Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables?

Abstract

Objective: Fatigue is known as one of the most common long-term sequelae of Q fever infections. The study aimed to determine the prevalence of fatigue symptoms, chronic fatigue, and chronic fatigue syndrome (CFS) in a sample of patients who were exposed to Q fever (Coxiella burnetii) infection compared to controls, and to contrast Q fever patients with and without fatigue symptoms related to somatoform symptoms, hypochondriacal worries and beliefs, psychosocial complaints, and social support.

Methods: Cross-sectional study of 84 Q fever exposed patients from a specific region in Jena (Germany) and 85 matched controls using standardized questionnaires (MFI, SF-12, CDC-SI, SOMS, Whiteley Index, OQ-45 and F-Sozu). Diagnostic interviews were performed to validate questionnaire results in a smaller subsample.

Results: Patients who were exposed to a Q fever infection in the past indicated more fatigue symptoms and chronic fatigue than controls (54.8 vs. 20%, 32.1 vs. 4.7%) but did not show more criteria for a CFS (1 patient in each group). Q fever patients showing fatigue symptoms revealed significantly higher scores in the SOMS, the Whiteley-Index, and higher psychosocial complaints measured with the OQ-45. Their health related Quality of Life was reduced, no differences were found related to perceived social support.

Conclusion: Although in our sample fatigue symptoms were common among Q fever patients, we found no increased prevalence of CFS in contrast to several other studies. The combination of fatigue symptoms with other psychosocial symptoms/problems support the view of a biopsychosocial etiology of fatigue symptoms.