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A population-based incidence study of chronic fatigue

  [ 28 votes ]   [ Discuss This Article ]
By Lawrie SM, Manders DN, Geddes JR, Pelosi AJ • • March 10, 1997

BACKGROUND: Most research on syndromes of chronic fatigue has been
conducted in clinical settings and is therefore subject to
selection biases. We report a population-based incidence study
of chronic fatigue (CF) and chronic fatigue syndrome (CFS).

METHODS: Questionnaires assessing fatigue and emotional
morbidity were sent to 695 adult men and women who had replied
to a postal questionnaire survey 1 year earlier. Possible CFS
cases, subjects with probable psychiatric disorder and normal
controls were interviewed.

RESULTS: Baseline fatigue score,
the level of emotional morbidity and a physical attribution
for fatigue were risk factors for developing CF. However,
after adjusting for confounding, premorbid fatigue score was
the only significant predictor. A minority of CF subjects, all
female, had consulted their general practitioner; higher
levels of both fatigue and emotional morbidity were associated
with consultation. Possible CFS cases reported similar rates
of current and past psychiatric disorder to psychiatric
controls, but after controlling for fatigue or a diagnosis of
neurasthenia the current rates were more similar to those of
normal controls. Two new cases of CFS were confirmed.

CONCLUSIONS: Both fatigue and emotional morbidity are integral
components of chronic fatigue syndromes. The demographic and
psychiatric associations of CFS in clinical studies are at
least partly determined by selection biases. Given that
triggering and perpetuating factors may differ in CFS, studies
that examine the similarities and differences between chronic
fatigue syndromes and psychiatric disorder should consider
both the stage of the illness and the research setting.

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