Biopsychosocial risk factors of persistent fatigue after acute infection: A systematic review to inform interventions, 2017, Hulme, Moss-Morris et al

Esther12

Esther12

Senior Member (Voting Rights)
Split from here.

While posting related papers, I'm afraid I just saw this Moss-Morris review was recently given a prize place on wikipedia's CFS entry:

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Biopsychosocial risk factors of persistent fatigue after acute infection: A systematic review to inform interventions.
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Hulme K1, Hudson JL2, Rojczyk P3, Little P4, Moss-Morris R5.
Author information

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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https://www.ncbi.nlm.nih.gov/pubmed/28712416
 
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This looks like an important paper in propping up the BPS model.

It's probably worth us looking into the papers that were screened and reviewed - why were some rejected from the review? What problems are there with the seventeen that were reviewed that might have biased the results?
 
Esther12 said:
Split from here.

While posting related papers, I'm afraid I just saw this Moss-Morris review was recently given a prize place on wikipedia's CFS entry:

​


https://www.ncbi.nlm.nih.gov/pubmed/28712416
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Doesn't the Pariente paper refute this? As the article itself isn't specific to 'CFS', while the Pariente paper is, there's probably a case to be made for using the more direct evidence.
 
Just skimming through but it doesn't appear to be much more than just trying to prop up the usual arguments and simply using a review as a convenient tool that they have been discussed at some point while adding their own prior perspective, as is tradition.

It says risk factors but as usual this is just fishing for weak correlations and arguing they may be causative. But it's been 30 years of this exact same fishing expedition with the same arguments by some of the same people with the same methods. Not even sure what's the point of this, it's just the same old rehashing as the last 30 years. At best it confirms this model has been stuck at the same place it began with and has not budged one bit.

I mean, it argues that GP visits and sick days are a "risk factor". Literally pointing at the smoke being responsible for the fire. What weird people with ridiculous ideas. They're completely stuck in the corner they painted and can't find their way out.
In conclusion, the evidence and model presented are dependent on studies' focus and methodology. Caution is advised when drawing conclusions about risk factors measured by a small number of studies.
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And yet this is exactly what they are doing, drawing conclusions that may have been true for 30 years and yet are clearly not.
As prolonged bed-rest, sick certification and all-or-nothing behaviour are associated with persistent fatigue, careful guidance about gradual return to work and activity may be more useful than suggesting patients should rest
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Here I'm not sure if they are being daft or simply feigning ignorance but surely by now they must know that most CFS patients are not bedbound and so prolonged bed-rest leading to deconditioning is a falsified hypothesis. As for diagnosis, or here "sick certification", being a risk factor in illness I simply have no words. A cancer diagnosis is a risk factor for cancer. Good grief what nonsense.

This review is mostly a poor attempt at trying to prop up the classic loopy cycle that has been used to explain various psychosomatic illness for decades, identical to the one used in peptic ulcers about some maladaptive pattern.

There's literally no point or purpose to this. Enough. Get over yourselves and move on to more productive pursuits, like planting trees or whatever.
 
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