Psychiatric Morbidity and Illness Experience of Primary Care Patients With Chronic Fatigue in Hong Kong

2000 ◽  
Vol 157 (3) ◽  
pp. 380-384 ◽  
Author(s):  
S. Lee
Keyword(s):  
Primary Care ◽  
Hong Kong ◽  
Psychiatric Morbidity ◽  
Chronic Fatigue ◽  
Illness Experience ◽  
Primary Care Patients

One-year outcome of unexplained fatigue syndromes in primary care: results from an international study

2003 ◽  
Vol 33 (5) ◽  
pp. 857-866 ◽  
Author(s):  
P. SKAPINAKIS ◽  
G. LEWIS ◽  
V. MAVREAS
Keyword(s):  
Primary Care ◽  
Psychiatric Morbidity ◽  
Collaborative Study ◽  
International Study ◽  
Composite International Diagnostic Interview ◽  
Chronic Fatigue ◽  
Diagnostic Interview ◽  
One Year ◽  
Definition Of ◽  
Stages Of Economic Development

Background. Outcome studies of chronic fatigue, neurasthenia and other unexplained fatigue syndromes are few and have been carried out in developed Western countries. This paper aimed to study the outcome of unexplained fatigue syndromes in an international primary care sample and to identify risk factors for persistence.Method. We used data from the WHO collaborative study of psychological problems in general health care, in which 3201 primary care attenders from 14 countries were followed-up for 12 months. The assessment included a modified version of the Composite International Diagnostic Interview.Results. Unexplained fatigue persisted in one-fifth to one-third of the subjects depending on the definition of fatigue. From the factors studied only severity of fatigue and psychiatric morbidity at baseline were associated with persistence 12 months later. Outcome did not differ between countries of different stages of economic development.Conclusions. The prognosis of fatigue syndromes in international primary care is relatively good. The study underlines the importance of psychological factors in influencing short-term prognosis.

scholarly journals Comparative epidemiology of chronic fatigue syndrome in Brazilian and British primary care: prevalence and recognition

2009 ◽  
Vol 194 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Hyong Jin Cho ◽  
Paulo Rossi Menezes ◽  
Matthew Hotopf ◽  
Dinesh Bhugra ◽  
Simon Wessely
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Medical Records ◽  
Chronic Fatigue ◽  
Sao Paulo ◽  
Sociocultural Factors ◽  
São Paulo ◽  
Fatigue Syndrome ◽  
Primary Care Patients ◽  
Comparative Epidemiology

BackgroundAlthough 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.AimsTo compare the prevalence, physician recognition and diagnosis of chronic fatigue syndrome in London and São Paulo.MethodPrimary 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.ResultsThe 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).ConclusionsThe 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.

Chronic fatigue in primary care attenders

1993 ◽  
Vol 23 (4) ◽  
pp. 987-998 ◽  
Author(s):  
Elizabeth McDonald ◽  
Anthony S. David ◽  
Anthony J. Pelosi ◽  
Anthony H. Mann
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Psychological Factors ◽  
Primary Care Physicians ◽  
Psychiatric Morbidity ◽  
Chronic Fatigue ◽  
Interview Schedule ◽  
Physical Evaluation ◽  
Fatigue Syndrome ◽  
Persistent Fatigue

SynopsisFrom 686 patients attending primary care physicians, 77 were identified by a screening procedure as having chronic fatigue. Of these, 65 were given a comprehensive psychological, social and physical evaluation. Seventeen cases (26%) met criteria for the chronic fatigue syndrome. Forty-seven (72%) received an ICD-9 diagnosis of whom 23 had neurotic depression, with a further 5 meeting criteria for neurasthenia. Forty-nine were ‘cases’ as defined by the revised Clinical Interview Schedule (CIS-R), and 42 if the fatigue item was excluded. Psychiatric morbidity was more related to levels of social stresses than was severity of fatigue. The main difference between these subjects and those examined in hospital settings is that the former are less liable to attribute their symptoms to wholly physical causes, including viruses, as opposed to social or psychological factors. Identification and management of persistent fatigue in primary care may prevent the secondary disabilities seen in patients with chronic fatigue syndromes.

A Comparison of the Characteristics of Chronic Fatigue Syndrome in Primary and Tertiary Care

1996 ◽  
Vol 168 (1) ◽  
pp. 121-126 ◽  
Author(s):  
R. Euba ◽  
T. Chalder ◽  
A. Deale ◽  
S. Wessely
Keyword(s):  
Primary Care ◽  
Chronic Fatigue Syndrome ◽  
Selection Bias ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Chronic Fatigue ◽  
Physical Illness ◽  
Hospital Unit ◽  
Fatigue Syndrome ◽  
Operational Criteria

BackgroundTo evaluate the characteristics of Chronic Fatigue Syndrome (CFS) in primary and tertiary care.MethodA comparison of subjects fulfilling criteria for CFS seen in primary care and in a hospital unit specialising in CFS. Subjects were 33 adults fulfilling criteria for CFS, identified as part of a prospective cohort study in primary care, compared to 79 adults fulfilling the same criteria referred for treatment to a specialist CFS clinic.ResultsHospital cases were more likely to belong to upper socio-economic groups, and to have physical illness attributions. They had higher levels of fatigue and more somatic symptoms, and were more impaired functionally, but had less overt psychological morbidity. Women were over-represented in both primary care and hospital groups. Nearly half of those referred to a specialist clinic did not fulfil operational criteria for CFS.ConclusionThe high rates of psychiatric morbidity and female excess that characterise CFS in specialist settings are not due to selection bias. On the other hand higher social class and physical illness attributions may be the result of selection bias and not intrinsic to CFS.

scholarly journals Primary care psychiatry: pertinent Arabian perspectives

2005 ◽  
Vol 11 (3) ◽  
pp. 449-458
Author(s):  
O. E. El Rufaie
Keyword(s):  
Primary Care ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Validity And Reliability ◽  
Critical Approach ◽  
Primary Care Doctors ◽  
Primary Care Patients ◽  
Primary Care Practitioners ◽  
Training Programmes ◽  
And Training

There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors

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