Fatigue as a manifestation of psychosocial distress in a low-income country: a population-based panel study.

Journal: Tropical medicine & international health : TM & IH

Volume: 21

Issue: 3

Year of Publication: 2016

Affiliated Institutions:  Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Aklilu-Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia. Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK. Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Abstract summary 

Fatigue is a common complaint worldwide and associated with disability and high health service use costs. We tested the hypothesis that maternal fatigue would be associated independently with maternal common mental disorder ('maternal CMD') in a rural, low-income country setting.The analysis was conducted using data from a population-based cohort located in the Butajira demographic surveillance site, Ethiopia. A total of 1065 women were recruited in pregnancy and followed up to 2.5 (n = 1009; 94.7%) and 3.5 years post-partum (n = 989; 92.9%). Maternal CMD symptoms were measured using a locally validated version of the Self-Reporting Questionnaire and fatigue was measured using a dichotomised item from the Patient Health Questionnaire-15. Physical health indicators included haemoglobin level, body mass index and illness episodes. Generalised estimating equations were used to conduct hypothesis-driven and exploratory multivariable analyses in the panel at 2.5 and 3.5 years.The prevalence of maternal fatigue was 8.3% at 2.5 years and 5.5% at 3.5 years post-partum. Psychological symptoms of maternal CMD were associated independently with complaints of fatigue after adjusting for anaemia, body mass index, physical ill health, poverty and other confounding variables: adjusted odds ratio (aOR), 1.46; 95% confidence interval (CI), 1.28-1.66 for each one point increase in SRQ score. In the multivariable model, only psychosocial factors (CMD and stressful life events) and self-reported physical ill health were associated significantly with complaints of fatigue.Complaints of fatigue are associated strongly with maternal CMD and other psychosocial risk factors in this rural, low-income country setting with a high burden of undernutrition and infectious disease. Fatigue should be understood as a potential indicator of CMD in primary care to improve detection and treatment.

Authors & Co-authors:  Smartt Caroline C Medhin Girmay G Alem Atalay A Patel Vikram V Dewey Michael M Prince Martin M Hanlon Charlotte C

Study Outcome 

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Statistics
Citations :  Jason LA, Evans M, Brown M, Porter N. What is fatigue? Pathological and nonpathological fatigue PMR 2010: 2: 327–331.
Authors :  7
Identifiers
Doi : 10.1111/tmi.12658
SSN : 1365-3156
Study Population
Women
Mesh Terms
Adolescent
Other Terms
DMC materno;Ethiopia;Ethiopie;Etiopía;PFR-PRI;PIBMs;angustia psicosocial;détresse psychosociale;estudio poblacional de paneles;fatiga;fatigue;low-and middle-income countries;maternal CMD;population-based panel study;psychosocial distress;étude de panel basée sur la population
Study Design
Cohort Study,Exploratory Study,Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
England