Fatigue & psychiatric disorder: different or the same? Chronic Fatigue Syndrome research

BACKGROUND: Fatigue and psychiatric symptoms are common in the
community, but their association and outcome are sparsely

METHOD: A total of 1177 patients were recruited from
UK primary care on attending their general practitioner.
Fatigue and psychiatric disorder was measured at three time
points with the 12-item General Health Questionnaire and the
11-item Fatigue Questionnaire.

RESULTS: Total scores for
fatigue and psychiatric disorder did not differ between the
three time points and were closely correlated (r around 0.6).
The association between non-co-morbid ('pure') fatigue and
developing psychiatric disorder 6 months later was the same as
that for being well and subsequent psychiatric disorder.
Similarly, having non-co-morbid psychiatric disorder did not
predict having fatigue any more than being well 6 months
previously. Between 13 and 15% suffered from non-co-morbid
fatigue at each time point and 2.5% suffered from fatigue at
two time points 6 months apart. Less than 1% of patients
suffered from non-co-morbid fatigue at all three time points.

CONCLUSIONS: The data are consistent with the existence of
'pure' independent fatigue state. However, this state is
unstable and the majority (about three-quarters) of patients
become well or a case of psychiatric disorder over 6 months. A
persistent, independent fatigue state lasting for 6 months can
be identified in the primary-care setting, but it is uncommon
of the order of 2.5%. Non-co-morbid (pure) fatigue did not
predict subsequent psychiatric disorder.

van der Linden G, Chalder T, Hickie I, Koschera A, Sham P, Wessely S

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