General and specific risk markers & preventive factors for chronic fatigue and irritable bowel syndromes

This research is examining the causes of chronic fatigue/ME and irritable bowel syndrome in the 1958 British Birth cohort, using data on health, family, education, and occupation gathered in childhood and adulthood before the illness develops. An understanding of the causes of these illnesses will contribute to preventing illness, as well as provide useful information for doctors, care providers, and patients and their families. Chronic fatigue syndrome, also known as ME is a debilitating illness, where the sufferer experiences long-term mental and physical tiredness that seriously affects daily life and activities. Little is known about what causes the illness. Few studies have information about the individual’s life before the illness develops and those that do suggest differing evidence for exercise, childhood illness and childhood depression as causes of chronic fatigue. Studies have also not yet examined whether the causes of chronic fatigue are different to the causes of other similar disorders, such as irritable bowel syndrome. This project is examining factors from childhood and adulthood that are thought to cause the development of chronic fatigue and which may also cause irritable bowel syndrome including childhood and adulthood depression, exercise habits, serious illnesses, neglect, and poor parenting in childhood.

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a debilitating illness characterised by prolonged fatigue lasting over 6 months, accompanied by a wide range of symptoms. CFS/ME typically develops in early to mid adulthood, but little is known about the aetiology of the illness, making prevention and treatment challenging.

Previous studies of preventive and risk markers for CFS/ME are predominantly case control studies limited by small samples, lacking prospective data. These studies suggest that psychological health, childhood adversity and physical inactivity are risk markers for CFS/ME. Prospective studies of preventive and risk markers are few and the findings disparate. Analyses of the 1970 birth cohort found that high levels of exercise in childhood decreased risk and childhood illness increased risk of CFS/ME at age 30; in contrast, similar analyses of the 1946 birth cohort found that high levels of exercise in childhood increased risk and childhood illness showed no associated with CFS/ME at age 53. These findings may reflect differential associations for diagnoses in early versus mid-adulthood but further replication is required to inform prevention strategies.

Prospective studies have yet to examine whether preventive and risk markers are specific for CFS/ME or whether they reflect general markers for functional disorders such as CFS/ME and irritable bowel syndrome (IBS). This two year project will utilize the prospective 1958 British Birth cohort data to develop hypothesis testing models of lifecourse preventive and risk markers of CFS/ME and IBS, examining general and specific markers for CFS/ME and IBS, as well as replicating previous analyses of the 1970 and 1946 cohorts in relation to CFS/ME.

The 1958 Cohort is a prospective study of over 17,000 births, followed up over a 45 year period. This project will focus on health outcomes at 42y (N=11419), and preventive and risk markers from childhood (7y, 11y, 16y) and adulthood (23y, 33y). Hypotheses testing preventive and risk factors relating to psychological health across the lifecourse, childhood adversity, physical inactivity, body mass index, and chronic childhood illness will be tested. Age of onset for CFS/ME and IBS is known enabling pre-morbid factors to be distinguished from post-morbid factors.

This project offers a unique opportunity to test many of the prevailing hypotheses relating to preventive and risk markers of CFS/ME and IBS in a large prospective dataset. Information about markers and the specificity of markers for CFS/ME and IBS will be a useful addition to knowledge for practitioners, care providers and patients.