Comparative epidemiology of chronic fatigue syndrome in Brazilian and British primary care: prevalence and recognition

Br J Psychiatry. 2009 Feb;194(2):117-22. doi: 10.1192/bjp.bp.108.051813.

Abstract

Background: Although fatigue is a ubiquitous symptom across countries, clinical descriptions of chronic fatigue syndrome have arisen from a limited number of high-income countries. This might reflect differences in true prevalence or clinical recognition influenced by sociocultural factors.

Aims: To compare the prevalence, physician recognition and diagnosis of chronic fatigue syndrome in London and São Paulo.

Method: Primary care patients in London (n=2459) and São Paulo (n=3914) were surveyed for the prevalence of chronic fatigue syndrome. Medical records were reviewed for the physician recognition and diagnosis.

Results: The prevalence of chronic fatigue syndrome according to Centers for Disease Control 1994 criteria was comparable in Britain and Brazil: 2.1% v. 1.6% (P=0.20). Medical records review identified 11 diagnosed cases of chronic fatigue syndrome in Britain, but none in Brazil (P<0.001).

Conclusions: The primary care prevalence of chronic fatigue syndrome was similar in two culturally and economically distinct nations. However, doctors are unlikely to recognise and label chronic fatigue syndrome as a discrete disorder in Brazil. The recognition of this illness rather than the illness itself may be culturally induced.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Chronic Disease
  • Cross-Cultural Comparison
  • Epidemiologic Methods
  • Fatigue / diagnosis
  • Fatigue / epidemiology
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care / organization & administration
  • Primary Health Care / statistics & numerical data*
  • Severity of Illness Index
  • United Kingdom / epidemiology
  • Young Adult