Bennett B K, Hickie I B, Vollmer-Conna U S, Quigley B, Brennan C M, Wakefield D, Douglas M P, Hansen G R, Tahmindjis A J, Lloyd A R
School of Psychiatry, University of New South Wales, Sydney, Australia.
Aust N Z J Psychiatry. 1998 Apr;32(2):180-6. doi: 10.3109/00048679809062727.
The aim of this paper is to explore the longitudinal relationships between physical and psychological symptoms and immunological factors following acute infective illnesses.
Preliminary data from a prospective investigation of patients with serologically proven acute infectious illnesses due to Epstein-Barr virus (EBV), Ross River virus (RRV) or Q fever are reported. Patients were assessed within 4 weeks of onset of symptoms and then reviewed 2 and 4 weeks later. Physical illness data were collected at interview. Psychological and somatic symptom profiles were assessed by standardised self-report questionnaires. Cell-mediated immune (CMI) function was assessed by measurement of delayed-type hypersensitivity (DTH) skin responses.
Thirty patients who had been assessed and followed over the 4-week period (including 17 patients with EBV, five with RRV and eight with Q fever) were included in this analysis. During the acute phase, profound fatigue and malaise were the most common symptoms. Classical depressive and anxiety symptoms were not prominent. Initially, 46% of cases had no DTH skin response (i.e. cutaneous anergy) indicative of impaired cellular immunity. Over the 4-week period, there was a marked improvement in both somatic and psychological symptoms, although fatigue remained a prominent feature in 63% of subjects. The reduction in reported fatigue was correlated with improvement in the DTH skin response (p = 0.001) and with improvement in General Health Questionnaire (GHQ) scores (p < 0.01).
Acute infectious illnesses are accompanied by a range of nonspecific somatic and psychological symptoms, particularly fatigue and malaise rather than anxiety and depression. Although improvement in several symptoms occurs rapidly, fatigue commonly remains a prominent complaint at 4 weeks. Resolution of fatigue is associated with improvement in cell-mediated immunity.
本文旨在探讨急性感染性疾病后身体和心理症状与免疫因素之间的纵向关系。
报告了一项对经血清学证实由爱泼斯坦-巴尔病毒（EBV）、罗斯河病毒（RRV）或Q热引起的急性感染性疾病患者进行前瞻性调查的初步数据。患者在症状出现后4周内接受评估，然后在2周和4周后进行复查。在访谈时收集身体疾病数据。通过标准化的自我报告问卷评估心理和躯体症状概况。通过测量迟发型超敏反应（DTH）皮肤反应评估细胞介导免疫（CMI）功能。
本分析纳入了在4周期间接受评估和随访的30名患者（包括17例EBV患者、5例RRV患者和8例Q热患者）。在急性期，严重疲劳和不适是最常见的症状。典型的抑郁和焦虑症状并不突出。最初，46%的病例没有DTH皮肤反应（即皮肤无反应性），表明细胞免疫受损。在4周期间，躯体和心理症状均有明显改善，尽管63%的受试者疲劳仍然是一个突出特征。报告的疲劳减轻与DTH皮肤反应的改善（p = 0.001）以及一般健康问卷（GHQ）评分的改善（p < 0.01）相关。
急性感染性疾病伴有一系列非特异性的躯体和心理症状，特别是疲劳和不适，而非焦虑和抑郁。尽管几种症状迅速改善，但疲劳通常在4周时仍是一个突出的主诉。疲劳的缓解与细胞介导免疫的改善相关。
