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Fatigue and psychiatric disorder: different or the same?

  • G. VAN DER LINDEN (a1), T. CHALDER (a1), I. HICKIE (a1), A. KOSCHERA (a1), P. SHAM (a1) and S. WESSELY (a1)
  • Published online: 01 July 1999

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.

Corresponding author
Address for correspondence: Dr G. van der Linden, Department of Psychiatry, Faculty of Medicine, PO Box 19063, Tygerberg, 7505, South Africa.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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