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Rethinking childhood adversity in chronic fatigue syndrome

Lookup NU author(s): Laura Maclachlan, Emerita Professor Julia Newton, Dr Stuart Watson



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Previous studies have consistently shown increased rates of childhood adversity in chronic fatigue syndrome (CFS). However, such aetiopathogenic studies of CFS are potentially confounded by co-morbidity and misdiagnosis particularly with depression. We examined the relationship between rates of childhood adversity using two complimentary approaches (1) a sample of CFS patients who had no lifetime history of depression and (2) a modelling approach. Childhood trauma questionnaire (CTQ) administered to a sample of 52 participants with chronic fatigue syndrome and 19 controls who did not meet criteria for a psychiatric disorder (confirmed using the Structured Clinical Interview for DSM-IV). Subsequently, Mediation Analysis (Baye’s Rules) was used to establish the risk childhood adversity poses for CFS with and without depression. In a cohort of CFS patients with depression comprehensively excluded, CTQ scores were markedly lower than in all previous studies and, in contrast to these previous studies, not increased compared with healthy controls. Post-hoc analysis showed that CTQ scores correlated with the number of depressive symptoms during the lifetime worst period of low mood. The probability of developing CFS given a history of childhood trauma is 4%, a two-fold increased risk compared to the general population. However, much of this risk is mediated by the concomitant development of major depression. The data suggests that previous studies showing a relationship between childhood adversity and CFS may be attributable to the confounding effects of co-morbid or misdiagnosed depressive disorder

Publication metadata

Author(s): Clark JE, Davidson SL, Maclachlan L, Newton JL, Watson S

Publication type: Article

Publication status: Published

Journal: Fatigue: Biomedicine, Health & Behavior

Year: 2018

Volume: 6

Issue: 1

Pages: 20-29

Print publication date: 01/01/2018

Online publication date: 10/10/2017

Acceptance date: 20/09/2017

Date deposited: 29/11/2017

ISSN (print): 2164-1846

ISSN (electronic): 2164-1862

Publisher: Taylor and Francis


DOI: 10.1080/21641846.2018.1384095


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