Skip to main content
SpringerLink
Log in

Immune Function in Chronic Fatigue Syndrome and Depression

Implications for Understanding these Disorders and for Therapy

  • Leading Article
  • Published:
Clinical Immunotherapeutics Aims and scope Submit manuscript

Summary

Considerable data now support the concept that patients with chronic fatigue syndrome and those with the melancholic subtype of major depression frequently have alterations in measures of immune function in vitro and in vivo. Although chronic fatigue syndrome and major depression have significant clinical similarity, the patterns of immunological and neuroendocrine alterations seen in the 2 disorders are dissimilar. The immunological changes provide tantalising clues to the pathophysiology of these disorders but, as yet, do not have clear implications for therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lloyd A, Wakefield D, Dwyer J, et al. What is myalgic encephalomyelitis? Lancet 1988; 1: 1286–7

    Article  PubMed  CAS  Google Scholar 

  2. Holmes GP, Kaplan JE, Gantz NM, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med 1988; 108: 387–9

    PubMed  CAS  Google Scholar 

  3. Sharpe MC, Archard LC, Banatvala JE, et al. A report — chronic fatigue syndrome: guidelines for research. J R Soc Med 1991; 84: 118–21

    PubMed  CAS  Google Scholar 

  4. Lloyd AR, Hickie I, Boughton CR, et al. The prevalence of chronic fatigue syndrome in an Australian population. Med J Aust 1990; 153: 522–8

    PubMed  CAS  Google Scholar 

  5. Cox B, Blaxter M, Buckle A, et al. The health and lifestyles survey. London: Health Promotion Research Trust, 1987

    Google Scholar 

  6. Chen MK. The epidemiology of self perceived fatigue among adults. Prev Med 1986; 15: 74–81

    Article  PubMed  CAS  Google Scholar 

  7. David A, Pelosi A, McDonald E, et al. Tired, weak, or in need of rest: fatigue among general practice attenders. BMJ 1990; 301: 1199–202

    Article  PubMed  CAS  Google Scholar 

  8. Harvard C. Lassitude. BMJ 1985; 290: 1161–2

    Article  Google Scholar 

  9. Kroenke K, Wood DR, Mangelsdorff AD, et al. Chronic fatigue in primary care: prevalence, patient characteristics and outcome. JAMA 1988; 260: 929–34

    Article  PubMed  CAS  Google Scholar 

  10. Hickie I, Lloyd A, Wakefield D, et al. The psychiatric status of patients with chronic fatigue syndrome. Br J Psychiatry 1990; 156: 534–40

    Article  PubMed  CAS  Google Scholar 

  11. Taerk GS, Toner BB, Salit IE, et al. Depression in patients with neuromyasthenia (benign myalgic encephalomyelitis). Int J Psychiatry Med 1987; 17: 49–56

    Article  PubMed  CAS  Google Scholar 

  12. Wessely S, Powell R. Fatigue syndromes: a comparison of chronic ‘postviral’ fatigue with neuromuscular and affective disorders. J Neurol Neurosurg Psychiatry 1989; 52: 940–8

    Article  PubMed  CAS  Google Scholar 

  13. Kruesi MJP, Dale J, Straus SE. Psychiatric diagnoses in patients who have chronic fatigue syndrome. J Clin Psychiatry 1989; 50: 53–6

    PubMed  CAS  Google Scholar 

  14. Katon WJ, Buchwald DS, Simon GE, et al. Psychiatric illness in patients with chronic fatigue and those with rheumatoid arthritis. J Gen Intern Med 1991; 6: 277–85

    Article  PubMed  CAS  Google Scholar 

  15. Lloyd AR, Wakefield D, Hickie I. Immunity and the pathophysiology of chronic fatigue syndrome. Ciba Found Symp 1993; 173: 176–92

    PubMed  CAS  Google Scholar 

  16. Wakefield D, Lloyd AR. The pathophysiology of myalgic encephalomyelitis. Lancet 1987; 2: 918–9

    Article  PubMed  CAS  Google Scholar 

  17. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd rev. ed. Washington DC: American Psychiatric Association, 1987

    Google Scholar 

  18. Kiloh LG, Andrews G, Neilsen M, et al. The relationship of the syndromes called endogenous and neurotic depression. Br J Psychiatry 1972; 121: 183–96

    Article  PubMed  CAS  Google Scholar 

  19. Hickie I, Hickie C, Silove D, et al. Is there significant immune dysfunction in depressive disorders? Psychol Med 1990; 20: 755–61

    Article  PubMed  CAS  Google Scholar 

  20. Stein M, Miller AH, Trestman RL. Depression, the immune system, and health and illness. Arch Gen Psychiatry 1991; 48: 171–7

