Psychiatric disorders and medical care utilization among people in the general population who report fatigue
Abstract
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.
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Elevated anxiety is linked to elevated risk for fatigue.
“More broadly, elevated anxiety is linked to elevated risk for full-blown anxiety disorders [20], major depression and depressive symptoms [21], and fatigue [22].”
Non-depressed individuals with fatigue are at a higher risk for developing MDD later in life compared with individuals without fatigue.
“Non-depressed individuals with fatigue are at a higher risk for developing MDD later in life compared with individuals without fatigue (Addington et al., 2001; Kroenke and Price, 1993; Walker et al., 1993).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Walker et al., 1993
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- Authors
- Walker, E. A., Katon, W. J., & Jemelka, R. P.
- Affiliations
- University of Washington (US)
- Venue
- Journal of General Internal Medicine
- Published
- 1993-08
- Volume
- 8
- Issue
- 8
- Pages
- 436-440
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- OpenAlex
- W1984083575
- Cited by
- 128
- References
- 28
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 6 · 2020: 1 · 2019: 4 · 2018: 8 · 2017: 3 · 2016: 5 · 2015: 7 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- fatigue, mental illness, somatization, health care utilization, major depressive disorder, dysthymia, panic disorder, somatoform disorders, mood disorders, anxiety disorders, prevalence, medical visits, psychiatric comorbidity
- MeSH terms
- Adult, Aged, Mental Disorders, Chronic Disease, Fatigue, Female, Health Services, Humans, Male, Middle Aged, Somatoform Disorders, United States, Fatigue Syndrome, Chronic, Prevalence, Odds Ratio
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