Trial Report Comparison of the symptom networks of long-COVID and chronic fatigue syndrome: From modularity to connectionism, 2024, Hyland

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https://onlinelibrary.wiley.com/doi/10.1111/sjop.13060

Scandinavian Journal of Psychology
Early View
Empirical Article
Open Access
Comparison of the symptom networks of long-COVID and chronic fatigue syndrome: From modularity to connectionism

Michael E. Hyland, Yuri Antonacci, Alison M. Bacon
First published: 21 July 2024
https://doi.org/10.1111/sjop.13060
Data are available from Yuri Antonacci, yuri.antonacci@community.unipa.it


Abstract

The objective was to compare the symptom networks of long-COVID and chronic fatigue syndrome (CFS) in conjunction with other theoretically relevant diagnoses in order to provide insight into the etiology of medically unexplained symptoms (MUS).

This was a cross-sectional comparison of questionnaire items between six groups identified by clinical diagnosis.

All participants completed a 65-item psychological and somatic symptom questionnaire (GSQ065).

Diagnostically labelled groups were long-COVID (N = 107), CFS (N = 254), irritable bowel syndrome (IBS, N = 369), fibromyalgia (N = 1,127), severe asthma (N = 100) and healthy group (N = 207).

The 22 symptoms that best discriminated between the six groups were selected for network analysis.

Connectivity, fragmentation and number of symptom clusters (statistically related symptoms) were assessed.

Compared to long-COVID, the symptom networks of CFS, IBS and fibromyalgia had significantly lower connectivity, greater fragmentation and more symptom clusters.

The number of clusters varied between 9 for CFS and 3 for severe asthma, and the content of clusters varied across all groups.

Of the 33 symptom clusters identified over the six groups 30 clusters were unique.

Although the symptom networks of long-COVID and CFS differ, the variation of cluster content across the six groups is inconsistent with a modular causal structure but consistent with a connectionist (network, parallel distributed processing) biological basis of MUS.

A connectionist structure would explain why symptoms overlap and merge between different functional somatic syndromes, the failure to discover a biological diagnostic test and how psychological and behavioral interventions are therapeutic.
 
The 65 symptoms according to this paper from 2018:
Symptom frequency and development of a generic functional disorder symptom scale suitable for use in studies of patients with irritable bowel syndrome, fibromyalgia syndrome or chronic fatigue syndrome Michael E. Hyland a, *, Alison M. Bacon a , Joseph W. Lanario a , Anthony F. Davies b

Waking up still feeling tired
Fatigue for no reason
Difficulty concentrating
Mental fog
Fatigue increasing the day after you are active 1
Memory problems
Waking up often at night
Easily feel too cold
Pain increasing the day after you are active
Bloating of the stomach
Pain in legs and arms which is not due to hard exercise
Back pain
Easily feel too hot/sweating
Very cold hands or feet
Difficulty getting to sleep
Pain moving from one place of body to another on different days
Sensitivity to noise
Stomach pain
Sensitive or tender skin
Irritable
Sensitivity to bright lights
Jittery, easily startled, often worried
More clumsy than others
Thirsty all the time
Numbness, tingling, pins and needles
Headaches
Feeling anxious for no reason
Itchy skin
Intolerant to some food
Itchy eyes
Constipation
Feeling out of breath for no reason
Racing heart
Swollen painful joints
Cramps in leg, foot or bottom
Very vivid dreams
Feeling very ill for no reason
Depression
Nausea for no reason
Fatigue increasing after a cold or sore throat
Diarrhoea
Blocked nose
Urinating two or more times per night
Face flushes
Hands tremble or shake
Ringing in ears
Heartburn
Running nose
Chest pain
Feeling faint
Twitching other than eyelid
Twitching of eyelid
Nightmares/night terrors
Double vision
Boils or pimples on face or body
Choking sensations
Skin rash
Head colds, sore throat, flu
Mouth ulcers, sores in mouth
Loss of voice
Cold sores on or near lips
 
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