    Article  PubMed  CAS  Google Scholar 

  21. Hickie I, Hickie C, Lloyd A, et al. Impaired cell-mediated immunity in melancholia. Br J Psychiatry 1993; 157: 65–71

    Article  Google Scholar 

  22. Lloyd A, Hickie I, Hickie C, et al. Cell-mediated immunity in patients with chronic fatigue syndrome, healthy control subjects and patients with major depression. Clin Exp Immunol 1992; 87: 76–9

    Article  PubMed  CAS  Google Scholar 

  23. Carrol BJ, Feinberg M, Greden JF, et al. A specific laboratory test for the diagnosis of melancholia: standardization, validation and clinical utility. Arch Gen Psychiatry 1981; 38: 15–22

    Article  Google Scholar 

  24. Demitrack MA, Dale JK, Straus SE, et al. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab 1991; 73: 1224–34

    Article  PubMed  CAS  Google Scholar 

  25. Bakheit AM, Behan PO, Dinan TG, et al. Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome. BMJ 1992; 304: 1010–2

    Article  PubMed  CAS  Google Scholar 

  26. Lopez-Ibor JJ. The involvement of serotonin in psychiatric disorders and behaviour. Br J Psychiatry 1988; 153 Suppl. 3: 26–9

    Google Scholar 

  27. Rivier C, Rivest S. Mechanisms mediating the effects of cytokines on neuroendocrine functions in the rat. Ciba Found Symp 1993; 172: 204–25

    PubMed  CAS  Google Scholar 

  28. Lloyd A, Hickie I, Wakefield D, et al. A double-blind, placebo-controlled trial of intravenous immunoglobulin therapy in patients with the chronic fatigue syndrome. Am J Med 1990; 89: 561–8

    Article  PubMed  CAS  Google Scholar 

  29. Cappel R, Gregoire F, Thiry L, et al. Antibody and cell-mediated immunity to herpes simplex virus in psychotic depression. J Clin Psychiatry 1978; 39: 266–8

    PubMed  CAS  Google Scholar 

  30. Levine P, Peterson D, McNamee F, et al. Does chronic fatigue syndrome predispose to non-Hodgkin’s lymphoma? Cancer Res 1992; Suppl 52: 5516–8

    Google Scholar 

  31. Kendler KS. A twin study of mortality in schizophrenia and neurosis. Arch Gen Psychiatry 1986; 43: 643–9

    Article  PubMed  CAS  Google Scholar 

  32. Murphy JM, Monson RR, Olivier DC, et al. Mortality risk and psychiatric disorders: results of a general physician survey. Social Psychiatry 1989; 24: 134–42

    CAS  Google Scholar 

  33. Bruce ML, Leaf PJ. Psychiatric disorders and 15-month mortality in a community sample of older adults. Am J Public Health 1989; 79: 727–30

    Article  PubMed  CAS  Google Scholar 

  34. Lloyd A, Hickie I, Brockman A, et al. Immunological and psychological therapy for patients with chronic fatigue syndrome: a double-blind, placebo-controlled trial. Am J Med 1993; 94: 197–203

    Article  PubMed  CAS  Google Scholar 

  35. Petersen PK, Shepard J, Macres M, et al. A controlled trial of intravenous immunoglobulin G in chronic fatigue syndrome. Am J Med 1990; 89: 554–60

    Article  Google Scholar 

  36. Gutterman J. Overview of advances in the uses of biological proteins in human cancer. Semin Oncol 1988; 15 Suppl. 5: 2–6

    PubMed  CAS  Google Scholar 

  37. McDonald EM, Mann AH, Thomas HC. Interferons as mediators of psychiatric morbidity: an investigation in a trial of recombinant alpha interferon in hepatitis B carriers. Lancet 1987; 2: 1175–9

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Infectious Diseases, Division of Medicine, The Prince Henry Hospital, Little Bay, NSW, Australia

    Andrew Lloyd

  2. Department of Immunopathology, Division of Pathology, The Prince Henry Hospital, Little Bay, NSW, Australia

    Andrew Lloyd & Denis Wakefield

  3. Inflammatory Diseases Unit, School of Pathology, The University of New South Wales, Sydney, NSW, Australia

    Andrew Lloyd & Denis Wakefield

  4. The Mood Disorders Unit, Division of Psychiatry, The Prince Henry Hospital, Little Bay, NSW, Australia

    Ian Hickie & Andrew Wilson

  5. School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia

    Ian Hickie & Andrew Wilson

Authors
  1. Andrew Lloyd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian Hickie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Denis Wakefield
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lloyd, A., Hickie, I., Wilson, A. et al. Immune Function in Chronic Fatigue Syndrome and Depression. Clin. Immunother. 2, 84–88 (1994). https://doi.org/10.1007/BF03259258

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03259258

Keywords

Search

Navigation