Prolonged fatigue, anxiety & depression: exploring relationships in a primary care sample – Chronic Fatigue Syndrome related research

OBJECTIVE: While prolonged fatigue states are frequently comorbid

with other forms of distress, they are now the subject of

independent aetiological and treatment research. The objective

of this study was to use principal component analysis to

clarify the relationships between proposed measures of

prolonged fatigue and anxiety and depression in data obtained

from patients attending primary care.

METHOD: Self-report

measures of prolonged fatigue and psychological distress

(anxiety and depression) were administered to consecutive

ambulatory care patients attending primary care.


from 1593 subjects were obtained. A two-factor principal

component solution (varimax rotation) demonstrated a clear

separation between fatigue-related items (Cronbach’s alpha =

0.81) as compared with those items describing anxiety and/or

depression (Cronbach’s alpha = 0.95). A four-factor solution

produced similar results with two factors describing general

psychological distress (contrasting anxiety and depression),

with two other factors describing the profiles of mental and

physical fatigue.

CONCLUSIONS: The results lend weight to the

argument that prolonged fatigue states can be measured

independently of conventional notions of anxiety and

depression in patients attending primary care.

Epidemiological, aetiological and treatment research in

psychiatry may need to focus greater attention on such

prolonged fatigue states.

Koschera A, Hickie I, Hadzi-Pavlovic D, Wilson A, Lloyd A

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