Chronic fatigue syndrome is more likely to be developed in individuals who experience trauma in childhood, according to an article released on January 5, 2008 in the Archives of General Psychiatry, one of the JAMA/Archives journals. This may be in conjunction with a suggested biological pathway, involving neuroendocrine dysfunctions associated with the early trauma in chronic fatigue syndrome patients.
Chronic fatigue syndrome (CFS) is a condition related to several painful and tiring symptoms, and is presently a poorly characterized condition at best. According to the article, CFS affects up to 2.5% of adults in the United States, but very little is known about its causes or development. However, several risk factors have been previously identified, including female sex, genetic predisposition, certain personality traits and physical and emotional stress.
The authors note the link of CFS with stress: “Stress in interaction with other risk factors likely triggers chronic fatigue syndrome symptoms through its effects on central nervous, neuroendocrine and immune systems, resulting in functional changes that lead to fatigue and associated symptoms such as sleep disruption, cognitive impairment and pain.” They continue: “However, obviously not every individual exposed to a stressor goes on to develop chronic fatigue syndrome, and it is therefore of critical importance to understand sources of individual differences in vulnerability to the pathogenic effects of stress.”
To investigate the association between stress early in life and chronic fatigue syndrome presentation, Christine Heim, Ph.D., of Emory University School of Medicine, Atlanta, and colleagues examined 113 patients with chronic fatigue syndrome and 124 healthy controls drawn from a general sample of adult residents of Georgia. These participants reported any childhood trauma, including sexual, physical, and emotional abuse and emotional and physical neglect. Additionally, screening was performed for depression, anxiety, post-traumatic stress disorder, and saliva cortisol hormone levels.
The group of participants with chronic fatigue syndrome had higher levels of childhood trauma, such that the trauma was associated with six times the risk of having the condition in comparison to controls. Trauma in the form of sexual abuse, emotional abuse, and emotional neglect were most closely associated with risk of CFS. Additionally, CFS patients were more likely to have depression, anxiety, and post-traumatic stress disorder.
The authors note that decreased levels of cortisol in the saliva may indicate decreased function of the body’s neuroendocrine stress response system, indicating an abnormality in the interaction between nervous and endocrine reactions. Further examination of cortisol levels indicated that patients with chronic fatigue syndrome who had experienced childhood trauma had decreased levels, while CFS patients without trauma did not. The authors infer, therefore, that early stress could create a biological susceptibility to chronic fatigue syndrome.
The authors conclude that this association must be seriously considered. “Our results confirm childhood trauma as an important risk factor of chronic fatigue syndrome,” they say. “In addition, neuroendocrine dysfunction, a hallmark feature of chronic fatigue syndrome, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of chronic fatigue syndrome.”
Childhood Trauma and Risk for Chronic Fatigue Syndrome: Association With Neuroendocrine Dysfunction
Christine Heim, PhD; Urs M. Nater, PhD; Elizabeth Maloney, MS, DrPH; Roumiana Boneva, MD, PhD; James F. Jones, MD; William C. Reeves, MD, MSc
Arch Gen Psychiatry. 2009;66(1):72-80.
Written by Anna Sophia McKenney