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Biopsychosocial risk factors of persistent fatigue after acute infection: a systematic review to inform interventions

Biopsychosocial risk factors of persistent fatigue after acute infection: a systematic review to inform interventions
Biopsychosocial risk factors of persistent fatigue after acute infection: a systematic review to inform interventions
Objectives:
Fatigue is a prevalent and debilitating symptom, preceded by an acute infectious episode in some patients. This systematic review aimed to identify risk factors for the development of persistent fatigue after an acute infection, to develop an evidence-based working model of post-infectious fatigue.
Methods:
Electronic databases (Medline, PsycINFO and EMBASE) were searched, from inception to March 2016, for studies which investigated biopsychosocial risk factors of on-going fatigue after an acute infection. Inclusion criteria were: prospective design; biological, psychological or social risk factors; standardised measure of post-infectious fatigue (self-report scales or clinical diagnosis). Studies were excluded if the sample had a pre-existing medical condition, infection was conceptualised as ‘vaccination’ or they were intervention trials. A narrative synthesis was performed.
Results:
Eighty-one full texts were screened, of which seventeen were included in the review. Over half included glandular fever populations. Other infections included dengue fever, ‘general’/’viral’ and Q-fever. Risk factors were summarised under biological, social, behavioural, cognitive and emotional subthemes. Patients’ cognitive and behavioural responses to the acute illness, and pre-infection or baseline distress and fatigue were the most consistent risk factors for post-infectious fatigue.
Conclusion:
An empirical summary model is provided, highlighting the risk factors most consistently associated with persistent fatigue. The components of the model, the possible interaction of risk factors and implications for understanding the fatigue trajectory and informing preventative treatments are discussed.
0022-3999
120-129
Hulme, Katrin
9d03cea4-ba29-4255-b852-7005f1180e5c
Hudson, Joanna L.
383f9969-e883-4765-b1f7-674fca78540f
Rojczyk, Philine
c7b8ee38-a374-477d-a6c1-f7575af08800
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Hulme, Katrin
9d03cea4-ba29-4255-b852-7005f1180e5c
Hudson, Joanna L.
383f9969-e883-4765-b1f7-674fca78540f
Rojczyk, Philine
c7b8ee38-a374-477d-a6c1-f7575af08800
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e

Hulme, Katrin, Hudson, Joanna L., Rojczyk, Philine, Little, Paul and Moss-Morris, Rona (2017) Biopsychosocial risk factors of persistent fatigue after acute infection: a systematic review to inform interventions. Journal of Psychosomatic Research, 99, 120-129. (doi:10.1016/j.jpsychores.2017.06.013).

Record type: Article

Abstract

Objectives:
Fatigue is a prevalent and debilitating symptom, preceded by an acute infectious episode in some patients. This systematic review aimed to identify risk factors for the development of persistent fatigue after an acute infection, to develop an evidence-based working model of post-infectious fatigue.
Methods:
Electronic databases (Medline, PsycINFO and EMBASE) were searched, from inception to March 2016, for studies which investigated biopsychosocial risk factors of on-going fatigue after an acute infection. Inclusion criteria were: prospective design; biological, psychological or social risk factors; standardised measure of post-infectious fatigue (self-report scales or clinical diagnosis). Studies were excluded if the sample had a pre-existing medical condition, infection was conceptualised as ‘vaccination’ or they were intervention trials. A narrative synthesis was performed.
Results:
Eighty-one full texts were screened, of which seventeen were included in the review. Over half included glandular fever populations. Other infections included dengue fever, ‘general’/’viral’ and Q-fever. Risk factors were summarised under biological, social, behavioural, cognitive and emotional subthemes. Patients’ cognitive and behavioural responses to the acute illness, and pre-infection or baseline distress and fatigue were the most consistent risk factors for post-infectious fatigue.
Conclusion:
An empirical summary model is provided, highlighting the risk factors most consistently associated with persistent fatigue. The components of the model, the possible interaction of risk factors and implications for understanding the fatigue trajectory and informing preventative treatments are discussed.

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Hulme_FatigueReview_JoPR_revised v2 - Accepted Manuscript
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Figure 1 v2 - Accepted Manuscript
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Appendix A Search terms - Accepted Manuscript
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Appendix B Quality Assessment tool - Accepted Manuscript
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Appendix C Study Characteristics v2 - Accepted Manuscript
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Appendix D Tables 3-7 - Accepted Manuscript
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Appendix E Table 8 v2 - Accepted Manuscript
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More information

Accepted/In Press date: 8 June 2017
e-pub ahead of print date: 16 June 2017
Published date: August 2017
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 411168
URI: http://eprints.soton.ac.uk/id/eprint/411168
ISSN: 0022-3999
PURE UUID: 89e6f937-8d80-49b4-996f-be042a3c9feb
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873

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Date deposited: 15 Jun 2017 16:31
Last modified: 12 Jul 2024 04:02

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Contributors

Author: Katrin Hulme
Author: Joanna L. Hudson
Author: Philine Rojczyk
Author: Paul Little ORCID iD
Author: Rona Moss-Morris

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