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Childhood sexual abuse and chronic fatigue syndrome

Published online by Cambridge University Press:  02 January 2018

Filip Van Den Eede
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine, University of Antwerp; CFS Reference Centre, Antwerp University Hospital; and Department of Psychiatry, Antwerp University Hospital (UZA), Wilrijkstraat 10, 2650 Edegem (Antwerp), Belgium. Email: filip.van.den.eede@uza
Tess Haccuria
Affiliation:
Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine, University of Antwerp
Maud De Venter
Affiliation:
Department of Psychiatry, Antwerp University Hospital, Edegem (Antwerp), and Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine, University of Antwerp
Greta Moorkens
Affiliation:
CFS Reference Centre, Antwerp University Hospital, Edegem (Antwerp), and Department of Internal Medicine, Antwerp University Hospital, Edegem (Antwerp), Belgium
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Abstract

Type
Columns
Copyright
Copyright © 2012 The Royal College of Psychiatrists 

We have read the important article on the premorbid risk markers for chronic fatigue syndrome in the 1958 British birth cohort Reference Clark, Goodwin, Stansfeld, Hotopf and White1 with a lot of interest. The authors reported that parental physical abuse, childhood gastrointestinal symptoms and parental reports of many colds were independently associated with self-reported chronic fatigue syndrome (CFS), after adjusting for psychopathology.

Notably, the authors did not comment on the fact that parental physical abuse, but not sexual abuse, was predictive of CFS, even though childhood sexual abuse is a well-documented risk factor for CFS. More precisely, chronic fatigue was significantly predicted by childhood sexual abuse in a population-based study by Taylor & Jason. Reference Taylor and Jason2 Also, childhood sexual abuse and emotional abuse were most effective in discriminating CFS cases from control individuals in two population-based studies by Heim et al (as well as emotional neglect in one of these studies). Reference Heim, Wagner, Maloney, Papanicolaou, Solomon and Jones3,Reference Heim, Nater, Maloney, Boneva, Jones and Reeves4 A possible reason for this inconsistency is the relatively low frequency of sexual abuse in the study by Clark et al Reference Clark, Goodwin, Stansfeld, Hotopf and White1 (6.3 %), compared with its frequency in the others studies (> 26%). Reference Taylor and Jason2Reference Heim, Nater, Maloney, Boneva, Jones and Reeves4

Interestingly, there may be a differential clinical effect according to the subtype of childhood trauma. In the study by Taylor & Jason, Reference Taylor and Jason2 a history of childhood sexual abuse emerged as a significant predictor of post-traumatic stress disorder. Furthermore, significant correlations between scores on a trauma questionnaire and scores for depression, anxiety and post-traumatic stress were observed by Heim et al. Reference Heim, Wagner, Maloney, Papanicolaou, Solomon and Jones3 These correlations remained unchanged when the analysis was restricted to the subscales sexual abuse and emotional neglect.

Recently, our research group examined the impact of childhood trauma in a well-described tertiary sample of patients with CFS. In accordance with the previously mentioned population-based studies, childhood sexual harassment was the best predictor of psychological symptoms in CFS (unpublished data). Taken together, these data emphasise the importance of childhood sexual abuse as a premorbid risk marker for CFS.

References

1 Clark, C, Goodwin, L, Stansfeld, SA, Hotopf, M, White, PD. Premorbid risk markers for chronic fatigue syndrome in the 1958 British birth cohort. Br J Psychiatry 2011; 199: 323–9.Google Scholar
2 Taylor, RR, Jason, LA. Chronic fatigue, abuse-related traumatization, and psychiatric disorders in a community-based sample. Soc Sci Med 2002; 55: 247–56.Google Scholar
3 Heim, C, Wagner, D, Maloney, E, Papanicolaou, DA, Solomon, L, Jones, JF, et al. Early adverse experience and risk for chronic fatigue syndrome: results from a population-based study. Arch Gen Psychiatry 2006; 63: 1258–66.Google Scholar
4 Heim, C, Nater, UM, Maloney, E, Boneva, R, Jones, JF, Reeves, WC. Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction. Arch Gen Psychiatry 2009; 66: 7280.Google Scholar
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