Hostname: page-component-5f56664f6-92sl5 Total loading time: 0 Render date: 2025-05-08T02:14:56.063Z Has data issue: false hasContentIssue false
  • English
  • Français

The epidemiology of fatigue and depression: a French primary-care study

Published online by Cambridge University Press:  09 July 2009

Rebecca Fuhrer  and
Simon Wessely
Rebecca Fuhrer*
Affiliation:
Institut National de la Santé et de la Recherche Médicale (INSERM Unité 360), France; Institute of Psychiatry, London
Simon Wessely
Affiliation:
Institut National de la Santé et de la Recherche Médicale (INSERM Unité 360), France; Institute of Psychiatry, London
*
1Address for correspondence: Dr Rebecca Fuhrer, INSERM U. 360, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13, France.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The prevalence of fatigue as a presenting complaint and as a symptom is evaluated in French general practice patients. The data for a sample of 3784 persons 18–64 years-of-age who were seen by 367 general practitioners were examined for fatigue as a presenting complaint, diagnosis, and reported symptoms of persistent fatigue. Gender, age, and socio-professional category were considered as potential risk correlates. At least one of the symptoms of persistent fatigue was reported by 41·2% of the patients, but only 7·6% had presented with fatigue to the doctor. Women reported more symptoms of fatigue than men, but they were only slightly more likely to present with, or be diagnosed with fatigue; women were more frequently diagnosed with depression. There was a strong relationship between the symptoms of depression as measured by the Center for Epidemiologic Studies – Depression Scale (CES-D) and fatigue, but fatigue was neither sensitive nor specific for the diagnosis of depression. Age and fatigue as a presenting complaint and diagnosis were strongly associated for men. After adjusting for sex and age, we found that lower social classes were less likely to be diagnosed as fatigued, though they were more likely to report symptoms of fatigue.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 5 , September 1995 , pp. 895 - 905
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Abbey, S. & Garfinkel, P. (1990). Chronic fatigue syndrome and the psychiatrist. Canadian Journal of Psychiatry 35, 625–633.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.APA: Washington, DC.Google Scholar
Bengtsson, C., Edstrom, K., Furunes, B., Sigurdsson, J. & Tibblin, G. (1987). Prevalence of subjectively experienced symptoms in a population sample of women with special reference to arterial hypertension. Scandinavian Journal of Primary Health Care 5, 155–162.CrossRefGoogle Scholar
BMDP Statistical Software Manual (1990). University of California Press: Los Angeles, Cal.Google Scholar
Briscoe, M. E. (1982). Sex Differences in Psychological Well Being. Psychological Medicine Monograph Suppl. 1. Cambridge University Press: Cambridge.Google Scholar
Buchwald, D., Sullivan, J. & Komaroff, A. (1987). Frequency of ‘Chronic Active Epstein-Barr Virus Infection’ in a general medical practice. Journal of the American Medical Association 257, 2303–2307.CrossRefGoogle Scholar
Cathébras, P., Robbins, J., Kirmayer, L. & Hayton, B. (1992). Fatigue in primary care: prevalence, psychiatric comorbidity, illness behaviour and outcome. Journal of General Internal Medicine 7, 276–286.CrossRefGoogle ScholarPubMed
Chen, M. (1986). The epidemiology of self-perceived fatigue among adults. Preventive Medicine 15, 74–81.CrossRefGoogle ScholarPubMed
David, A. (1991). Postviral fatigue syndrome and psychiatry. British Medical Bulletin 47, 966–988.CrossRefGoogle ScholarPubMed
David, A., Wessely, S. & Pelosi, A. (1988). Post-viral fatigue: time for a new approach. British Medical Journal 296, 696–699.CrossRefGoogle Scholar
David, A., McDonald, E., Mann, A., Pelosi, A., Stephens, D., Ledger, D. & Rathbone, R. (1990). Tired, weak or in need of rest: fatigue among general practice attenders. British Medical Journal 301, 1199–1202.CrossRefGoogle ScholarPubMed
Dowsett, E., Ramsay, A., McCartney, R. & Bell, E. (1990). Myalgic encephalomyelitis, a persistent enteroviral infection? Postgraduate Medical Journal 66, 526–530.CrossRefGoogle ScholarPubMed
Essen-Moller, E. (1956). Individual traits and morbidity in a Swedish rural population. Acta Psychiatrica Scandinavica 100 (suppl), 1–160.Google Scholar
Fuhrer, R. & Rouillon, F. (1989). La version française de l'échelle CES-D: description et traduction de l'échelle d'auto-évaluation. Psychiatry and Psychobiology 4, 163–166.CrossRefGoogle Scholar
Fuhrer, R. & Rouillon, F. (1991). Psychotropic drug prescriptions in French primary care attenders: prevalence and relationship with depressive disorders.Paper presented at the World Psychiatric Association Symposium on Psychiatric Epidemiology and Social Sciences.Oslo,June 1991.Google Scholar
Goldberg, D. & Huxley, P. (1992). Common Mental Disorders: A Bio-Social Model. Tavistock: London.Google Scholar
Ho-Yen, D. & McNamara, I. (1991). General practitioners' experience of the chronic fatigue syndrome. British Journal of General Practice 41, 324–326.Google ScholarPubMed
Institut National de la Statistique et des Etudes Economiques (1983). Nomenclature des Catégories Socio-professionnelles. INSEE: Paris.Google Scholar
Janet, P. (1911). Les Obsessions et la Psychasthénie. Felix Alcan: Paris.Google Scholar
