title: Fatigue, depressive symptoms, and anxiety from adolescence up to young adulthood: a longitudinal study.
abstract: Fatigue is a common complaint among adolescents. We investigated the course of fatigue in females during the transition from adolescence to young adulthood and examined psychological, immunological, and life style risk factors for development of fatigue and chronic fatigue syndrome (CFS)-related symptoms. Six hundred and thirty-three healthy females (age 14.63±1.37 years) filled out questionnaires measuring fatigue severity, depressive symptoms, anxiety, chronic fatigue syndrome (CFS)-related symptoms, sleep features, and life style characteristics at baseline and 4½ years thereafter. Of 64 participants LPS- and CD2CD28-induced cytokine data at baseline were available. The best predictor of fatigue in young adulthood was previous fatigue severity. In participants who were non-fatigued during adolescence and who experienced a notable increase in fatigue, fatigue development was preceded by emotional problems and CFS-related complaints during adolescence. Increases as well as decreases in fatigue severity were accompanied by respectively increase and decrease in depressive symptoms and anxiety, suggesting that these symptoms cluster and co-vary over time. Higher interferon (IFN)-γ, higher IFN-γ/interleukin (IL)-4 ratio, lower tumor necrosis factor-α and lower IL-10 at baseline were related to fatigue severity at follow up. The rise in total number of CFS-related symptoms at follow up was predicted by anxiety and decreased physical activity during adolescence. Sleep and substance use were associated with fatigue severity and anxiety and depression. In conclusion, vulnerability to develop fatigue and associated symptoms in young adulthood can to a certain extent be identified already years before the manifestation of complaints.
authors.affiliation: Laboratory of Neuroimmunology and Developmental Origins of Disease, University Medical Center Utrecht, Office KC 03.068.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
authors.forename: Maike
authors.initials: M
authors.lastname: ter Wolbeek
authors.forename: Lorenz J P
authors.initials: LJ
authors.lastname: van Doornen
authors.forename: Annemieke
authors.initials: A
authors.lastname: Kavelaars
authors.forename: Marijke D J
authors.initials: MD
authors.lastname: Tersteeg-Kamperman
authors.forename: Cobi J
authors.initials: CJ
authors.lastname: Heijnen
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001007:Anxiety / Q000097:blood / Q000453:epidemiology*; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D018450:Disease Progression; D004644:Emotions; D005221:Fatigue / Q000097:blood / Q000453:epidemiology*; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D007899:Leisure Activities; D008019:Life Style; D009426:Netherlands / Q000453:epidemiology; D000297:Psychology, Adolescent; D012720:Severity of Illness Index; D012890:Sleep; D019966:Substance-Related Disorders / Q000097:blood / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D055815:Young Adult
chemical_list: C508609:IL10 protein, human; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma