The epidemiology of chronic fatigue in San Francisco

After years of relative obscurity, the problems of patients with excessive fatigue that defies simple explanation are again in the news. These symptoms are now acquiring the label "chronic fatigue syndrome" (CFS). The subject of CFS is extraordinarily rich and complex. Recent reviews and chapters have considered the condition from the point of view of such diverse disciplines as anthropology, endocrinology, history, immunology, neurophysiology, neuropsychology, psychiatry, and virology. Progress has been made in many of these fields, although consensus remains elusive. This review concerns the epidemiology of CFS, and it will therefore emphasize studies that have taken a population or primary care perspective. Readers requiring detailed information on nonepidemiologic aspects of CFS are referred elsewhere (1, 2).

The Epidemiology of Chronic Fatigue Syndrome

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)65450-5.pdf

Chronic fatigue syndrome

/pdf/the-epidemiology-of-chronic-fatigue-syndrome-3xawlubteo.pdf

The epidemiology of chronic fatigue syndrome

Background: Chronic Fatigue Syndrome (CFS) is characterized by unexplained fatigue that lasts for at least 6 months alongside a constellation of other symptoms. CFS was historically thought to be most common among White women of higher socio-economic status. However, some recent studies in the USA suggest that the prevalence is actually higher in some minority ethnic groups. If there are convincing differences in prevalence and risk factors across all or some ethnic groups, investigating the causes of these can help unravel the pathophysiology of CFS. Methods: A systematic review was conducted to explore the relationship between fatigue, chronic fatigue (CF-fatigue lasting for 6 months), CFS and ethnicity. Studies were population-based and health servicebased. Meta-analysis was also conducted to examine the population prevalence of CF and CFS across ethnic groups. Results: Meta-analysis showed that compared with the White American majority, African Americans and Native Americans have a higher risk of CFS [Odds Ratio (OR) 2.95, 95% confidence interval (CI): 0.69-10.4; OR = 11.5, CI: 1.1-56.4, respectively] and CF (OR = 1.56, CI: 1.03-2.24; OR = 3.28, CI: 1.63-5.88, respectively). Minority ethnic groups with CF and CFS experience more severe symptoms and may be more likely to use religion, denial and behavioural disengagement to cope with their condition compared with the White majority. Conclusions:Hashizume Although available studies and data are limited, it does appear that some ethnic minority groups are more likely to suffer from CF and CFS compared with White people. Ethnic minority status alone is insufficient to explain ethnic variation of prevalence. Psychosocial risk factors found in high-risk groups and ethnicity warrant further investigation to improve our understanding of aetiology and the management of this complex condition. Published by Oxford University Press on behalf of the International Epidemiological Association. © The Author 2009.

Denise Koo

Papers

Fatiguing illness among employees in three large state office buildings, California, 1993: Was there an outbreak?