Psychosocial risk factors in the developmental of infectious mononucleosis.

In a 4-year prospective seroepidemiological study of infectious mononucleosis (IM) of one class of some 1400 cadets at the West Point Military Academy, susceptibles and immunes were identified by the absence or presence of antibody to Epstein-Barr virus (EBV), the causative agent, and new infections by the appearance of antibody (seroconversion). On entry, about 1/3 lacked EBV antibody, 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: 1) having fathers who were "overachievers"; 2) having a high level of motivation; 3) 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 two additional indices of infection or illness could also be predicted from the same set of psychosocial risk factors.