E2 ModerateModerate confidencePEM not requiredLongitudinalPeer-reviewedMachine draft
A longitudinal study of the relationship between psychological distress and recurrence of upper respiratory tract infections in chronic fatigue syndrome.
Faulkner, Susan, Smith, Andrew · British journal of health psychology · 2008 · DOI
Quick Summary
This study tracked 21 ME/CFS patients and 18 healthy people over 15 weeks to see if stress affects how often they catch colds and respiratory infections. ME/CFS patients caught infections much more frequently than healthy people, and importantly, high stress levels in one week predicted who would get sick the next week. The same stress also made their fatigue symptoms worse.
Why It Matters
This research provides evidence that psychological stress may be a modifiable risk factor for infection susceptibility in ME/CFS patients, suggesting that stress management interventions could potentially reduce infection frequency and symptom severity. Understanding the stress-infection-fatigue link helps validate patients' experiences and may inform holistic treatment approaches.
Observed Findings
- CFS patients reported significantly more URTIs over 15 weeks compared to healthy matched controls.
- Stress scores were significantly elevated in the week preceding URTI occurrence compared to weeks with no subsequent illness.
- Negative mood was similarly elevated in weeks before infection occurred.
- High psychological stress preceded increased severity of fatigue symptoms in CFS patients.
Inferred Conclusions
- Psychological stress precedes and may precipitate URTI recurrence in ME/CFS patients.
- Stress management may be relevant for reducing infection frequency in this population.
- Psychological distress contributes to both infection susceptibility and symptom severity in ME/CFS.
Remaining Questions
- What are the biological mechanisms linking psychological stress to impaired immune function in ME/CFS?
- Do stress-reduction interventions actually reduce URTI frequency and symptom severity in ME/CFS patients?
- Does this stress-infection relationship differ between ME/CFS and other chronic illnesses?
- How do individual coping styles and illness duration modify the stress-infection association?
What This Study Does Not Prove
This study demonstrates correlation between stress and infection timing, not causation—other unmeasured factors could influence both stress and infection susceptibility simultaneously. The small sample size (21 CFS patients) and reliance on self-reported symptoms limit generalizability. The study cannot establish whether stress directly suppresses immune function or operates through other biological mechanisms.
Tags
Symptom:Fatigue
Phenotype:Infection-Triggered
Method Flag:PEM Not DefinedWeak Case DefinitionSmall Sample
Metadata
- DOI
- 10.1348/135910706X171469
- PMID
- 17535488
- Review status
- Machine draft
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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