Psychiatric disorders and medical care utilization among people in the general population who report fatigue.

OBJECTIVE

To study the prevalence of fatigue in the general population and its association with psychiatric disorders, somatization, and medical utilization.

SETTING

The public-use data tape from the 1984 National Institute of Mental Health Epidemiologic Catchment Area Study.

PARTICIPANTS

Household sample of 18,571 subjects.

INTERVENTIONS

Structured psychiatric interviews were reviewed to study the prevalence of complaints of current and lifetime fatigue and their relationship to selected psychiatric disorders.

RESULTS

Fatigue has high current (6.7%) and lifetime (24.4%) prevalences in the general population. Medically unexplained fatigue also has high current (6.0%) and lifetime (15.5%) prevalences. When compared with those reporting no current fatigue, subjects who reported current (one-month) fatigue were significantly more likely to have experienced current and lifetime episodes of major depression, dysthymic disorder, panic disorder, and somatization disorder. They also had significantly higher mean numbers of lifetime and current DSM-III psychiatric diagnoses, medically unexplained physical symptoms (not just fatigue-related symptoms), and visits to health care providers than did patients without current episodes of fatigue.

CONCLUSIONS

The high prevalence of fatigue in the general population appears to be significantly associated with increased lifetime and current risk for affective, anxiety, and somatoform disorders, as well as increased utilization of medical services. These data suggest that assessment of both medical and psychological health may be essential for the proper care of patients with fatigue.