A randomised controlled trial of a psycho-educational intervention to aid recovery in infectious mononucleosis.
OBJECTIVE
Glandular fever is associated with an approximate fivefold increase in fatigue at 6 months. Reduced levels of fitness and illness beliefs may be important predictors of fatigue following glandular fever. We therefore developed a brief psycho-educational intervention aimed at improving recovery from infectious mononucleosis, and piloted a randomised controlled trial to evaluate the intervention.


METHODS
We performed a randomised-controlled trial in primary health care in Southeast London and Kent. Sixty-nine patients aged between 16 and 45 years who were diagnosed, serologically and clinically, with acute infectious mononucleosis between December 1999 and December 2000 were randomised. The control group received a standardised fact-sheet about infectious mononucleosis, which gave no advice on rehabilitation. Patients who were randomised to the intervention received an individual treatment session, two follow-up telephone calls, and an information booklet. Fatigue score 6 months after the onset of infectious mononucleosis was the main outcome measure.


RESULTS
Sixty-nine out of 139 patients referred were recruited and randomised. Eighty-seven percent of those recruited completed the Fatigue Questionnaire at 6 months. The intervention was acceptable to all who received it. There were fewer fatigue cases in the intervention group than the control group at 6 months follow-up (odds ratio 0.31, 95% confidence interval 0.09-0.91).


CONCLUSIONS
A brief intervention at the diagnosis of infectious mononucleosis is acceptable, and may help prevent the development of chronic fatigue. Definitive randomised controlled trials are required to test the intervention.
Candy
Bridget
B
Department of Psychological Medicine, Guy's, King's and St. Thomas' School of Medicine, 103 Denmark Hill, London SE5 8AZ, UK.
Chalder
Trudie
T
Cleare
Anthony J
AJ
Wessely
Simon
S
Hotopf
Matthew
M
D000293:Adolescent; D000328:Adult; D015673:Fatigue Syndrome, Chronic / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006266:Health Education; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications / Q000628:therapy*; D008297:Male; D008605:Mental Health Services / Q000600:supply & distribution*; D008875:Middle Aged; D011320:Primary Health Care; D020127:Recovery of Function; D011795:Surveys and Questionnaires