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Prevalence, Patient Characteristics, and Outcome

Kurt Kroenke, MD; David R. Wood, DO; A. David Mangelsdorff, PhD, MPH; Nancy J. Meier, RN; John B. Powell, PhD

JAMA. 1988;260(7):929-934.

Abstract
Although fatigue is one of the most common complaints in ambulatory care, research has been minimal. Of the 1159 consecutive patients surveyed in two adult primary-care clinics, 276 (24%) indicated that fatigue was a major problem. Fatigue was more prevalent in women than in men (28% vs 19%). Extensive clinical, laboratory, psychometric, and functional data were gathered for 102 fatigued patients and 26 controls. Laboratory testing was not useful in detecting unsuspected medical conditions or in determining the cause of fatigue. Depression or somatic anxiety or both were suggested by screening psychometric instruments in 82 fatigued patients (80%) compared with three controls (12%). Global dysfunction was marked, as reported by patients on the Sickness Impact Profile. The mean score on the Sickness Impact Profile of 11.3 for fatigued patients is similar to that reported for patients with major medical illnesses. After one year of follow-up, only 29 fatigued patients (28%) had improved. The high prevalence, persistence, and functional consequences of fatigue mandate a search for effective therapy.

(JAMA 1988;260:929-934)

Author Affiliations
From the Departments of Medicine (Drs Kroenke and Wood and Ms Meier) and Psychology (Dr Powell), Brooke Army Medical Center, and Health Care Studies and Clinical Investigation Activity, Health Services Command (Dr Magelsdorff), Fort Sam Houston, Tex.

Footnotes
Read before the National Meeting of the Society for Research and Education in Primary Care Internal Medicine, San Diego, May 1, 1987, and the Conference on Mental Disorders in General Health Care Settings of the National Institute of Mental Health, Seattle, June 25, 1987.

The opinions or assertions herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Box 523, Beach Pavilion, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200 (Dr Kroenke).

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