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Prevalence of clinically significant functional fatigue or weakness in specialty outpatient clinics of Pune, India.

Journal of the Indian Medical Association

epidemiology, Adult, Ambulatory Care, Clinical Medicine, Culture, Dermatology, Fatigue Syndrome, Chronic, ethnology, Female, Humans, India, Male, Medicine, Ayurvedic, Muscle Weakness, Neurasthenia, Prevalence, Psychiatry, Severity of Illness Index, Sickness Impact Profile, Treatment Outcome

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      Abstract

      Disorders of fatigue are important in clinical practice but inadequately studied in developing countries. Questions about their consistency and variation across cultures also require attention. The standard professional diagnostic formulations of these disorders, namely, chronic fatigue syndrome and neurasthenia, are not used widely in India, perhaps due to lack of research and poor appreciation of their clinical significance. Recognising patients with clinically significant functional fatigue or weakness often seek help from various care-givers, prevalence of this condition was studied in four specialty clinics of Sassoon Hospital, Pune. An operationally defined set of criteria was used to create a screening instrument. Trained research assistants surveyed 1,874 consecutive patients from psychiatry, medicine, dermatology, and ayurved clinics. Data were entered and analysed to compute the rates of this condition, compare them across clinics and between sexes, and to compute rates adjusted for age, sex, and the clinic attended. Overall prevalence was 5.02% with higher rates in the dermatology and ayurved clinics than in psychiatry and medicine clinics. The female preponderance (63.83%) was notable (p < 0.001). Mean age of patients with this condition was similar across clinics. Logistic regression showed female sex (OR 2.19, 95% CI 1.41 to 3.40) and dermatology clinic (OR 1.70, 1.02 to 2.85) to be significant predictors of CS-FoW. Female preponderance indicates the need for studies with gender focus. Clinical and cultural epidemiological studies informing psychiatrists as well as other physicians are necessary. Need for counselling for majority of these patients calls for appropriate changes in healthcare delivery.

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