Fatigue in selected primary care settings: sociodemographic and psychiatric correlates

Abstract

Objectives To determine the prevalence and sociodemographic and psychiatric correlates of prolonged fatigue syndromes among patients in primary care. Design Prospective questionnaire survey. Patients and setting Adults over 18 years attending three general practices in metropolitan Sydney and one on the Central Coast, north of Sydney. Results Of 1593 patients, 25% had prolonged fatigue, while 37% had psychological disorder. Of the patients with fatigue, 70% had both fatigue and psychological disorder, while 30% had fatigue only. The factors associated with prolonged fatigue were concurrent psychological disorder, female gender, lower socioeconomic status and fewer total years of education. Patients with fatigue were more likely to have a current depressive disorder. Conclusions Prolonged fatigue/neurasthenia syndromes are common in Australian primary care settings, and are commonly associated with current depressive disorders. Such syndromes, however, do not fit readily into current international psychiatric classification systems.

Depression in multiple sclerosis: a review

“…42 Another found that depression and fatigue were independent predictors of QoL in MS. 7 Although fatigue is well recognised as a somatic symptom accompanying depression and anxiety, prolonged fatigue is also common in community based studies of psychological morbidity. 46 Moreover it appears that some people who appear to have no other explanation experience fatigue as the main feature of a psychological illness. 13 46 For this reason some psychiatrists interested in the epidemiology and classification of psychological illness have recommended the recognition of neurasthenia to account for this group of patients and to analyse the value of treatments.…”

An epidemiological approach to study fatigue in the working population: the Maastricht Cohort Study

“…[5][6][7][8] Discussion points include whether fatigue is a discrete entity (chronic fatigue syndrome, myalgic encephalomyelitis), a set of symptoms of unknown origin, or a specific form of psychological disturbance. We do know, however, that fatigue is a common complaint, [9][10][11][12][13][14][15] which is best seen as a subjective sensation with behavioural, emotional, and cognitive components. 5 In a review on the epidemiology of fatigue in both the community and primary care settings, Lewis and Wessely 5 reported preva-lence rates varying from 7% to 45%.…”

“…5 In a review on the epidemiology of fatigue in both the community and primary care settings, Lewis and Wessely 5 reported preva-lence rates varying from 7% to 45%. Although different definitions and measurements of fatigue, different settings and response rates, as well as different duration criteria for fatigue hinder a direct comparison, the prevalence of fatigue was 14.3% in men and 20.4% in women in the US Health and Nutrition Examination Survey, 9 22% (11% for six months or longer) in the general Norwegian population, 15 25% (at least two weeks duration) in an Australian primary care study, 14 and 38% (18% for six months or longer) in a UK community survey. 12 Several studies conducted in the community and in primary care settings have shown that fatigue is continuously distributed, with some degree of fatigue in nearly all of the population.…”

Fatigue in the Danish general population. Influence of sociodemographic factors and disease

“…46 47 The results on the association between age and fatigue are even more contradictory. Some found no associations,5 36 37 39 44 48 49 some found an increase of fatigue with age3 40 42 43 45 while others found lower levels of fatigue in older people 3847 50Generally higher education and social status has been associated with less fatigue,3 37 40 41 48 51 but some studies did not identify any such trend 1…”

“…Some found no associations,5 36 37 39 44 48 49 some found an increase of fatigue with age3 40 42 43 45 while others found lower levels of fatigue in older people 3847 50Generally higher education and social status has been associated with less fatigue,3 37 40 41 48 51 but some studies did not identify any such trend 15 43 46 Strong associations with mental health have been reported,42 47especially for depression,3 but also for anxiety, independent of depression 52…”