JRSM > Volume 97, Number 12 > Pp. 571-575

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Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001

Arlene M Gallagher MSc  ¹ Janice M Thomas MSc  ¹ William T Hamilton FRCGP  ²   Peter D White MD  ¹

¹ Centre for Psychiatry and Department of Information Services, Queen Mary School of Medicine and Dentistry, St Bartholomew's Hospital, London EC1A 7BE
² Division of Primary Health Care, University of Bristol, Bristol BS6 6JL, UK

Correspondence to: Professor P D White, Department of Psychological Medicine, Barts and the London, Queen Mary's School of Medicine and Dentistry, St Bartholomew's Hospital, London EC1A 7BE, UK E-mail: p.d.white{at}qmul.ac.uk

Little is known about whether the incidence of symptoms of fatigue presented in primary care, and the consequent diagnoses made, change over time. The UK General Practice Research Database was used to investigate the annual incidence of both fatigue symptoms and diagnoses recorded in UK primary care from 1990 to 2001.

The overall incidence of all fatigue diagnoses decreased from 87 per 100 000 patients in 1990 to 49 in 2001, a reduction of 44%, while postviral fatigue syndromes decreased from 81% of all fatigue diagnoses in 1990 to 60% in 2001. Chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME) together increased from 9% to 26% of all fatigue diagnoses. The incidence of fibromyalgia increased from less than 1 per 100 000 to 35 per 100 000. In contrast, there was no consistent change in the incidence of all recorded symptoms of fatigue, with an average of 1503 per 100 000, equivalent to 1.5% per year. CFS/ME and fibromyalgia were rarely diagnosed in children and were uncommon in the elderly. All symptoms and diagnoses were more common in females than in males.

The overall incidence of fatigue diagnoses in general has fallen, but the incidence rates of the specific diagnoses of CFS/ME and fibromyalgia have risen, against a background of little change in symptom reporting. This is likely to reflect fashions in diagnostic labelling rather than true changes in incidence.

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