Cho H J, Bhugra D, Wessely S
Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
Acta Psychiatr Scand. 2008 Jul;118(1):34-41. doi: 10.1111/j.1600-0447.2008.01200.x. Epub 2008 May 22.
Causal attribution influences symptom experience, help-seeking behaviour and prognosis in chronic fatigue syndrome. We compared causal attribution of patients with unexplained chronic fatigue (UCF) in Brazil and Britain.
Primary care attenders in São Paulo (n = 3914) and London (n = 2459) were screened for the presence of UCF. Those with UCF (São Paulo n = 452; London n = 178) were assessed for causal attribution (physical vs. psychosocial), perceived chronicity (i.e. reported duration of fatigue) and disability.
British UCF patients were more likely to attribute their fatigue to physical causes (adjusted odds ratio 1.70, P = 0.037) and perceived their fatigue to be more chronic (adjusted beta 0.15, P = 0.002). There was no significant difference in current disability (adjusted beta -0.01, P = 0.81).
Despite similar disability levels, UCF patients in different cultural settings presented different attributions and perceptions about their illness. Sociocultural factors may have an important role in shaping illness attribution and perception around chronic fatigue.
因果归因会影响慢性疲劳综合征患者的症状体验、求助行为和预后。我们比较了巴西和英国不明原因慢性疲劳(UCF)患者的因果归因情况。
对圣保罗(n = 3914)和伦敦(n = 2459)的基层医疗就诊者进行UCF筛查。对患有UCF的患者(圣保罗n = 452;伦敦n = 178)进行因果归因(身体原因与心理社会原因)、感知慢性程度(即报告的疲劳持续时间)和残疾情况评估。
英国UCF患者更倾向于将疲劳归因于身体原因(调整后的优势比为1.70,P = 0.037),并认为他们的疲劳更具慢性(调整后的β值为0.15,P = 0.002)。当前残疾情况无显著差异(调整后的β值为 -0.01,P = 0.81)。
尽管残疾水平相似,但不同文化背景下的UCF患者对其疾病的归因和认知存在差异。社会文化因素可能在塑造围绕慢性疲劳的疾病归因和认知方面发挥重要作用。