The British Journal of Psychiatry (2009) 194: 117-122. doi: 10.1192/bjp.bp.108.051813
© 2009 The Royal College of Psychiatrists
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Comparative epidemiology of chronic fatigue syndrome in Brazilian and British primary care: prevalence and recognition

Hyong Jin Cho, MD, MSc, PhD

Department of Psychiatry, Federal University of São Paulo, Brazil, and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Paulo Rossi Menezes, MD, MSc, PhD

Department of Preventive Medicine, University of São Paulo Medical School, and Section of Epidemiology, University Hospital, University of São Paulo, Brazil

Matthew Hotopf, BSc, MBBS, MRCPsych, MSc, PhD

Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Dinesh Bhugra, MPhil, FRCPsych, PhD

Health Services Research Department, Institute of Psychiatry, King's College London, UK

Simon Wessely, MD, FRCPsych

Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK

Correspondence: H. J. Cho, Department of Psychiatry, Federal University of São Paulo, Rua Botucatu 740, CEP 04023-900, São Paulo, Brazil. Email: h.cho{at}iop.kcl.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Although fatigue is a ubiquitous symptom across countries, clinical descriptions of chronic fatigue syndrome have arisen from a limited number of high-income countries. This might reflect differences in true prevalence or clinical recognition influenced by sociocultural factors.

Aims

To compare the prevalence, physician recognition and diagnosis of chronic fatigue syndrome in London and São Paulo.

Method

Primary care patients in London (n=2459) and São Paulo (n=3914) were surveyed for the prevalence of chronic fatigue syndrome. Medical records were reviewed for the physician recognition and diagnosis.

Results

The prevalence of chronic fatigue syndrome according to Centers for Disease Control 1994 criteria was comparable in Britain and Brazil: 2.1% v. 1.6% (P=0.20). Medical records review identified 11 diagnosed cases of chronic fatigue syndrome in Britain, but none in Brazil (P<0.001).

Conclusions

The primary care prevalence of chronic fatigue syndrome was similar in two culturally and economically distinct nations. However, doctors are unlikely to recognise and label chronic fatigue syndrome as a discrete disorder in Brazil. The recognition of this illness rather than the illness itself may be culturally induced.


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