Prolonged fatigue in Ukraine and the United States: prevalence and risk factors

Abstract

Background: Prolonged, severe, unalleviated fatigue may be disabling whether it occurs on its own or in conjunction with medical or psychiatric conditions. This paper compares the prevalence and correlates of prolonged fatigue in general population samples in Ukraine versus the US. Methods: Population surveys were conducted in 2002 in both Ukraine (Ukraine World Mental Health [WMH] Survey) and the US (National Comorbidity Survey-Replication; NCS-R). Both surveys administered the Composite International Diagnostic Interview (CIDI 3.0), which contained modules assessing: neurasthenia (prolonged fatigue); mood, anxiety, and alcohol/drug use disorders; chronic medical conditions; and demographic characteristics. Multivariable logistic regression was used to examine risk factors in each country. Results: The lifetime prevalence of prolonged fatigue was higher in Ukraine (5.2%) than the US (3.7%). In both countries, one-fifth of individuals with prolonged fatigue had no medical or DSM-IV psychiatric condition. Also in both settings, fatigue was significantly associated with socio-demographic characteristics (being female, not working, and married before) as well as early onset and adult episodes of mood/anxiety disorder. Fatigue prevalence in Ukraine increased with age, but decreased in the US at age 70. Unique risk factors for fatigue in Ukraine included lower socio-economic status, Ukrainian versus Russian ethnicity, and cardiovascular disease. Unique risk factors in the US were parental depression/anxiety, adult episodes of alcohol/drugs, pain conditions, and other health problems. Conclusions: The lifetime prevalence of prolonged fatigue in Ukraine was 40% higher than that found in US data. In addition, fatigue prevalence increased sharply with age in Ukraine perhaps due to limited social and medical resources and greater comorbidity.