title: The association between chronic diseases and fatigue in the working population.
abstract: OBJECTIVE
  The aims of this study were to examine (a) whether employees with a chronic disease report more fatigue than employees without a chronic disease, (b) whether number or type of chronic disease is related to fatigue, and (c) whether differences in fatigue level in various types of chronic diseases are related to psychological distress.
  
  
  METHODS
  Data were taken from 12,137 employees. Fatigue was measured with the Checklist Individual Strength (CIS).
  
  
  RESULTS
  Employees with a chronic disease reported more fatigue (OR=2.9, 95% CI=2.7-3.2). Small differences were observed in the level of fatigue in various types of diseases. A strong linear association between the number of chronic diseases and fatigue was found. Psychological distress explained the higher level of fatigue in some chronic diseases (gastrointestinal diseases and migraine).
  
  
  CONCLUSIONS
  Fatigue is more common in employees with a chronic disease. A strong association between number of chronic diseases and fatigue exists. Fatigue in employees with a chronic disease can partly be explained by psychological distress. Some chronic diseases show a stronger association between psychological distress and fatigue.
authors.affiliation: Department of Epidemiology, Maastricht University, P.O. Box 616, The Netherlands.
authors.forename: Pascal M L
authors.initials: PM
authors.lastname: Franssen
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
authors.forename: Ijmert
authors.initials: I
authors.lastname: Kant
authors.forename: Ludovic G P M
authors.initials: LG
authors.lastname: van Amelsvoort
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D004651:Employment; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011159:Population Surveillance; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires