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Abstract
(1) To evaluate the prevalence of severe and chronic fatigue in subjects with and without chronic disease; (2) to assess to which extent multi-morbidity contributes to severe and chronic fatigue; and (3) to identify predisposing and associated factors for severe and chronic fatigue and whether these are disease-specific, trans-diagnostic, or generic. The Dutch Lifelines cohort was used, including 78,363 subjects with (n = 31,039, 53 ± 12 years, 33% male) and without (n = 47,324, 48 ± 12 years, 46% male) ≥ 1 of 23 chronic diseases. Fatigue was assessed with the Checklist Individual Strength-Fatigue. Compared to participants without a chronic disease, a higher proportion of participants with ≥ 1 chronic disease were severely (23% versus 15%, p < 0.001) and chronically (17% versus 10%, p < 0.001) fatigued. The odds of having severe fatigue (OR [95% CI]) increased from 1.6 [1.5–1.7] with one chronic disease to 5.5 [4.5–6.7] with four chronic diseases; for chronic fatigue from 1.5 [1.5–1.6] to 4.9 [3.9–6.1]. Multiple trans-diagnostic predisposing and associated factors of fatigue were found, explaining 26% of variance in fatigue in chronic disease. Severe and chronic fatigue are highly prevalent in chronic diseases. Multi-morbidity increases the odds of having severe and chronic fatigue. Several trans-diagnostic factors were associated with fatigue, providing a rationale for a trans-diagnostic approach.
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Details
1 Ciro, Department of Research and Development, Horn, The Netherlands (GRID:grid.491136.8); NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands (GRID:grid.5012.6) (ISNI:0000 0001 0481 6099); Maastricht University Medical Centre (MUMC+), Department of Respiratory Medicine, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382)
2 Amsterdam University Medical Centers, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (GRID:grid.7177.6) (ISNI:0000000084992262)
3 Ciro, Department of Research and Development, Horn, The Netherlands (GRID:grid.491136.8); Maastricht University, Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands (GRID:grid.5012.6) (ISNI:0000 0001 0481 6099)
4 Radboud university medical center, Department of Medical Psychology, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382)
5 Ciro, Department of Research and Development, Horn, The Netherlands (GRID:grid.491136.8); NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands (GRID:grid.5012.6) (ISNI:0000 0001 0481 6099); Maastricht University Medical Centre (MUMC+), Department of Respiratory Medicine, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382); Hasselt University, REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium (GRID:grid.12155.32) (ISNI:0000 0001 0604 5662)
6 Hasselt University, REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Diepenbeek, Belgium (GRID:grid.12155.32) (ISNI:0000 0001 0604 5662)
7 Radboud university medical center, Department of Lung Diseases, Radboud Institute for Health Sciences, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382)
8 Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (GRID:grid.12380.38) (ISNI:0000 0004 1754 9227)
9 Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands (GRID:grid.12380.38) (ISNI:0000 0004 1754 9227)
10 University of Amsterdam, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands (GRID:grid.7177.6) (ISNI:0000000084992262)
11 Ciro, Department of Research and Development, Horn, The Netherlands (GRID:grid.491136.8)
12 NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands (GRID:grid.5012.6) (ISNI:0000 0001 0481 6099); Maastricht University Medical Centre (MUMC+), Department of Respiratory Medicine, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382)
13 University of Groningen, Departments of Psychiatry and Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands (GRID:grid.4830.f) (ISNI:0000 0004 0407 1981)