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The epidemiology of chronic fatigue in San Francisco.

Steele L, Dobbins JG, Fukuda K, Reyes M, Randall B, Koppelman M, Reeves WC.
The epidemiology of chronic fatigue in San Francisco.
Am J Med 105(3A):83S-90S, 1998.

Summary

Important questions remain about the epidemiology of CFS and unexplained chronic fatigue, particularly about the extent to which they affect minority and lower income populations. The purpose of this cross-sectional telephone survey was to describe the prevalence and demographic distribution of conditions associated with chronic fatigue in residents of San Francisco, California. Interviews were completed for 16,970 individuals. Two percent of adult respondents reported unexplained chronic fatigue, defined as severe fatigue lasting 6 months or longer, not explained by self-reported diagnoses. About one-tenth of those with unexplained chronic fatigue (0.2% of the study population) met criteria for a CFS-like illness, based on self-reported symptoms. The prevalence of CFS-like illness was elevated among blacks and Native Americans (lower among Asians), and was most common among women and persons with annual household incomes below $40,000.

Abstract

Purpose: Despite considerable research on chronic fatigue syndrome (CFS) and conditions associated with unexplained fatigue, little is known about their prevalence and demographic distribution in the population. The present study describes the epidemiology and characteristics of self-reported chronic fatigue syndrome and related conditions in a diverse urban community.

Methods: The study used a cross-sectional telephone screening survey of households in San Francisco, followed by interviews with fatigued and non-fatigued residents. Respondents who appeared to meet case definition criteria for CFS, based on self-reported fatigue characteristics, symptoms, and medical history, were classified as CFS-like cases. Subjects who reported idiopathic chronic fatigue (ICF) that did not meet CFS criteria were classified as ICF-like cases.

Results: Screening interviews were completed for 8004 households, providing fatigue and demographic information for 16,970 residents. Unexplained chronic fatigue was extremely rare among household residents under 18 years of age, but was reported by two percent of adult respondents. Thirty-three adults (0.2% of the study population) were classified as CFS-like cases, and 259 as ICF-like cases (1.8%). Neither condition clustered within households. CFS- and ICF-like illness were most prevalent among women and persons with annual household incomes below $40,000, and least prevalent among Asians. The prevalence of CFS-like illness was elevated among blacks, Native Americans, and persons engaged in clerical occupations. Although CFS-like cases were more severely ill than those with ICF-like illness, a similar symptom pattern was observed in both groups.

Conclusion: Conditions associated with unexplained chronic fatigue occur in all socioeconomic groups but appear to be most prevalent among women, persons with lower income, and some racial minorities.

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