A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour.
OBJECTIVE
Comparison of Q fever fatigue syndrome (QFS) and chronic fatigue syndrome (CFS) patients, with a focus on markers of inflammation and fatigue-related cognitive-behavioural variables.


METHODS
Data from two independent prospective studies on QFS (n=117) and CFS (n=173), respectively, were pooled and analyzed.


RESULTS
QFS patients were less often female, had a higher BMI, and had less often received treatment for depression before the onset of symptoms. After controlling for symptom duration and correcting for differences in diagnostic criteria for QFS and CFS with respect to the level of impairment and the presence of additional symptoms, differences in the proportion of females and BMI remained significant. After correction, QFS patients were also significantly older. In all analyses QFS patients were as fatigued and distressed as CFS patients, but reported less additional symptoms. QFS patients had stronger somatic attributions, and higher levels of physical activity. No differences were found with regard to inflammatory markers and in other fatigue-related cognitive-behavioural variables. The relationship between cognitive-behavioural variables and fatigue, previously established in CFS, could not be confirmed in QFS patients with the exception of the negative relationship between physical activity and fatigue.


CONCLUSIONS
Differences and similarities between QFS and CFS patients were found. Although the relationship between perpetuating factors and fatigue previously established in CFS could not be confirmed in QFS patients, the considerable overlap in fatigue-related cognitive-behavioural variables and the relationship found between physical activity and fatigue may suggest that behavioural interventions could reduce fatigue severity in QFS patients.
Radboud Expertise Centre for Q fever, Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands; Expert Centre for Chronic Fatigue, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Stephan.Keijmel@radboudumc.nl.
Stephan P
SP
Keijmel
Radboud Expertise Centre for Q fever, Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: j_saxe@gmx.de.
Johanna
J
Saxe
Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Jos.vanderMeer@radboudumc.nl.
Jos W M
JW
van der Meer
Expert Centre for Chronic Fatigue, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Stephanie.Nikolaus@radboudumc.nl.
Stephanie
S
Nikolaus
Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Mihai.Netea@radboudumc.nl.
Mihai G
MG
Netea
Expert Centre for Chronic Fatigue, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Gijs.Bleijenberg@radboudumc.nl.
Gijs
G
Bleijenberg
Radboud Expertise Centre for Q fever, Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands; Department of Internal Medicine, Division of Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Chantal.Bleeker-Rovers@radboudumc.nl.
Chantal P
CP
Bleeker-Rovers
Expert Centre for Chronic Fatigue, Radboud university medical center, Nijmegen, The Netherlands. Electronic address: Hans.Knoop@radboudumc.nl.
Hans
H
Knoop
D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D003071:Cognition; D005221:Fatigue / Q000276:immunology* / Q000628:therapy; D015673:Fatigue Syndrome, Chronic / Q000276:immunology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011778:Q Fever / Q000150:complications*
CFS; Chronic fatigue syndrome; Coxiella burnetii; Q fever; Q fever fatigue syndrome; QFS