Mental Health and Chronic Fatigue Syndrome: Is Mental Health the Culprit Behind Your Fatigue?, 2020, Raza et al

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http://thebiomedicapk.com/articles/819.pdf

ORIGINAL ARTICLE
Mental Health and Chronic Fatigue Syndrome: Is Mental Health the Culprit Behind Your Fatigue?

Tahira Raza, 1 Muhammad Ashraf Chaudhry2, Ahsan Masud3, Massiha Gulzar Ahmed4, Minahil Ahmed5, Bushra Amin6

ABSTRACT

Background and Objective:

Mental health has proved to affect the physical and emotional aspects of one’s life.

Appreciation of its influence on the physical functionality and efficacy of an individual may provide better treatment plans and coping strategies.

This study was designed to find out the frequency of depression, anxiety, and stress among medical students at different levels of education, taking gender differences into account and its relation to chronic fatigue syndrome.

Methods:

This cross-sectional descriptive study was carried out from October 2017 – March 2018. Standardized questionnaire was given to 270 MBBS students of Combined Military Hospital (CMH) Medical College, Lahore.

The sampling method was non probability convenience sampling.

The participants gave free consent.

The data was analyzed using SPSS version 23.

Results:

Out of the 270 candidates, 246 had fatigue.

Females scored higher on both questionnaires and showed greater frequency of fatigue and mental health problems like stress [P = 0.004].

Over all mental health traits showed statistically significant association with chronic fatigue (P = 0.001).

Conclusion:

Frequency of chronic fatigue among medical students suffering from anxiety, depression and stress is higher as compared to normal students.

Female students suffer more from chronic fatigue syndrome, depression, anxiety and stress as compared to males.

Strategies to evaluate and rigorously review medical student’s mental problems, and devising appropriate coping mechanisms is essential for their well-being and optimum health.

KEYWORDS: Depression, Anxiety, Stress, Fatigue, Medical students, Chronic fatigue syndrome, Mental health.

How to Cite This: Raza T, Chaudhry MA, Masud A, Ahmed MG, Ahmed M, Amin B. Mental health and chronic fatigue syndrome: is mental health the culprit behind your fatigue? Biomedica. 2020; 36 (2): 183-7. 1.

Dr. Tahira Raza Assistant Professor, Department of Community Medicine, CMH Lahore Medical College, Lahore – Pakistan 2. Prof. Dr. Muhammad Ashraf Chaudhry Professor, Department of Community Medicine. CMH Lahore Medical College, Lahore – Pakistan. 3. Dr. Ahsan Masud Senior Demonstrator. Department of Community Medicine. University of Lahore Medical College, Lahore – Pakistan. 4. Massiha Gulzar Ahmed House Officer, CMH Lahore Medical College, Lahore – Pakistan. 5. Minahil Ahmed House Officer, CMH Lahore Medical College, Lahore – Pakistan. 6. Bushra Amin Department of Community Medicine, CMH Lahore Medical College, Lahore – Pakistan. Corresponding to: Dr. Tahira Raza Assistant Professor, Department of Community Medicine, CMH Lahore Medical College, Lahore – Pakistan. Email: tahiraraza@hotmail.com

Received for publication: 17-02-2020  First revision received: 08-06-2020  Second revision received: 19-06-2020  Accepted for publication: 24-06-2020
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Is Mental Health the Culprit Behind Your Fatigue?

No. Next question, please.

- - - - -

There are some very common reasons why people might be fatigued that would never come to the surface with just a questionnaire, or even two of them. Just a few that come to mind that might be very common in university students, particularly women :

Iron deficiency or iron deficiency anaemia
Nutrient deficiencies of other kinds e.g. Low vitamin B12 and/or folate, low vitamin D
Thyroid problems
Poor diet

But I would guess that the people writing the above paper just assumed that people who can attend university must be healthy.
 
A link to the DASS 21 depression scale:

https://www.depression-test.net/support-files/dass21-dmz.pdf

and they used the Chalder Fatigue Scale (to my mind showing they're doing turkey science):

http://www.goodmedicine.org.uk/files/assessment, chalder fatigue scale.pdf

and an analysis of just how good it is:

https://www.s4me.info/threads/explo...ic-fatigue-syndrome-1998-morriss-et-al.11065/

Personally, if I can't have my wish that the likes of Nath et al do some real research my consolation prize wish would be that people stop signing up for this kind of useless study.
 
Really adding to my growing hypothesis that all along this was an experiment gone wrong into submitting joke papers to test whether they would get through the peer review process and things just got out of hand after people found themselves flush with free cash to keep going. It reads like someone trying to copy the standard Wessely-Chalder method but reading from a translation of a translation of a translation.

This is quite frankly laughably bad and I have trouble processing the fact that these people make life and death decisions. Hell, I'm not sure they should be making decisions about anyone's lunch.
 
The study has some limitations. Firstly, the study tool depends on recall and self-reported measures leaving room for bias. Secondly, no systemic or biochemical examination was carried out on students to rule out any undiagnosed health issues. Data on prevalence of depression, stress and anxiety among the candidates before the commencement of their medical education is also not available, so we cannot determine how medical education might have influenced their mental health.
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They seem to be referring to stress throughout the paper as in the above quote and also in the discussion section yet they call this chronic fatigue syndrome so this seems to be a tertiary issue of hearing from someone who heard from someone what cfs is.
 
They aren't even measuring "chronic fatigue", just "fatigue" as measured by a questionnaire.

To measure "chronic fatigue syndrome", they have to operationalise the criteria in a meaningful way. Given that their sample is medical students, it's quite possible that none of the participants had CFS.

The whole thing is ridiculous, it is well known that medical school requires a lot of time and effort, can be quite stressful and students can feel anxious since they desperately want to pass. This study says very little about chronic fatigue, let alone CFS.
 
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