Chronic fatigue and indicators of long-term employment disability in psychosomatic inpatients (original) (raw)
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Journal of Epidemiology & Community Health, 2004
Study objective: To identify risk factors of the development of the chronic fatigue syndrome (CFS), the persistence or recurrence of fatigue, or recovery from fatigue in a large sample of fatigued employees. Design: Analyses were based on the Maastricht cohort study (MCS), a prospective population based cohort study among more than 12 000 employees. Multiple regression models were used to identify predictors of CFS-like caseness (meeting research criteria for CFS), non-CFS fatigue caseness, or no fatigue caseness. Setting: The working population in the Netherlands. Participants: 1143 employees with medically unexplained fatigue were followed up prospectively for 44 months. Main results: At 44 month follow up, 8% of the employees were CFS-like cases (none of who reported to have received a CFS diagnosis), 40% were non-CFS fatigue cases, and 52% were no longer fatigue cases. Factors that predicted CFS-like caseness compared with non-CFS fatigue caseness were high age, exhaustion, female sex, low education, and visits to the general practitioner. Factors that predicted CFSlike caseness compared with no fatigue caseness were fatigue, exhaustion, low education, visits to the GP and occupational physician, and bad self rated health. Factors that predicted non-CFS fatigue caseness compared with no fatigue caseness were fatigue, low self perceived activity, exhaustion, anxious mood, and bad self rated health. Conclusions: Unexplained fatigue among employees in some instances is a precursor of the development of CFS. The prognostic role of self rated health suggests that prevention and treatment of chronic fatigue should be aimed at changing the perception of health or illness. Less clear is the role of health care seeking or receiving a CFS diagnosis.
The association between chronic diseases and fatigue in the working population
Journal of Psychosomatic Research, 2003
Objective: The aims of this study were to examine (a) whether employees with a chronic disease report more fatigue than employees without a chronic disease, (b) whether number or type of chronic disease is related to fatigue, and (c) whether differences in fatigue level in various types of chronic diseases are related to psychological distress. Methods: Data were taken from 12,137 employees. Fatigue was measured with the Checklist Individual Strength (CIS). Results: Employees with a chronic disease reported more fatigue (OR = 2.9, 95% CI = 2.7 -3.2). Small differences were observed in the level of fatigue in various types of diseases. A strong linear association between the number of chronic diseases and fatigue was found. Psychological distress explained the higher level of fatigue in some chronic diseases (gastrointestinal diseases and migraine). Conclusions: Fatigue is more common in employees with a chronic disease. A strong association between number of chronic diseases and fatigue exists. Fatigue in employees with a chronic disease can partly be explained by psychological distress. Some chronic diseases show a stronger association between psychological distress and fatigue. D
Validation of a neuropsychological battery in a sample of patients with chronic fatigue syndrome
Ghent University Academic Bibliography (Ghent University), 2011
In our study we have followed the health state and the lifestyle of the Romanian adult population; the prevalence of the main symptoms and diseases together with the role of some economical, psychological and social factors. Aim: The aim of our research is to study the psychical health state of Romanian adults in three counties from the middle of the country. Method: The study is based on a complex questionnaire which was completed by a representative sample among the adult population. Results: According to our results depression is the most common psychological illness with 9.1% diagnosed, but there was also a much higher rate of depressive symptoms. According to the Beck score, it was established that there was a significant difference in females, elderly people, those of a lower educational level, and those belonging to an urban population. The percentage of suicide attempts among the studied population was 2.9%. According to the WHO Positive life quality test, in two-thirds of cases, the adult population considered that they were psychologically healthy. We analyzed how gender, age, professional and social status, living and working conditions and different social factors influenced the health state. Conclusions: In our study, the role of religious feelings and the importance of health promotion and education to improve the psychological living standards of the population is highlighted. We conclude that improving living standards, modifying in a proper way the lifestyle of the population can positively influence the physical and mental health state of the Romanian adult population.
Chronic fatigue syndrome--a clinically empirical approach to its definition and study
BMC medicine, 2005
The lack of standardized criteria for defining chronic fatigue syndrome (CFS) has constrained research. The objective of this study was to apply the 1994 CFS criteria by standardized reproducible criteria. This population-based case control study enrolled 227 adults identified from the population of Wichita with: (1) CFS (n = 58); (2) non-fatigued controls matched to CFS on sex, race, age and body mass index (n = 55); (3) persons with medically unexplained fatigue not CFS, which we term ISF (n = 59); (4) CFS accompanied by melancholic depression (n = 27); and (5) ISF plus melancholic depression (n = 28). Participants were admitted to a hospital for two days and underwent medical history and physical examination, the Diagnostic Interview Schedule, and laboratory testing to identify medical and psychiatric conditions exclusionary for CFS. Illness classification at the time of the clinical study utilized two algorithms: (1) the same criteria as in the surveillance study; (2) a standard...
Characterization of Fatigue States in Medicine and Psychiatry by Structured Interview
Psychosomatic Medicine, 2014
Context: Unexplained fatigue states are prevalent, with uncertain diagnostic boundaries. Objective: Patients with fatigue-related illnesses were investigated by questionnaire and a novel semistructured interview to identify discriminatory features. Methods: Crosssectional samples of women from specialist practices with chronic fatigue syndrome (n = 20), postcancer fatigue (PCF; n = 20), or major depression (n = 16) were recruited. Additionally, two longitudinal samples were studied: women with fatigue associated with acute infection who subsequently developed postinfective fatigue syndrome (n = 20) or recovered uneventfully (n = 21), and women undergoing adjuvant therapy for breast cancer experiencing treatment-related fatigue who subsequently developed PCF (n = 16) or recovered uneventfully (n = 16). Patients completed self-report questionnaires, and trained interviewers applied the Semi-structured Clinical Interview for Neurasthenia. The receiver operating characteristics curves of the interview were measured against cliniciandesignated diagnoses. Cluster analyses were performed to empirically partition participants by symptom characteristics. Results: The interview had good internal consistency (Cronbach > ''fatigue'' = .83), and diagnostic sensitivity and specificity for chronic fatigue syndrome (100% and 83%) and major depression (100% and 72%), with reasonable parameters for PCF (72% and 58%). Empirical clustering by ''fatigue'' or ''neurocognitive difficulties'' items allocated most patients to one group, whereas ''mood disturbance'' items correctly classified patients with depression only. Conclusions: The Semi-structured Clinical Interview for Neurasthenia offers reliable diagnostic use in assessing fatigue-related conditions. The symptom domains of fatigue and neurocognitive difficulties are shared across medical and psychiatric boundaries, whereas symptoms of depression such as anhedonia are distinguishing.