employment with household responsibilities, while unemployed women reported feelings of invisibility, dependency, and diminished self-worth

Prediction bias for physical exertion in chronic fatigue: Evidence from an observational paradigm.

Shenqi funeng xingnao prescription regulated the TNF/NOD‒like receptor signaling pathway and brain-gut axis dysfunction caused by exercise-induced fatigue.

Bojungikki-tang enhances M1-like macrophage activation and promotes antitumor responses through IFN-γ co-stimulation.

The COVID-19 pandemic triggered an unprecedented global health crisis, with significant repercussions on the mental and neurological health of millions of individuals. Long COVID, characterized by persistent and debilitating symptoms, including chronic fatigue, pain, cognitive impairment, and mood swings, represents a substantial therapeutic challenge. In this context, neuromodulation emerges as a promising therapeutic strategy, offering new perspectives for the management of refractory neurological symptoms. This article aims to critically review the current evidence on the use of neuromodulation in patients with long COVID.

As the world recovers from the height of the COVID-19 pandemic with ongoing plans for a strengthened behavioral health infrastructure-from crisis services to long-term care-one of the health conditions that has emerged is long COVID. This multisystem condition is characterized by persistent symptoms that develop after the acute phase of COVID-19 infection. Although the full clinical and scientific understanding of long COVID's neuropsychiatric impact is still evolving, a sizable cohort of patients has emerged with various long-term and often confusing symptoms, which can include cognitive impairment, mood dysregulation (e.g., anxiety or depression), sleep disturbances, posttraumatic symptoms, and chronic fatigue. Recognizing long COVID's debilitating impact on quality of life and wide-ranging societal consequences, the authors sought to summarize current knowledge about long COVID among individuals with a preexisting serious mental illness and to propose care and treatment recommendations for clinicians and public policy makers.

The study updated a meta-analysis on emotional and behavioral problems among children with chronic physical health conditions (CPHCs) as assessed with the Achenbach System of Empirically Based Assessment. A systematic search in electronic databases (PsycInfo, Medline, Web of Science, and PSYNDEX) identified 1,337 studies that were analyzed with multilevel meta-analysis. Young people with CPHCs had, on average, higher levels of internalizing (g = .51 standard mean difference), externalizing (g = .25), and total behavior problems (g = .49) than peers without CPHCs or test norms. Elevations of total problems were larger than in the past meta-analysis. The largest elevations of internalizing problems were found for chronic fatigue syndrome, while the largest elevations of total problems and externalizing problems were observed in the case of thalassemia. Effect sizes tended to be larger when parent reports were used rather than adolescent self-reports. Effect sizes also varied by country and, in part, by duration of the CPHCs, sampling, target of comparison, equivalence of the compared groups, response rate, age, and gender. The results call for regular screening for psychological distress in children with CPHCs.

ABSTRACT Background Fatiguing conditions such as myalgic encephalomyelitis/ chronic fatigue syndrome and post-COVID condition affect millions globally, presenting challenges for diagnosis and management due to their complex, multisystemic nature. Post-exertional malaise (PEM) is a key symptom of fatiguing conditions that involves a severe worsening of symptoms after physical or cognitive exertion. Objectives This theoretical paper proposes a PEM-informed physiological decision-making framework that reconceptualizes PEM as a manifestation of impaired physiological recovery rather than solely a subjective symptom response. Drawing on evidence from serial cardiopulmonary exercise testing, the framework integrates reproducible abnormalities in respiratory variables during exercise as objective indicators of impaired metabolic recovery. Methods The authors synthesize current evidence on the use of serial cardiopulmonary exercise tests to objectively assess physiological markers of PEM across two consecutive days. Protocol recommendations are provided. The framework further outlines how exercise test-derived metrics can be translated into rehabilitation decision-making to guide pacing, intensity limits, and progression while minimizing symptom exacerbation. Conclusions The authors provide an evidence-based approach to activity management aimed at reducing harm, avoiding the push – crash cycle, and supporting functional stability and quality of life in individuals living with fatiguing conditions. When done correctly, exercise testing and therapy can be a safe and valuable tool to enhance recovery and quality of life in individuals living with fatiguing conditions, including those experiencing PEM.

Likely neurodivergence and variant connective tissue in patients with chronic pain/chronic fatigue: a case-control study.

