Table 1 Summary of selected studies

McLennan [21]

2016

257

H/B

Maslach

HCC

Nl

Schmidt [69] (part 1)

2016

265

Breast Cancer

FAQ

DAC, CAR, SCR, NSC

↑NSC, ↑AUC, Nl CAR, Nl DAC, ↓SCR

Pts. mostly on chemotherapy (ChTx); schemes not specified. No controls, only correlation between fatigue levels and tests. ChTx related to worse fatigue. Initial tests performed during, w/ or w/o ChTx.

Schmidt [69] (part 2)

2016

265

Breast Cancer

FAQ

DAC, CAR, SCR, NSC

↑AUC, ↑CAR, ↑NSC, ↑SCR, Nl DAC

Second test of the study, performed after 14 weeks of procedures.

Sjors [25]

2015

220

H/B

SMBQ

DAC, CAR

↓CAR, ↑DAC

Results normalized after adjustment of anti-depressive use; SCR results not provided

Oosterholt [28]

2015

91

H/B

Maslach

DAC, CAR, SCR, AUC, CAR 60 min

Nl SCR, ↓CAR, Nl AUC, Nl CAR 60 min, ↓DAC

Control of variations did not change results

De Vente [22]

2015

95

H/B

Acute Psychosocial Stressor diagnosis

MSC, MST

Nl MSC, Nl MST

MST: Nl (women), reduced (men); MSC: Nl (men), reduced (women). Mental arithmetic and public speech stressors also performed

Lennartsson [24]

2015

56

H/B

DCSRD; exclusion w/ SEQ

DHEA-S; ACTH; ACTH and DHEA-S post-TSST (TSST stress test performed)

↓DHEA-S, ↓post-TSST DHEA-S, Nl ACTH, Nl post-TSST ACTH

Tao [23]

2015

171

H/B

Maslach

MSC, ACTH

↑ACTH, ↑MSC

Jonsson [29]

2015

51

H/B

SMBQ

MSC, MST

Nl MSC, ↓MST

Lennartsson [27]

2015

56

H/B

DCSRD and SMBQ

MSC, MST, ACTH, ACTH post-TSST (TSST stress test performed)

Nl MSC, Nl MST, Nl ACTH, Nl post-TSST ACTH

Severe BO: lower ACTH, cortisol response to TSST vs controls, whereas low BO: higher ACTH, cortisol responses vs controls

Schmaling [26]

2015

62

Healthy

ADAS

AUC, SCR

↓AUC, ↓SCR

31 couples studied, one of which had chronic fatigue (but not CFS)

Sveinsdottir [68]

2015

1150

Chronic Lombalgia

CFQ

DAC, CAR, SCR, NSC

Nl DAC, Nl CAR, Nl NSC, Nl SCR

**Colocar como SAUDÁVEL – porque é só lombalgia (increased CAR in Low back pain)

Powell [67]

2015

76

Multiple Sclerosis

CFQ

DAC, CAR, SCR

↓DAC, ↑CAR, Nl SCR

Sleep disorders excluded; adjusted for depressive symptoms; NSC not published. Multiple sclerosis had increased awakening cortisol and decreased CAR

Cruz [70]

2015

43

Breast cancer

BFI and CFQ

MSC, DHEA-S

Nl MSC, Nl DHEA-S

Pts undergoing ChTx included anthracyclines

Marchand [31]

2014

1043

H/B

Maslach

DAC, CAR, SCR, NSC

↑DAC, ↓CAR, ↑SCR, ↓NSC

Only BO; Groups of severe distress or depression not included

Aggarwal [30]

2014

227

Healthy

CFQ

MSC, NSC, 0.25 mg DST, DHEA-S

Nl MSC, Nl NSC, Nl 0.25 mg DST, ↓DHEA-S

Evaluation of chronic, widespread pain, chronic orofacial pain, chronic fatigue (but not CFS), irritable bowel syndrome

Tell D [71]

2014

130

Breast cancer

MFI

DAC, CAR, SCR, NSC

↓CAR, ↓SCR, ↑DAC, ↑NSC

Post-surgery breast cancer, regardless of ChTx. Not adjusted to sleeping patterns

Wolfram [32]

2013

53

H/B

Maslach

MSC, 1 mcg CST, DST/CRH test (1.5 mg DST + 100 mcg CRH)

