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General Practice

Population based study of fatigue and psychological distress

BMJ 1994; 308 doi: (Published 19 March 1994) Cite this as: BMJ 1994;308:763
  1. T Pawlikowska,
  2. T Chalder,
  3. S R Hirsch,
  4. P Wallace,
  5. D J M Wright,
  6. S C Wessely
  1. Department of General Practice, St Mary's Hospital Medical School, London
  2. Department of Psychological Medicine, King's College School of Medicine and Dentistry, London SE5 9RS
  3. Departments of Medical Microbiology and Psychiatry, Charing Cross Hospital Medical School, London
  4. Department of General Practice, Royal Free Hospital School of Medicine, London NW3
  1. Correspondence to Dr Wessely.


    Abstract Objectives: To determine the prevalence of fatigue in the general population and the factors associated with fatigue.

    Design: Postal survey.

    Setting: Six general practices in southern England.

    Subjects: 31 651 men and women aged 18-45 years registered with the practices.

    Main outcome measures: Responses to the 12 item general health questionnaire and a fatigue questionnaire which included self reported measures of duration, severity, and causes of fatigue. Results - 15 283 valid questionnaires were returned, giving a response rate of 48.3%, (64% after adjustment for inaccuracies in the practice registers). 2798 (18.3%) of respondents reported substantial fatigue lasting six months or longer. Fatigue and psychological morbidity were moderately correlated (r=0.62). Women were more likely to complain of fatigue than men, even after adjustment for psychological distress. The commonest cited reasons for fatigue were psychosocial (40% of patients). Of 2798 patients with excessive tiredness, only 38 (1.4%) attributed this to the chronic fatigue syndrome.

    Conclusion: Fatigue is distributed as a continuous variable in the community and is closely associated with psychological morbidity.

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