Post-COVID syndrome (PCS) continues to pose a serious public health issue, with persistent symptoms requiring ongoing medical care after the acute phase of infection. Despite its clinical significance, data on its burden on hospital systems and healthcare costs have been limited. This study updates the national analysis of PCS-related hospitalizations in Germany for the year 2023, focusing on patient demographics, primary diagnoses, procedures, and inpatient costs. Using nationwide data from the Institute for the Hospital Remuneration System (InEK) and the German Diagnosis-Related Groups (G-DRG), the study identified patients with PCS via the diagnosis code "U09.9!" as a secondary diagnosis. Parameters included age, sex, diagnoses, procedures, length of stay (LOS), and direct cost estimates. Incidence rates were calculated using official population data. There were 17,209 PCS-related hospital admissions, translating to 48.9 cases per 100,000 people. Women represented 60% of cases, with peak prevalence in the 55-60 age group. Common diagnoses were chronic fatigue, dyspnea, and general malaise; procedures mainly involved respiratory and neurological evaluations. Only 4% required care dependency assessments. The average LOS was 8.3 days (SD 11.6 days). LOS showed a right-skewed distribution. The median LOS was 7.1 days [interquartile range (IQR): 3.9-7.9 days]. Total inpatient costs reached €67.9 million. Compared to early-pandemic data, the number of PCS-related hospitalizations decreased substantially in 2023, while diagnostic complexity and inpatient resource utilization remained high. PCS continues to challenge healthcare systems, underlining the need for ongoing research, policy adjustments, and resource planning.

Introduction and purpose: Overtraining syndrome (OTS) might occur in athletes experiencing extreme physical and mental stress over a longer period of time without adequate recovery (Meeusen et al., 2013). A decrease in sports performance and chronic fatigue are the most frequent symptoms (Carrard et al., 2021; Meeusen et al., 2013). Reliable diagnostic and monitoring tools are lacking but are strongly needed due to the high prevalence of OTS of 5 to 64 % (depending on definition and sample) and its potential reducing risk of injury (Meeusen et al., 2013). We aimed to develop novel sex-specific, non-invasive and multiparametric recovery monitoring models. Methods: Seventy-three youth and young adult elite athletes (51 females, age 19.7 ± 4.0 years) from mainly team and speed/power-oriented sports, e.g., handball and athletics, participated. Weekly measurements were conducted over 16 weeks to assess the athletes’ recovery state, resulting in 663 measurement timepoints. Forty parameters – including sleep, training load, occupational load, social load, menstrual cycle, heart rate and heart rate variability (HRV), core body temperature, grip strength, and single and double leg jump performance – served as predictors of the athletes’ subjective rating of recovery and stress (Short Recovery and Stress Scale, SRSS, Kellmann & Kölling, 2020). Lasso, Ridge, and Elastic Net regularized regression was applied for automated parameter selection, training, and cross-validation of the binomial prediction models. Results: For the female athletes’ model AUC = 0.819 was calculated (sensitivity = 79.8%, specificity = 72.9%). Thereby, the parameters social load, single and double leg jump performance, sleep quality, training load, grip strength, and occupational load were ranked within the top ten highest predictive parameters (Figure 1). The male athletes’ model demonstrated similar predictive performance with AUC = 0.797 (sensitivity = 74.3%, specificity = 71.4%). Thereby, grip strength, HRV, single leg jump performance, and social load were among the top ten most predictive parameters. Discussion: A broad and novel combination of non-invasive parameters was analysed to capture a holistic picture of the athletes’ recovery and stress state. The resulting sex-specific models showed good predictive performance. The development of sex-specific recovery monitoring prediction models seemed crucial due to the observed differences in parameter importance. Conclusion: This study provides a deeper understanding of the relevance of specific parameters for recovery and stress monitoring in female and male youth and young adult elite athletes.

