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. 2015 Dec;79(6):484-91.
doi: 10.1016/j.jpsychores.2015.10.004. Epub 2015 Oct 19.

Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue

J McBeth  1 , B Tomenson  2 , C A Chew-Graham  3 , G J Macfarlane  4 , J Jackson  5 , A Littlewood  6 , F H Creed  5
Affiliations

Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue

J McBeth et al. J Psychosom Res. 2015 Dec.

Abstract

Objective: Chronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety.

Methods: We 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.

Results: Of 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.

Discussion: This 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.

Keywords: Chronic fatigue; Epidemiology; Fibromyalgia; Functional somatic syndromes; Medically unexplained symptoms; Population based.

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Figures

Fig. 1
Fig. 1
Flow of study participants.
Fig. 2
Fig. 2
a comparison of symptom groups with and without anxiety/depression: risk factors with a common effect across the symptoms. Fig. 2b comparison of symptom groups with and without anxiety/depression: risk factors without a common effect across the symptoms.
See this image and copyright information in PMC

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