Centre for Psychiatry, Barts & the London School of Medicine & Dentistry, Queen Mary University of London, Charterhouse Square, UK.
Br J Psychiatry. 2011 Oct;199(4):323-9. doi: 10.1192/bjp.bp.110.083956. Epub 2011 Aug 18.
Little is known about the aetiology of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME); prospective studies suggest a role for premorbid mood disorder.
To examine childhood and early adult adversity, ill health and physical activity as premorbid risk markers for CFS/ME by 42 years, taking psychopathology into account.
Data were from the 1958 British birth cohort, a prospective study from birth to 42 years (n = 11 419). The outcomes were self-reported CFS/ME (n = 127) and operationally defined CFS-like illness (n = 241) at 42 years.
Adjusting for psychopathology, parental physical abuse (odds ratio (OR) = 2.10, 95% CI 1.16-3.81), childhood gastrointestinal symptoms (OR = 1.58, 95% CI 1.00-2.50) and parental reports of many colds (OR = 1.65, 95% CI 1.09-2.50) were independently associated with self-reported CFS/ME. Female gender and premorbid psychopathology were the only risk markers for CFS-like illness, independent of comorbid psychopathology.
This confirms the importance of premorbid psychopathology in the aetiological pathways of CFS/ME, and replicates retrospective findings that childhood adversity may play a role in a minority.
慢性疲劳综合征/肌痛性脑脊髓炎（CFS/ME）的病因知之甚少；前瞻性研究表明，发病前的情绪障碍可能起作用。
通过考虑精神病理学，研究发病前的儿童和成年早期逆境、健康不良和身体活动是否为 CFS/ME 的风险标志物。
数据来自 1958 年英国出生队列，这是一项从出生到 42 岁的前瞻性研究（n=11419）。结果为 42 岁时自我报告的 CFS/ME（n=127）和经操作定义的 CFS 样疾病（n=241）。
调整精神病理学后，父母身体虐待（比值比（OR）=2.10，95%置信区间 1.16-3.81）、儿童期胃肠道症状（OR=1.58，95%置信区间 1.00-2.50）和父母报告的多次感冒（OR=1.65，95%置信区间 1.09-2.50）与自我报告的 CFS/ME 独立相关。女性性别和发病前精神病理学是 CFS 样疾病的唯一风险标志物，独立于共病精神病理学。
这证实了发病前精神病理学在 CFS/ME 的发病机制中的重要性，并复制了回顾性研究结果，即儿童时期的逆境可能在少数人中起作用。
