RESUMEN
OBJECTIVE: The aim of this paper is to explore the longitudinal relationships between physical and psychological symptoms and immunological factors following acute infective illnesses. METHOD: 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. RESULTS: 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). CONCLUSIONS: 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.
Asunto(s)
Fatiga/psicología , Inmunidad Celular/inmunología , Infecciones/psicología , Rol del Enfermo , Adaptación Psicológica/fisiología , Adolescente , Adulto , Anciano , Infecciones por Alphavirus/inmunología , Ansiedad/inmunología , Ansiedad/psicología , Estudios de Cohortes , Depresión/inmunología , Depresión/psicología , Fatiga/inmunología , Femenino , Estudios de Seguimiento , Herpesvirus Humano 4/inmunología , Humanos , Hipersensibilidad Tardía/inmunología , Infecciones/inmunología , Mononucleosis Infecciosa/inmunología , Mononucleosis Infecciosa/psicología , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Estudios Prospectivos , Psiconeuroinmunología , Fiebre Q/inmunología , Fiebre Q/psicología , Virus del Río Ross/inmunologíaRESUMEN
Over the past 20 years the taking of anabolic steroids by healthy athletes for the purpose of increasing body weight and strength has become very widespread. The ability of these agents to cause potentially serious side effects is discussed. In a series of 20 subjects studied over 18 months, no side effects of significance were recorded, and marked increases in strength and body weight were achieved.
