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The European Journal of Public Health Advance Access published online on August 18, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckp113
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Fatigue and chronic fatigue syndrome-like complaints in the general population*

Marjolein van’t Leven1,2, Gerhard A. Zielhuis1, Jos W. van der Meer3, André L. Verbeek1 and Gijs Bleijenberg2

1 Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, the Netherlands
2 Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, the Netherlands
3 Department of Internal Medicine, Radboud University Nijmegen Medical Centre, the Netherlands

Correspondence: Prof. GA Zielhuis, Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, 133, PO Box 9101, 6500 HB Nijmegen, the Netherlands, tel: +31 24 3616975, fax: +31 24 3613505, e-mail: g.zielhuis{at}ebh.umcn.nl

Received January 19, 2009 , accepted July 15, 2009

Background: Most knowledge on chronic fatigue (CF) and chronic fatigue syndrome (CFS) is based on clinical studies, not representative of the general population. This study aimed to assess the prevalence of fatigue in an adult general population and to identify associations with lifestyle factors. Methods: Total 22 500 residents of Nijmegen were selected at random and interviewed by questionnaire. Data on 9062 respondents (43% response) were analysed, taken into account age, gender and concomitant disease. Subjects were classified into four groups: not fatigued (NF, reference group), short-term fatigue (SF, <6 months), chronic fatigue (CF, ≥6 months) and CFS-like fatigue (in accordance with the Center for Disease Control criteria for CFS, without clinical confirmation). Results: Our study population showed the following breakdown: NF 64.4% (95% CI 63.6–65.6%), SF 4.9% (95% CI 4.5–5.4%), CF 30.5% (95% CI 29.5–31.4%) and CFS-like fatigue 1.0% (95% CI 0.8–1.2%). Compared with the NF group, more of the CFS respondents were female [odds ratio (OR) = 1.9], obese (OR = 4.1), using analgesics (OR = 7.8), had a low alcohol intake (OR = 0.4), were eating less healthy food (OR = 0.5) and were physically less active (OR = 0.1). These associations largely applied to the SF and CF group. The fatigue could have been due to a concomitant disease in 34 and 55.5% of the SF and CF cases, respectively. Conclusion: The prevalence of CF in the general population appears to be much higher than previously indicated. Even with strict criteria for CFS, it is estimated that ~1% of the adult population experiences this condition. Interestingly, a large part of this group remains unrecognized by the general practitioner. A striking similarity in lifestyle pattern between SF, CF and CFS calls for further research.

Keywords: chronic fatigue, epidemiology, lifestyle.


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Fatigue and the general practitioner
Peter Lucassen, et al.
The European Journal of Public Health, 7 Sep 2009 [Full text]
Re: Fatigue and the general practitioner
Gerhard A Zielhuis, et al.
The European Journal of Public Health, 28 Sep 2009 [Full text]

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