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Cited by 106Fibromyalgia and Chronic Fatigue Syndrome ResearchPsychosomatic Disorders and Their TreatmentsLong-Term Effects of COVID-19

Temporal relations between unexplained fatigue and depression: longitudinal data from an international study in primary care

Skapinakis, Petros, Lewis, Glyn, Mavreas, Venetsanos·2004·Psychosomatic Medicine
DOI 10.1097/01.psy.0000124757.10167.b1
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Abstract

OBJECTIVE: Unexplained fatigue syndromes, such as chronic fatigue syndrome and neurasthenia, are strongly associated with depression, but the temporal nature of this association is not clear. METHODS: The authors examined this issue by using data from the World Health Organization collaborative study of psychological problems in general health care. Three thousand two hundred one subjects from 15 primary care centers in 14 countries were followed up for 12 months. The Composite International Diagnostic Interview was the main instrument used. Odds ratios and their 95% confidence intervals (CI) were calculated using logistic regression models adjusted for sociodemographic variables, physical morbidity and intercenter variability. RESULTS: Cases of depression were found to have an increased risk of developing a new episode of unexplained fatigue at follow-up with an adjusted odds ratio of 4.15 (95% CI = 2.64-6.54). Similarly, cases of unexplained fatigue were found to have an increased risk of developing a new episode of depression at follow-up with an adjusted odds ratio of 2.76 (95% CI = 1.32-5.78). Further adjustment for subthreshold symptoms at baseline weakened the reported associations, especially between fatigue and development of a new episode of depression, but these remained significant. CONCLUSIONS: The findings support the view that unexplained fatigue and depression might act as independent risk factors for each other.

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  • Fatigue is strongly associated with depression, and longitudinal studies show fatigue is a risk factor for depression and vice versa.

    “It is strongly associated with depression (Wessely et al., 1996; Bakshi et al., 2000; Kroencke et al., 2000; Pittion-Vouyovitch et al., 2006), and longitudinal studies have demonstrated that fatigue represents a risk factor for depression (and vice versa; Skapinakis et al., 2004).”

    From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Skapinakis et al., 2004

  • Longitudinal studies have shown that the causal relation between fatigue and depression is unlikely to be unidirectional, but that both act as independent risk factors for each other.

    “Longitudinal studies have shown that the causal relation between fatigue and depression is unlikely to be unidirectional, but that both act as independent risk factors for each other (Skapinakis et al., 2004).”

    From Allostatic Self-efficacy: A Metacognitive Theory of Dyshomeostasis-Induced Fatigue and Depression (2016) · cites this paper as Skapinakis et al., 2004

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Authors
Skapinakis, P., Lewis, G., & Mavreas, V.
Affiliations
University of Ioannina (GR)
Corresponding author
Skapinakis, Petros
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2004-05
Volume
66
Issue
3
Pages
330-335
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/01.psy.0000124757.10167.b1
OpenAlex
W2056886136
Cited by
106
References
23
Citations by year
2026: 4 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 2 · 2016: 7 · 2015: 9 · 2014: 3 · 2013: 9 · 2012: 10
FWCI
3.11
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
  • Explore Bristol Research (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Keywords
unexplained fatigue, chronic fatigue syndrome, neurasthenia, depression, temporal relations, bidirectional relationship, subthreshold symptoms, primary care, risk factors, longitudinal follow-up
MeSH terms
Adult, Cross-Sectional Studies, Cross-Cultural Comparison, Depressive Disorder, Female, Follow-Up Studies, Health Status, Health Surveys, Humans, Longitudinal Studies, Male, Neurasthenia, Primary Health Care, Psychiatric Status Rating Scales, Surveys and Questionnaires, Risk Factors, World Health Organization, Fatigue Syndrome, Chronic, Comorbidity, Prevalence, Logistic Models, Odds Ratio, International Classification of Diseases

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