Nl MSC, ↓post-1 mcg ACTH, Nl ACTH and cortisol DST-CRH

High over-commitment present blunted serum and salivary cortisol and ACTH responses to DST-CRH test

Klaassen [33]

2013

27

Healthy

MP (Beck & Luine, 2010) and Stress Tasks (Wang, 2006)

MSC, post-stress

Nl MSC, Nl post-stress

A complex test sequence was performed but not reproduced

Eek [34]

2012

581

Healthy

SOFI-20

DAC, CAR, NSC, SCR, MSC

Nl DAC, Nl CAR, Nl NSC, Nl SCR, Nl MSC

Women: reduced awakening, increased CAR, increased SCR; Men: increased awakening and reduced CAR – when fatigued

Sjors [35]

2012

247

H/B

DCSRD and SMBQ

DAC, 15 min CAR

Nl DAC, Nl 15 min CAR

Rahman [54]

2011

30

CFS

Previous Dx – No questionnaire

MSC, SCR, NSC

Nl MSC, Nl SCR, Nl NSC

Moya-Albiol [37]

2010

64

H/B

Maslach

DAC, CAR

Nl DAC, Nl CAR

Kumari [38]

2009

4,299

Healthy

SF-36

DAC, CAR, NSC, SCR

↓DAC, ↓CAR, ↑NSC, ↓SCR

Adjusted for WC, BMI, sleep duration, CVD medication, depressive symptoms, smoking, alcohol intake provides Nl awakening but lower SCR

Osterberg [39]

2009

304

H/B

Maslach

DAC, CAR, NSC, SCR

Nl DAC, Nl CAR, ↓NSC, ↑SCR

0.5 mg DST was not compared to controls

Wingenfeld [41]

2009

279

H/B

Maslach and Maastricht

AUC, SCR

Nl AUC, Nl SCR

DAC and CAR not done; conclusions different from results. For AUC, Low BO: Nl, moderate: increased, severe: decreased

Rydstedt [40]

2009

76

Healthy

NRWS

DAC, NSC

Nl DAC, Nl NSC

Papadopoulos [55]

2009

38

CFS

CFQ and SF-36

MSC, AUC, morning AUC, 0,5 mg DST

↑MSC, ↑AUC, ↑MAUC, Nl 0.5 mg DST

Data on absolute cortisol levels at each point not published. DST reduction evaluated by percent reduction.

Bay [72]

2009

75

Post traumatic brain injury

POMS

AUC

Nl AUC

Correlation between brain injury-related fatigue level and cortisol AUC. Basal and NSC results not reported; SCR not evaluated.

Sudhaus [73]

2009

43

Chronic Lombalgia

MFI

DAC, CAR, MAUC

↓CAR, Nl DAC, Nl MAUC (correlation between fatigue levels among low back pain subjects)

Lindeberg [36]

2008

78

Healthy

SF-36

DAC, CAR, NSC, SCR

Nl DAC, ↓CAR, Nl NSC, ↓SCR

Sertoz [42]

2008

72

H/B

Maslach

Basal and post 1.0 mcg DST cortisol

Nl basal cortisol and 1.0 mg DST

Bellingrath [43]

2008

101

H/B

Maslach and Maastricht

DAC, CAR, NSC, SCR, 0.25 mg DST

Nl DAC, Nl CAR, Nl NSC, Nl SCR, ↓0.25 mg DST

Nater [57]

2008

185

CFS

SF-36 and MFI

DAC, CAR, MAUC

Nl DAC, Nl CAR, ↓MAUC

Torres-Harding [56]

2008

108

CFS

FSE

AUC, SCR

Nl AUC, Nl SCR

Multiple psychological tests performed. Data on NSC, basal and CAR not published.

Sonnenschein [45]

2007

42

H/B

Maslach

CAR, 0.5 mg DST, DHEA-S

Nl CAR, Nl 0.5 mg DST, Nl DHEA-S

Adjusted for depression, sleep quality. Awakening levels and each level graphics not available

Harris [44]

2007

44

Healthy

SF-36

DAC, CAR, NSC, SCR

Nl DAC, Nl CAR, Nl NSC, Nl SCR

Other aspects also correlated: complains, job stress and demand, QOL and coping. Adjusted for coffee and tobacco.

