title: Are fatigue symptoms and chronic fatigue syndrome following Q fever infection related to psychosocial variables?
abstract: OBJECTIVE
  Fatigue is known as one of the most common long-term sequelae of Q fever infections. The study aimed to determine the prevalence of fatigue symptoms, chronic fatigue, and chronic fatigue syndrome (CFS) in a sample of patients who were exposed to Q fever (Coxiella burnetii) infection compared to controls, and to contrast Q fever patients with and without fatigue symptoms related to somatoform symptoms, hypochondriacal worries and beliefs, psychosocial complaints, and social support.
  
  
  METHODS
  Cross-sectional study of 84 Q fever exposed patients from a specific region in Jena (Germany) and 85 matched controls using standardized questionnaires (MFI, SF-12, CDC-SI, SOMS, Whiteley Index, OQ-45 and F-Sozu). Diagnostic interviews were performed to validate questionnaire results in a smaller subsample.
  
  
  RESULTS
  Patients who were exposed to a Q fever infection in the past indicated more fatigue symptoms and chronic fatigue than controls (54.8 vs. 20%, 32.1 vs. 4.7%) but did not show more criteria for a CFS (1 patient in each group). Q fever patients showing fatigue symptoms revealed significantly higher scores in the SOMS, the Whiteley-Index, and higher psychosocial complaints measured with the OQ-45. Their health related Quality of Life was reduced, no differences were found related to perceived social support.
  
  
  CONCLUSIONS
  Although in our sample fatigue symptoms were common among Q fever patients, we found no increased prevalence of CFS in contrast to several other studies. The combination of fatigue symptoms with other psychosocial symptoms/problems support the view of a biopsychosocial etiology of fatigue symptoms.
authors.affiliation: Jena University Hospital, Friedrich-Schiller University, Institute of Psychosocial Medicine and Psychotherapy, Germany. Bernhard.strauss@med.uni-jena.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Strauss
authors.forename: Maria
authors.initials: M
authors.lastname: Löschau
authors.forename: Thomas
authors.initials: T
authors.lastname: Seidel
authors.forename: Andreas
authors.initials: A
authors.lastname: Stallmach
authors.forename: Andrea
authors.initials: A
authors.lastname: Thomas
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D006998:Hypochondriasis / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011778:Q Fever / Q000523:psychology*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires