TGI Friday! Our weekly round-up of recently published research abstracts | 22 May 2015

From Fatigue: Biomedicine, Health and Behavior, 12 May 2015 (e-published before print).

Variability in symptoms complicates utility of case definitions

Stephanie L. McManimen, Leonard A. Jason(*) & Yolonda J. Williams
– Center for Community Research, DePaul University, Chicago, IL, USA
* Corresponding author



Ambiguities in case definitions have created difficulties in replicating findings and estimating the prevalence rates for chronic fatigue syndrome (CFS) and Myalgic Encephalomyelitis (ME).


The current study examined differences in occurrence rates for CFS and ME cardinal symptoms (i.e. post-exertional malaise, unrefreshing sleep, and neurocognitive deficits).


Findings indicated that there is a wide range of occurrence rates on critical symptoms of the case definition, suggesting that either the types of patients recruited differ in various settings or the questions assessing core symptoms vary in their wording or criteria among different researchers.


The polythetic nature of the case definition may contribute to the wide ranges of symptom occurrence that was found. In order to increase assessed reliability of the symptoms and case definitions, there is a need to better standardize data collection methods and operationalization of symptoms. This solution would reduce the heterogeneity often seen in populations of CFS patients.

From Fatigue: Biomedicine, Health and Behavior, 27 April 2015 (e-published before print).

Coping with chronic fatigue syndrome: a review and synthesis of qualitative studies

Irma Pinxsterhuis(a,b,*), Elin B. Strand(a) & Unni Sveen(c,d)
a) Division of Medicine, Oslo University Hospital, P.O. Box 4959 Nydalen, 0424 Oslo, Norway
b) Faculty of Medicine, University of Oslo, Oslo, Norway
c) Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
d) Department of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
* Corresponding author



Interventions that potentially improve coping with chronic fatigue syndrome (CFS) are important for patients, clinicians, and researchers.


To identify factors experienced by patients to promote coping with CFS and to provide recommendations for adequate interventions in this patient group.


A systematic review of qualitative studies was performed. Structured searches were conducted in major scientific databases. Two reviewers independently performed the study selection and assessment. Meta-ethnography was applied to review and synthesise the studies. The analysis provided key concepts that could be aggregated using second-order interpretations.


Fifteen studies were included. Findings suggested that coping strategies, including activity management and the use of cognitive and
emotional strategies, and psychological processes, such as acceptance and the rebuilding of identities and lives, may promote coping with CFS. The use of adequate coping strategies appeared to be facilitated by progress in these psychological processes. Coping appeared to be facilitated mainly by self-management, occasionally complemented by treatments and social support.


Interventions focusing on coping may include the use of adequate coping strategies and take into account progress in psychological
processes, which may fluctuate over time. Interventions may be complemented by self-management, other types of treatments, and social

From Fatigue: Biomedicine, Health and Behavior, 8 May 2015 (e-published before print).

Perceived fatigue interference and depressed mood: comparison of chronic fatigue syndrome/myalgic encephalomyelitis patients with fatigued breast cancer survivors

Daniel L. Hall(a,*), Michael H. Antoni(a,b,c), Emily G. Lattie(a), Devika R. Jutagir(a), Sara J. Czaja(c), Dolores Perdomo(c), Suzanne C. Lechner(b), Jamie M. Stagl(d), Laura C. Bouchard(a), Lisa M. Gudenkauf(a), Lara Traeger(d), Mary Ann Fletcher(e) & Nancy G. Klimas(e)
a) Department of Psychology, University of Miami, Coral Gables, FL, USA
b) Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Coral Gables, FL, USA
c) Department of Psychiatry and Behavioral Sciences, University of Miami, Coral Gables, FL, USA
d) Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
e) Institute for Neuro Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
* Corresponding author



Persistent fatigue and depressive symptoms are both highly prevalent among patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one’s daily functioning in both patient populations to better understand their relationships with depressed mood.


Participants were 95 female CFS/ME patients and 67 females who were approximately five years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants’ fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates.


CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p<.001. These factors were significantly positively correlated among CFS/ME patients (beta=.36, p<.001), but not among the fatigued breast cancer survivors (beta=.18, p=.19). CONCLUSIONS CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed.

From Sociology of Health & Illness, 24 April 2015 (e-published before print).

Medical constructions of long-term exhaustion, past and present

Olaug S. Lian(1,*) and Hilde Bondevik(2)
1) Department of Community Medicine, University of Tromso – The Arctic University of Norway, Norway
2) Institute of Health and Society, University of Oslo, Norway
* Address for correspondence: Olaug S. Lian, Department of Community Medicine, Faculty of Health Sciences, University of Tromso – The Arctic University of Norway, N-9037 Tromso, Norway. E-mail:


Culture and history affect the ways in which medical knowledge is shaped, sustained and changed. The less knowledge we have, the larger
the space for the cultural imprint becomes.

Based on these assumptions, we ask: how have medical constructions of long-term exhaustion changed over time, and how are changing constructions related to societal change?

To discuss these questions we conducted a comparative study of medical texts from two historical periods: 1860-1930 and 1970-2013. Our data are limited to two diagnoses: neurasthenia and encephalomyelitis.

After comparing the two periods by identifying diverging and converging aspects, we interpreted observed continuities and interruptions in relation to historical developments.

We found that in the medical literature, long-term exhaustion became transformed from a somatic ailment bred by modern civilisation to a self-inflicted psychiatric ailment. At the same time, it changed from being a male-connoted high-status condition to a female-connoted low-status condition.

We interpret these changes as contingent upon culturally available modes of interpretations. Medical knowledge thereby becomes infused with cultural norms and values which give them a distinct cultural bias. The historical controversies surrounding this medically contested condition neatly display the socially contingent factors that govern the social construction of medical knowledge.


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