Psychosocial Risk Factors in the Developmental of Infectious Mononucleosis*

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Abstract
In a 4 yr prospective seroepidemiological study of infectious mononucleosis (IM) of 1 class of some 1400 cadets at the West Point Military Academy [New York, USA], susceptibles and immunes were identified by the absence or presence of antibody [Ab] to Epstein-Barr virus (EBV), the causative agent, and new infections by the appearance of Ab (seroconversion). On entry, about 1/3 lacked EBV Ab, of whom some 20% became infected (seroconverted); about 1/4 of seroconverters developed definite, clinical and recognized IM. Psychosocial factors that significantly increased the risk of clinical IM among seroconverters included having fathers who were overachievers, having a high level of motivation and doing relatively poorly academically. The combination of high motivation and poor academic performance interacted in predicting clinical IM. Additional data on presence of elevated titers among seroconverters with inapparent disease and on length of hospitalization among cases of clinical IM revealed that these 2 additional indices of infection or illness could be predicted from the same set of psychosocial risk factors.

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