Skip to main content
Full access
New Research
Published Online: 1 May 2013

Prevalence and Correlates of Prolonged Fatigue in a U.S. Sample of Adolescents

Abstract

Persistent fatigue is frequently comorbid with anxiety and depression and, even if it is not, can be a pathological condition that may not be recognized as such, thus resulting in no health care being sought despite the favorable treatment course in this population.

Abstract

Objective

Prolonged fatigue in adolescents has a major impact on social functioning and school attendance. In adults, prolonged fatigue substantially overlaps with mood and anxiety disorders. Extending the data to adolescents, the authors studied the prevalence and correlates of fatigue in a representative U.S. sample.

Method

The participants were 10,123 adolescents ages 13–18 years from the National Comorbidity Survey Adolescent Supplement. They were interviewed about prolonged fatigue, defined as extreme fatigue with at least one associated symptom (pains, dizziness, headache, sleep disturbance, inability to relax, irritability) that does not resolve by resting or relaxing and lasting at least 3 months.

Results

The prevalence of prolonged fatigue was 3.0% (SE=0.3), with 1.4% (SE=0.2) for prolonged fatigue only and 1.6% (SE=0.2) for prolonged fatigue concomitant with a depressive or anxiety disorder. Nearly 60% of the adolescents with prolonged fatigue only had severe or very severe disability, and their rates of poor physical and mental health were comparable to those of adolescents with mood or anxiety disorders only. Adolescents with prolonged fatigue and comorbid mood or anxiety disorders had significantly greater disability, poorer mental health, and more health service use than those with either condition alone.

Conclusions

These findings suggest that prolonged fatigue is associated with disability and is an important clinical entity independent of mood and anxiety disorders in adolescents. Persistent fatigue with a comorbid mood or anxiety state is related to even more functional impairment, suggesting that prolonged fatigue may reflect greater severity of mood and anxiety disorders in adolescents.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 502 - 510
PubMed: 23632835

History

Received: 6 April 2012
Revision received: 21 September 2012
Revision received: 27 November 2012
Accepted: 4 December 2012
Published online: 1 May 2013
Published in print: May 2013

Authors

Details

Femke Lamers, Ph.D.
From the Genetic Epidemiology Research Branch, Intramural Research Program, NIMH, Bethesda, Md.; and the Clinical Research Unit, Brain & Mind Research Institute, University of Sydney.
Ian Hickie, M.D., F.R.A.N.Z.C.P.
From the Genetic Epidemiology Research Branch, Intramural Research Program, NIMH, Bethesda, Md.; and the Clinical Research Unit, Brain & Mind Research Institute, University of Sydney.
Kathleen R. Merikangas, Ph.D.
From the Genetic Epidemiology Research Branch, Intramural Research Program, NIMH, Bethesda, Md.; and the Clinical Research Unit, Brain & Mind Research Institute, University of Sydney.

Notes

Address correspondence to Dr. Merikangas ([email protected]).

Funding Information

Dr. Hickie reports that 1) he currently serves on the board of the Psychosis Australia Trust (unpaid position) and on the Defence Mental Health Advisory Group (government committee); 2) he currently receives fees for consulting or reports from Bupa Australia (private health insurance) as a member of the Medical Advisory Panel; 3) he has received travel support in the last 5 years from Servier, AstraZeneca, PricewaterhouseCoopers, the American Psychiatric Association, Returned and Services League (RSL) National Congress, the Chinese Society of Psychiatry and Neurology, Australian General Practice Network, and Focus—Sunshine Coast; 4) he has received research support in the last 5 years from Servier and Pfizer; 5) he has received payments for educational seminars or resources in the last 5 years from Servier, AstraZeneca, Pfizer (Wyeth), Eli Lilly, Broadcast Psychiatry, Janssen Cilag, Merck Sharp and Dohme, Elixir Healthcare Education, the Australian Mental Health Leadership Program, Australian Independent Schools of New South Wales, Australian Doctor Education, and Intelligence Squared Australia; 6) he previously had a business interest in St. George Neuropsychiatry Pty. Ltd. (director); 7) he previously held positions at the Australian Department of Health and Ageing (sitting fee for the National Advisory Council on Mental Health), the Australian National Council on Drugs, and Headspace: the National Youth Mental Health Foundation (director on behalf of the University of Sydney, a member of the company); 8) he previously served on the following government advisory committees: Mental Health Expert Working Group (member), Access to Allied Psychological Services (member of expert advisory committee), National Advisory Council for Mental Health (member), and Common Approach to Assessment Referral and System Task Force co-convened by the Minister for Families, Housing, and Community Services (member); 9) he previously received payments for consulting, reports, or advisory work from Drinkwise Australia, Western Australia (Labor) Government, the Australian Department of Health and Ageing, Sydney Magazine, Sydney City Council, the Royal Australian and New Zealand College of Psychiatry, Wyeth, and Eli Lilly; 10) his partner Dr. Elizabeth Scott is Clinical Director of Headspace Camperdown and Cambebelltown and previously had a business interest in Pearl 100, a partnership (ABN 55 251 484 962) trading as The Clinical Centre and registered to S. Duncan and St. George Neuropsychiatry Pty. Ltd.; 11) mental health research conducted at the Brain & Mind Research Institute has been supported by Servier, Pfizer, the Heart Foundation, Beyond Blue, and the Bupa Foundation. The other authors report no financial relationships with commercial interests.Supported by NIMH Intramural Research Program grant Z01 MH-002808-08 and, through the National Comorbidity Survey Adolescent Supplement (NCS-A) and the larger program of related NCS surveys, NIMH grant U01 MH-60220. Dr. Lamers is supported by a Rubicon Fellowship from the Netherlands Organisation for Scientific Research (NWO) and by a Supplemental Intramural Research Training Award from the NIMH Genetic Epidemiology Research Branch.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - American Journal of Psychiatry

PPV Articles - American Journal of Psychiatry

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share