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Associations of physical and psychiatric conditions with chronic fatigue syndrome in Germany: an exploratory case-control study

Published online by Cambridge University Press:  20 July 2020

Louis Jacob
Affiliation:
Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
Josep Maria Haro
Affiliation:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain
Karel Kostev*
Affiliation:
Epidemiology, IQVIA, Frankfurt, Germany
*
Author for correspondence: Karel Kostev, E-mail: Karel.Kostev@iqvia.com

Abstract

Background

Only a few studies have analyzed the effects of physical and psychiatric conditions on the risk of chronic fatigue syndrome (CFS). Therefore, the goal of this exploratory case-control study was to investigate the associations of physical and psychiatric conditions with CFS in almost 19 800 adults from Germany.

Methods

This study included patients diagnosed for the first time with CFS in one of 1238 general practices in Germany between 2010 and 2017 (index date). Controls without CFS were matched (1:1) to cases with CFS by sex, age, index year, and practice. Physical and psychiatric conditions diagnosed in the year prior to the index date were included if they were present in at least 3% of patients with CFS. Associations between physical and psychiatric conditions (33 potential independent variables) and CFS (dependent variable) were analyzed in an adjusted conditional logistic regression model, and physical and psychiatric disorders were included in the model using forward stepwise selection.

Results

This study included 9896 cases with CFS and 9896 controls without CFS [65.1% women; mean (standard deviation) age 49.5 (18.3) years]. Seven conditions were associated with CFS in the adjusted regression model. The disorders displaying the strongest relationship with CFS were cancer [odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.24–2.95], sleep disorders (OR = 1.88, 95% CI = 1.66–2.12) and depression (OR = 1.77, 95% CI = 1.61–1.95).

Conclusions

Cancer, sleep disorders, and depression were strongly and positively associated with CFS. Additional studies are needed to gain a better understanding of the mechanisms underlying these relationships.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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