Fatigue and psychiatric disorder: different or the same (original) (raw)
Related papers
2008
Objective: The study aimed to describe the prevalence of chronic fatigue in the general population and to investigate the extent to which its association with physical illness was independent of other symptoms of common mental disorders. Methods: Data from the second British National Survey of Psychiatric Morbidity (2000) were analyzed. The survey covered people aged 16 to 74 years living in private households. Chronic fatigue (significant reported fatigue lasting 6 months or more) was ascertained using the revised Clinical Interview Schedule. Information on reported physical illness and sociodemographic factors was considered. Psychiatric symptoms were also assessed using the revised Clinical Interview Schedule. Results: The prevalence of chronic fatigue was 15.0%, and this showed a significant association with the number of reported physical illnesses (odds ratio [OR] per reported illness, 1.79; 95% confidence interval, 1.68-1.90). It was higher in midlife, in women, in participants with less skilled occupations, and in those with lower educational attainment. Chronic fatigue was strongly associated with the presence of depressive symptoms (OR, 5.37), anxiety-related symptoms (OR, 4.66), and with sleep complaints (OR, 4.41). After adjustment for all sociodemographic and psychiatric factors, the number of reported physical illnesses was less strongly but still significantly associated with chronic fatigue (OR, 1.51; 1.39-1.63). Conclusion: Physical illness is strongly associated with chronic fatigue. Symptoms of common mental disorders are also associated with chronic fatigue, but the association between physical illness and chronic fatigue is evident even after adjusting for psychiatric symptoms. The assessment of physically ill people should include chronic fatigue and psychiatric symptoms.
Psychosomatic medicine, 2004
OBJECTIVE: Unexplained fatigue syndromes, such as chronic fatigue syndrome and neurasthenia, are strongly associated with depression, but the temporal nature of this association is not clear. METHODS: The authors examined this issue by using data from the World Health Organization collaborative study of psychological problems in general health care. Three thousand two hundred one subjects from 15 primary care centers in 14 countries were followed up for 12 months. The Composite International Diagnostic Interview was the main instrument used. Odds ratios and their 95% confidence intervals (CI) were calculated using logistic regression models adjusted for sociodemographic variables, physical morbidity and intercenter variability. RESULTS: Cases of depression were found to have an increased risk of developing a new episode of unexplained fatigue at follow-up with an adjusted odds ratio of 4.15 (95% CI = 2.64-6.54). Similarly, cases of unexplained fatigue were found to have an increased risk of developing a new episode of depression at follow-up with an adjusted odds ratio of 2.76 (95% CI = 1.32-5.78). Further adjustment for subthreshold symptoms at baseline weakened the reported associations, especially between fatigue and development of a new episode of depression, but these remained significant. CONCLUSIONS: The findings support the view that unexplained fatigue and depression might act as independent risk factors for each other.
American Journal of …, 2003
OBJECTIVE: The authors investigated whether narrow definitions of unexplained fatigue syndromes that require additional minor somatic symptoms are more strongly associated with psychiatric morbidity than wider ones. METHOD: This was a secondary analysis of the World Health Organization Collaborative Project on Psychological Problems in General Health Care. A total of 5,438 primary care patients from 14 countries were assessed with the Composite International Diagnostic Interview. RESULTS: The prevalence of fatigue syndromes fell from 7.99 to 1.69 as somatic criteria were added. Patients with depression or anxiety were more likely to report unexplained fatigue, but this association was stronger for definitions of unexplained fatigue with more somatic criteria. CONCLUSIONS: Definitions of unexplained fatigue syndromes that require more somatic criteria selected more patients with psychiatric disorders in this culturally diverse sample. These findings might have implications for the revision of existing international diagnostic criteria for neurasthenia or chronic fatigue syndrome.
BACKGROUND: Outcome studies of chronic fatigue, neurasthenia and other unexplained fatigue syndromes are few and have been carried out in developed Western countries. This paper aimed to study the outcome of unexplained fatigue syndromes in an international primary care sample and to identify risk factors for persistence. METHOD: We used data from the WHO collaborative study of psychological problems in general health care, in which 3201 primary care attenders from 14 countries were followed-up for 12 months. The assessment included a modified version of the Composite International Diagnostic Interview. RESULTS: Unexplained fatigue persisted in one-fifth to one-third of the subjects depending on the definition of fatigue. From the factors studied only severity of fatigue and psychiatric morbidity at baseline were associated with persistence 12 months later. Outcome did not differ between countries of different stages of economic development. CONCLUSIONS: The prognosis of fatigue syndromes in international primary care is relatively good. The study underlines the importance of psychological factors in influencing short-term prognosis.
The American journal of psychiatry, 1996
This study assessed relationships among psychological symptoms, past and current psychiatric disorder, functional impairment, somatic symptoms, chronic fatigue, and chronic fatigue syndrome. A prospective cohort study was followed by a nested case-control study. The subjects, aged 18-45 years, had been in primary care for either clinical viral infections or a range of other problems. Questionnaire measures of fatigue and psychological symptoms were completed by 1,985 subjects 6 months later; 214 subjects with chronic fatigue were then compared with 214 matched subjects without fatigue. Assessments were made with questionnaires, interviews, and medical records of fatigue, somatic symptoms, psychiatric disorder, and functional impairment. Subjects with chronic fatigue were at greater risk than those without chronic fatigue for current psychiatric disorder assessed by standardized interview (60% versus 19%) or by questionnaire (71% versus 31%). Chronic fatigue subjects were more likely...
Factors associated with acute fatigue in primary care
Psychological Medicine, 2010
Background. To examine the role of psychological distress, negative life events, social support and lack of fitness (using breathlessness on exertion as a proxy) in the development of new onset fatigue in a primary care population.