Background: Although fatigue is a ubiquitous symptom across countries, clinical descriptions of chronic fatigue syndrome have arisen from a limited number of high-income countries. This might reflect differences in true prevalence or clinical recognition influenced by sociocultural factors.
Aims: To compare the prevalence, physician recognition and diagnosis of chronic fatigue syndrome in London and Sao Paulo.
Method: Primary care patients in London (n=2,459) and Sao Paulo (n=3,914) were surveyed for the prevalence of chronic fatigue syndrome. Medical records were reviewed for the physician recognition and diagnosis.
• The prevalence of chronic fatigue syndrome according to Centers for Disease Control 1994 criteria was comparable in Britain and Brazil: 2.1% v. 1.6% (P=0.20).
• Medical records review identified 11 diagnosed cases of chronic fatigue syndrome in Britain, but none in Brazil (P<0.001).
Conclusions: The primary care prevalence of chronic fatigue syndrome was similar in two culturally and economically distinct nations. However, doctors are unlikely to recognize and label chronic fatigue syndrome as a discrete disorder in Brazil. The recognition of this illness rather than the illness itself may be culturally induced.
Source: British Journal of Psychiatry, Feb 2009;194(2):117-22. PMID: 19182171, by Cho HJ, Menezes PR, Hotopf M, Bhugra D, Wessely S. University Hospital, University of Sao Paulo, Brazil; Institute of Psychiatry, King’s College London, UK. [E-mail: email@example.com]