Depression, disability days, and days lost from work in a prospective epidemiologic survey

Article Abstract:

People with minor depressive symptoms, as well as those with major depressive disorders, may lose more days from work than people who are not depressed. This was examined in 2,980 people who participated in the North Carolina Component of the Epidemiologic Catchment Area Program, an epidemiologic study sponsored by the National Institute of Mental Health. One set of interviews (Wave I) took place between 1982 to 1983; follow-up interviews (Wave II) were carried out one year later. The Wave I results grouped participants into five categories based on their scores on the Diagnostic Interview Schedule (a psychiatric evaluation tool): (1) major depression; (2) dysthymia (a form of depression); (3) minor depression with mood disturbance; (4) minor depression without mood disturbance; and (5) no depression. In Wave II interviews, participants were questioned regarding the number of days of work they had missed during the preceding three months due to illness, or the number of days they had been late to work or spent most of a day in bed. Results showed that, overall, women and single people tended more toward depression than men and married people, respectively. People with major depression had a considerably increased risk of disability over those without symptoms - almost five times as high; those with minor depression with mood disturbance had a risk 1.55 times as great. Although those with major depression had the highest number of disability days, this type of depression is not widespread (overall incidence, 1.8 percent). Minor depression with mood disturbance, because it is more common, may account for one and one-half times the disability days of major depression. To adequately understand the effects depression has on our society, days lost from work by people with even minor depression need to be considered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Demographic aspects, Sick leave

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Chronic fatigue: a prospective clinical and virologic study

Article Abstract:

A health problem known as chronic fatigue has recently been recognized, but its cause has not been identified. Patients report a variety of symptoms including extreme fatigue, which interferes with their work, daily activities, and relationships. Medical examinations of these patients have generally shown no evidence of a disease that could cause these symptoms. However, several studies recent have found that chronic fatigue patients had high levels of antibodies against the Epstein-Barr virus (EBV). This study evaluated 26 chronic fatigue patients and 18 healthy control subjects; examinations included repeated tests of EBV levels in the blood and saliva, physical examinations, and psychiatric evaluations. Tests showed that there was no difference between the chronic fatigue patients and the healthy controls in the frequency of isolating EBV in blood or saliva. Active EBV infection rates did not differ by group, and the level of EBV antibodies was not higher in patients with more severe symptoms. The groups also did not differ in levels of antibodies against human herpesvirus type 6. Previous and current episodes of depression were dramatically more common among the fatigue patients than the controls. It was found that the fatigue patients had higher activity of natural killer cells and lower production of interleukin 2; these physiological phenomena could be caused by mental depression. During the course of the study, over half the fatigue patients reported that their symptoms improved; their improvement was not associated with any change in EBV levels. It is concluded that most patients experience gradual improvement in their symptoms over time and that depression may be the primary illness in some patients with chronic fatigue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Prognosis, Epstein-Barr virus diseases

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Chronic Fatigue Syndrome

Article Abstract:

Most of the theories about chronic fatigue syndrome (CFS) focus on viral, immunologic, psychiatric, and anatomic causes. Patients with CFS have symptoms similar to those with fibromyalgia and multiple chemical sensitivity, leading doctors to suspect these diseases may represent variations of the same condition.

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