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9 - Depression and chronic fatigue

from Part 2 - Depression and specific health problems

Published online by Cambridge University Press:  17 September 2009

By
Peter D. White
Edited by
Andrew Steptoe
Peter D. White
Affiliation:
Department of Psychological Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK
Andrew Steptoe
Affiliation:
University College London
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Summary

Introduction

This chapter reviews fatigue as a symptom and some of its syndromes, including chronic fatigue syndrome and vital exhaustion. The chapter also reviews the similarities and differences between fatigue and depression. The links include common symptoms, sleep disturbance, physical inactivity and common treatments with both cognitive – behavioural therapy (CBT) and graded exercise therapy. The differences involve aetiology, pathophysiology, nosology and response to antidepressants. Depression and fatigue should be considered as separate phenomena with common presentations and associations.

Epidemiology of fatigue

Fatigue is a common symptom in both the community and primary care. Between 10% and 20% of people in the community, if asked, will admit to feeling abnormally tired at any one time [1]. At the same time, fatigue is distributed continuously within the community, with no point of rarity [2]. Therefore, any cut-off is arbitrary, and the prevalence will vary by definition of fatigue, how the question is asked or the symptom volunteered, and its context; for instance, fewer people volunteer fatigue to their general practitioner (GP). Studies of fatigue reporting to primary-care doctors from Ireland and Holland calculated annual incidences of 6.5 and 5.3 reports per 100 patients, respectively [3, 4]. One study showed that the incidence of the complaint of fatigue and its synonyms (e.g. tired, worn out, exhausted) recorded by GPs in the UK did not change in the 12 years between 1990 and 2001, being reported by 1.5% of GP attenders per annum [5].

Keywords

chronic fatigue syndromedepressionhypothalamic-pituitary-adrenal axismelancholic depressive illnessvital exhaustionpathophysiological differencesmyalgic encephalomyelitis
Type
Chapter
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Depression and Physical Illness , pp. 195 - 210
Publisher: Cambridge University Press
Print publication year: 2006

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  • Depression and chronic fatigue
    • By Peter D. White, Department of Psychological Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.010
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  • Depression and chronic fatigue
    • By Peter D. White, Department of Psychological Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.010
Available formats
×

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  • Depression and chronic fatigue
    • By Peter D. White, Department of Psychological Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, London, UK
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.010
Available formats
×