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Fatigue and psychiatric disorder: different or the same?

Published online by Cambridge University Press:  01 July 1999

G. VAN DER LINDEN
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia
T. CHALDER
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia
I. HICKIE
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia
A. KOSCHERA
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia
P. SHAM
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia
S. WESSELY
Affiliation:
From the Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa; Department of Psychological Medicine, Institute of Psychiatry and King's College School of Medicine, London; and School of Psychiatry, St George Hospital and Community Health Service, Academic Department of Psychiatry, University of New South Wales, Kogarah, NSW, Australia

Abstract

Background. Fatigue and psychiatric symptoms are common in the community, but their association and outcome are sparsely studied.

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.

Type
Research Article
Copyright
© 1999 Cambridge University Press

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