Abstract
ObjectiveChronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety. MethodsWe mailed questionnaires to a randomly selected sample of people in the UK to identify participants with chronic widespread pain (ACR 1990 definition) and those with chronic fatigue. The questionnaire assessed sociodemographic factors, health status, healthcare use, childhood factors, adult attachment, and psychological stress including anxiety and depression. To identify persons with unexplained chronic widespread pain or unexplained chronic fatigue; we examined participant's medical records to exclude medical illness that might cause these symptoms. ResultsOf 1443 participants (58.0% response rate) medical records of 990 were examined. 9.4% (N=93) had unexplained chronic widespread pain and 12.6% (N=125) had unexplained chronic fatigue. Marital status, childhood psychological abuse, recent threatening experiences and other somatic symptoms were commonly associated with both widespread pain and fatigue. No common effect was found for few years of education and current medical illnesses (more strongly associated with chronic widespread pain) or recent illness in a close relative, neuroticism, depression and anxiety scores (more strongly associated with chronic fatigue). Putative associated factors with a common effect were associated with unexplained chronic widespread pain or unexplained chronic fatigue only when there was concurrent anxiety and/or depression. DiscussionThis study suggests that the associated factors for chronic widespread pain and chronic fatigue need to be studied in conjunction with concurrent depression/anxiety. Clinicians should be aware of the importance of concurrent anxiety or depression.
Highlights
Chronic widespread pain and chronic fatigue are common and may be disabling; they have complex aetiologies [1,2,3,4,5,6,7,8]
depression and anxiety were much more closely associated with chronic fatigue than the other symptoms groups
general medical illness appears to be independent of psychiatric disorder
Summary
Chronic widespread pain and chronic fatigue are common and may be disabling; they have complex aetiologies [1,2,3,4,5,6,7,8]. Commonly occur in individuals with chronic fatigue and the risk factors for chronic fatigue differ between those with, and those without, concurrent anxiety or depression [15]. It is plausible that the observation of common associated factors across chronic fatigue and chronic widespread pain is explained by co-morbid anxiety and depression. The aim of this study was to test the hypothesis that the associated factors commonly associated with both chronic widespread pain and chronic fatigue would be explained by the presence of concurrent depression/ anxiety
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