Langelaan [46]

2006

55

H/B

Maslach

DAC, CAR, 0.5 mg DST, DHEA-S

Nl DAC, Nl CAR, Nl 0.5 mg DST, Nl DHEA-S

Engaged work also compared and had stronger suppression in DST

Mommersteeg [47]

2006

109

Healthy

NC-WHO

DAC, CAR, 0.5 mg DST, SCR, AUC, NSC

Nl DAC, Nl CAR, Nl NSC, Nl SCR, Nl 0.5 mg DST, Nl AUC

Barroso [74]

2006

40

HIV

HRFS

MSC, NSC

↓MSC, ↑NSC

Jerjes [58]

2006

80

CFS

CFQ

UFC, TCM

↓UFC, Nl TCM

Grossi [48]

2005

64

H/B

SMBQ

DAC, CAR

↓DAC, ↑CAR

Groups were high x moderate x low BO score; correlation was significant

Segal [59]

2005

40

CFS

No questionnaire

MSC, 1 mcg CST

↓ MSC, ↓1 mcg CST

DHEA-S collected only in CFS. No questionnaires used.

Jerjes [60]

2005

35

CFS

CFQ

MSC, SCR, NSC, AUC

↓MSC, ↓SCR, ↓AUC ↓, Nl NSC

Bower [75]

2005

29

Breast cancer

SF-36

DAC, AUC, SCR, NSC

↑AUC, ↓SCR, Nl DAC, ↑NSC

Post-ChTx (regardless of time) complete cancer remission and exclusion of other disorders

McLean [76]

2005

55

Fybro-mialgia

SF-36

DAC, 60 min CAR, SCR, AUC, NSC

Nl DAC, Nl 60 min CAR, Nl SCR, Nl AUC, Nl NSC (correlation between fatigue levels among FMG subjects)

FMG subjects presented Nl DAC and CAR, as controls.

Roberts [62]

2004

92

CFS

CFQ and SF-36

DAC, CAR, MAUC

Nl DAC, ↓CAR, ↓MAUC

Crofford [61]

2004

72

CFS/FMG

POMS

ACTH, MSC, SCR, NSC, AUC

Nl ACTH, Nl SCR, Nl NSC, ↓AUC, Nl MSC

Tests performed in: CFS, FMG and CFS + FMG; FMG w/o fatigue had Nl AUC and increased BMC levels

Moch [50]

2003

16

H/B

Maslach

UFC, DHEA-S, ACTH, MSC

↓UFC, Nl DHEA-S, Nl ACTH, ↓MSC

Only women; longitudinal evaluation – Nl initial cortisol.

De Vente [49]

2003

45

H/B

Maslach

DAC, MSC, post-TSST

↑DAC, ↑MSC, Nl post-TSST

Gaab [63]

2002

42

CFS

MFI

DAC, CAR, SCR, 0.5 mg DST

↓0.5 mg DST, Nl AUC, Nl CAR, Nl DAC, Nl SCR, Nl NSC

CAR also performed at 15, 45 and 60 min.

Dekkers [77]

2000

53

Rheumatoid Arthritis

MFI

DAC, CAR, SCR, AUC

Nl AUC, Nl SCR Nl, ↓DAC, ↑CAR

5/25 subjects with RA taking prednisone (5–10 mg/d); RS subjects had smaller SCR, increased AM cortisol and decreased CAR. 15 and 45 min CAR also performed.

Melamed [51]

1999

111

H/B

SMBQ and Maastricht

MSC and 4 PM cortisol

↑MSC, Nl 4 PM cortisol

Pruessner [52]

1999

66

Healthy

Maslach

DAC, CAR, 0.5 mg DST

↓DAC, ↓CAR, ↓0.5 mg DST

15 min and 60 min CAR also performed

Strickland [65]

1998

74

CFS

Not specified/detailed

MSC, NSC

↓NSC, Nl MSC

Adjusted for depression

Young [66]

1998

45

CFS

NC-WHO

UFC, SCR, MSC, AUC

Nl UFC, Nl SCR, Nl MSC, Nl AUC

Scott [64]

1998

28

CFS

Not specified (not detailed)

MSC, ACTH, 100 mcg CRH cortisol stimulation

Nl MSC, Nl ACTH, CRH stim test: ↓cortisol, ↓ACTH

Raikkonen [53]

1996

22

Healthy

Not assessed

1 mcg CST, DST (non specified), OGTT, MSC, ACTH, cortisol/ACTH ratio

↑Cortisol/ACTH ratio; ↑CST, Nl DST, Nl OGTT, Nl MSC, Nl ACTH

Full article not assessed – not in PUBMED or other database