Background: In the context of long COVID, persistent fatigue is among the most prevalent symptoms that can develop after SARS-CoV-2 infection. Mitochondrial myopathy and endothelial dysfunction, which are triggers of inflammation, have emerged as prominent causes of long COVID-induced fatigue. Interestingly, the intake of flavanols, particularly (-)-epicatechin (EC), has been associated with the positive modulation of endothelial and mitochondrial structure and function. Methods: In this work, we conducted a randomized, double-blind, placebo-controlled clinical trial to determine whether an EC-enriched supplement (ECES) improves plasma markers of inflammation, endothelial structure, and fatigue-related endpoints in patients with long COVID-19. Results: The study included 46 subjects (mean age 52 years) who were instructed to consume two capsules/day for 90 days of either ECES (n = 23) or placebo (n = 23). Endpoints assessed included mean changes in plasma inflammatory markers (IL-1β, IL-6, and TNF-α) and endothelial dysfunction markers (syndecan-1), handgrip strength, fatigue scale, and quality of life (QoL). The results showed significant improvements in the ECES group for inflammatory markers, syndecan-1, and fatigue compared with the placebo group. Conclusions: The results yield intriguing positive findings for EC and open a new avenue for treating long COVID.

Associated factors and assessment of clinical symptoms including fatigue, insomnia, and gastrointestinal discomfort of chronic fatigue syndrome: a cross-sectional case-control study.

Motor vehicle crashes (MVCs) are a leading cause of injury among adults aged 65 years and older ("older adults"). As the number of older drivers grows, it is increasingly important to understand clinical factors associated with an increased risk of MVC. A major barrier, however, is the lack of data. To address this, we linked two large-scale administrative databases, the New Jersey Safety and Health Outcomes (NJ-SHO) Data Warehouse, which contains information on all police-reported crashes in New Jersey from 2004 to 2019, and Medicare Fee-for-Service (FFS) insurance claims, which contains health care encounters and prescription drug dispensings among older adults in the United States over the same period. This paper explains the linkage process, describes selected work leveraging these data to study MVCs in older drivers, and highlights features and strengths of this linkage for future research. The NJ-SHO-Medicare linkage was performed using categories of name (first and last), sex, age (birth and death date), and residence (state and ZIP code). Matches were ranked by quality and overall confidence. After comparing different match strategies, we accepted a match when (1)the name match quality was High or Medium and the age match was High or (2)the name, sex, and residence match categories were all High. Of the 2,722,773 individuals successfully linked, we accepted 2,661,782 matches (97.76% of individuals linked and 91.59% of those submitted for linkage). All accepted matches were Strong or Fair. Among accepted matches who enrolled in Medicare FFS in 2019, 342,422 (28.57%) were 65-69 years old, 619,437 (51.69%) were female, and 955,309 (79.72%) were non-Hispanic White. Only 29,561 (2.47%) experienced an MVC and 25,478 (2.13%) received a citation. The most prevalent clinical conditions ever diagnosed were cataracts (669,044; 55.83%); chronic pain, fatigue, and fibromyalgia (367,165; 30.64%); and glaucoma (287,420; 23.98%). With extensive temporal and population coverage, the NJ-SHO-Medicare linkage supports studying the relationships between clinical exposures (e.g., medications ), driving events (e.g., crashes, citations) and medical care trajectories, which can help advance the driving safety of older adults and inform future efforts to integrate administrative data.

Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome is a disease of uncertain aetiology that affects up to 400,000 individuals in the UK. Exposure of cultured cells to the sera of people with ME has been proposed to cause phenotypic changes in these cells in vitro when compared to sera from healthy controls. ME serum factors causing these changes could inform the development of diagnostic tests. In this study, we performed a large-scale, pre-registered replication of an experiment from Fluge et al (2016) that reported an increase in maximal respiratory capacity in healthy myoblasts after treatment with serum from people with ME compared to serum from healthy controls. We replicated the original experiment with a larger sample size, using sera from 67 people with ME and 53 controls to treat healthy cultured myoblasts, and generated results from over 1,700 mitochondrial stress tests performed with a Seahorse Bioanalyser. We observed no significant differences between treatment with ME or healthy control sera for our primary outcome of interest, oxygen consumption rate at maximal respiratory capacity. Results from our study provide strong evidence against the hypothesis that ME blood factors differentially affect healthy myoblast mitochondrial phenotypes in vitro.

Heightened prevalence of chronic fatigue syndrome in U.S. sexual minorities.

Armillaria mellea polysaccharide improves chronic fatigue through intestinal flora.

Chronic Pain Prevalence, Characteristics, and Impact in United States Adults With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

Who receives a diagnostic label for fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome? A study in the lifelines cohort