Jenkins, R. (1985). Sex Differences in Minor Psychiatric Morbidity. Psychological Medicine. Monograph 7 (suppl). Cambridge University Press: Cambridge.Google Scholar
Katon, W. & Russo, J. (1992). Chronic fatigue syndrome criteria: a critique of the requirement for multiple physical complaints. Archives of Internal Medicine 152, 1604–1609.CrossRefGoogle ScholarPubMed
Kroenke, K. & Mangelsdorff, D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy and outcome. American Journal of Medicine 86, 262–266.CrossRefGoogle ScholarPubMed
Kroenke, K., Wood, D., Mangelsdorff, D., Meier, N. & Powell, J. (1988). Chronic fatigue in primary care: prevalence, patient characteristics and outcome. Journal American Medical Association 260, 929–934.CrossRefGoogle Scholar
Lamberts, H. & Wood, M. (eds.) (1987). ICPC: International Classification of Primary Care. Oxford University Press: Oxford.Google Scholar
Lane, T., Matthews, D. & Manu, P. (1990). The low yield of physical examinations and laboratory investigations of patients with chronic fatigue. American Journal Medical Science 299, 313–318.CrossRefGoogle ScholarPubMed
Lewis, G. & Wessely, S. (1992). The epidemiology of fatigue: more questions than answers. Journal of Epidemiology and Community Health 46, 92–97.Google Scholar
Lloyd, A., Hickie, I., Boughton, C., Spencer, O. & Wakefield, D. (1990). Prevalence of chronic fatigue syndrome in an Australian population. Medical Journal of Australia 153, 522–528.Google Scholar
McDonald, E., David, A., Pelosi, A. & Mann, A. (1993). Chronic fatigue in general practice attenders. Psychological Medicine 23, 987–998.Google Scholar
Miettinen, O. (1974). Proportion of disease caused or prevented by a given exposure trait or intervention. American Journal of Epidemiology 99, 325–332.CrossRefGoogle ScholarPubMed
Morrell, D. (1972). Symptom interpretation in general practice. Journal of the Royal College of General Practitioners 22, 297–309.Google ScholarPubMed
Morrison, J. (1980). Fatigue as a presenting complaint in family practice. Journal of Family Practice 10, 795–801.Google ScholarPubMed
National Ambulatory Medical Care Survey (1988). USA: 1975–1981 and 1985 trends. US Dept. Health Human Services, Series 13, No. 93. National Center for Health Statistics: Hyattsville, Maryland.Google Scholar
Nelson, E., Kirk, J., McHugo, G., Douglass, R., Ohler, J., Wason, J. & Zubkoff, M. (1987). Chief complaint fatigue: a longitudinal study from the patient's perspective. Family Practice Research Journal 6, 175–188.Google Scholar
Office of Population Census and Surveys (1981). Morbidity Statistics from General Practice: Third National Survey. 1981–1982. HMSO: London.Google Scholar
Ormel, J., Van Den Brink, W., Koeter, M., Giel, R., Van Der Meer, K., Van De Willige, G. & Wilmink, F. (1990). Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study. Psychological Medicine 20, 909–923.CrossRefGoogle ScholarPubMed
Pawlikowska, T., Chalder, T., Hirsch, X., Wallace, P., Wright, D. J. M. & Wessely, S. C. (1994). Population based study of fatigue and psychological distress. British Medical Journal 308, 743–746.CrossRefGoogle ScholarPubMed
Payer, L. (1988). Medicine and Culture: Varieties of Treatment in the United States, West Germany and France. Henry Holt: New York.Google Scholar
Price, R., Dunkel, J., Fraser, V., Wessely, S. & Robins, L. (1990). Social and psychiatric correlates of chronic fatigue syndrome in a general population.Paper presented at the International Sociological Organization,Madrid,13 July 1990.Google Scholar
Radloff, L. (1977). The CES-D scale: a self report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401.CrossRefGoogle Scholar
Rubinstein, H. (1991). Le Virus de la De'prime, le Syndrome de la Fatigue Chronique. Bourin: Paris, France.Google Scholar
SAS Users's Guide (1991). Version 6. SAS Institute: Cary, North Carolina.Google Scholar
Shorter, E., (1992). From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. MacMillan: New York, NY.Google Scholar
Sugarman, J. & Berg, A. (1984). Evaluation of fatigue in a family practice. Journal of Family Practice 19, 643–647.Google Scholar
Valdini, A., Steinhardt, S. & Feldman, E. (1989). Usefulness of a standard battery of laboratory tests in investigating chronic fatigue in adults. Family Practice, 6, 286–291.Google Scholar
Wadsworth, M., Butterfield, W. & Blaney, R. (1971). Health and Sickness: The Choice of Treatment. Tavistock: London.Google Scholar
Wessely, S. (1989). The epidemiology of fatigue: evidence from a large UK National Survey. M.Sc. thesis, University of London.Google Scholar
Wessely, S. (1991 a). History of the postviral fatigue syndrome. British Medical Bulletin 47, 919–941.CrossRefGoogle ScholarPubMed
Wessely, S. (1991 b). Viruses and fatigue: the current status of the chronic fatigue syndrome. In Psychiatry and Biological Factors (ed. Kurstak, E.), pp. 231–256. Plenum: New York.Google Scholar
Wessely, S. (1994). The epidemiology of chronic fatigue syndrome. In Epidemiologic Reviews (ed. Anthony, J., Eaton, W. and Henderson, S.), 17, 1–13.Google Scholar
Wessely, S. & Powell, R. (1989). Fatigue syndromes: a comparison of chronic ‘postviral’ fatigue with neuromuscular and affective disorders. Journal of Neurology, Neurosurgery and Psychiatry 52, 940–948.CrossRefGoogle ScholarPubMed
Wessely, S., Nickson, J. & Cox, B. (1990). Symptoms of low blood pressure: a population study. British Medical Journal 301, 363–365.CrossRefGoogle ScholarPubMed