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The British Journal of Psychiatry (2003) 182: 205-209
© 2003 The Royal College of Psychiatrists

Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care

PETROS SKAPINAKIS, MPH

Departments of Psychiatry, University of Bristol, UK and University of Ioannina School of Medicine, Greece

GLYN LEWIS, FRCPsych

Department of Psychiatry, University of Bristol, UK

VENETSANOS MAVREAS, PhD

Department of Psychiatry, University of Ioannina School of Medicine, Greece

Correspondence: Petros Skapinakis, Department of Psychiatry, University of Bristol, Cotham House, Cotham Hill, Bristol BS6 6JL, UK. E-mail: p.skapinakis{at}bristol.ac.uk

Declaration of interest None.

Background Unexplained fatigue has been extensively studied but most of the samples used were from Western countries.

Aims To present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.

Method Secondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.

Results The prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17-4.33) and 15.05 (95% CI 10.85-20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.

Conclusions In less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.




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