Common and unique associated factors for medically unexplained chronic widespread pain and chronic fatigue

J. McBeth*, B. Tomenson, C. A. Chew-Graham, G. J. Macfarlane, J. Jackson, A. Littlewood, F. H. Creed

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)
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Objective: Chronic widespread pain and chronic fatigue share common associated factors but these associations may be explained by the presence of concurrent depression and anxiety. Methods: We mailed questionnaires to a randomly selected sample of people in the UK to identify participants with chronic widespread pain (ACR 1990 definition) and those with chronic fatigue. The questionnaire assessed sociodemographic factors, health status, healthcare use, childhood factors, adult attachment, and psychological stress including anxiety and depression. To identify persons with unexplained chronic widespread pain or unexplained chronic fatigue; we examined participant's medical records to exclude medical illness that might cause these symptoms. Results: Of 1443 participants (58.0% response rate) medical records of 990 were examined. 9.4% (N = 93) had unexplained chronic widespread pain and 12.6% (N = 125) had unexplained chronic fatigue. Marital status, childhood psychological abuse, recent threatening experiences and other somatic symptoms were commonly associated with both widespread pain and fatigue. No common effect was found for few years of education and current medical illnesses (more strongly associated with chronic widespread pain) or recent illness in a close relative, neuroticism, depression and anxiety scores (more strongly associated with chronic fatigue). Putative associated factors with a common effect were associated with unexplained chronic widespread pain or unexplained chronic fatigue only when there was concurrent anxiety and/or depression. Discussion: This study suggests that the associated factors for chronic widespread pain and chronic fatigue need to be studied in conjunction with concurrent depression/anxiety. Clinicians should be aware of the importance of concurrent anxiety or depression.

Original languageEnglish
Pages (from-to)484-491
Number of pages8
JournalJournal of Psychosomatic Research
Issue number6
Early online date19 Oct 2015
Publication statusPublished - 1 Dec 2015

Bibliographical note

We are grateful to the participants in the project and to the General Practitioners and their teams who facilitated it. The study was funded by the UK Medical Research Council (G0500272). The UK MRC had no role in study design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.


  • Chronic fatigue
  • Epidemiology
  • Fibromyalgia
  • Functional somatic syndromes
  • Medically unexplained symptoms
  • Population based


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