title: The awareness of chronic fatigue syndrome: a comparative study in Brazil and the United Kingdom.
abstract: OBJECTIVE
  While in many Western affluent countries there is widespread awareness of chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME), little is known about the awareness of CFS/ME in low- and middle-income countries. We compared the awareness of CFS in Brazil and the United Kingdom.
  
  
  METHODS
  Recognition and knowledge of CFS were assessed among 120 Brazilian specialist doctors in two major university hospitals using a typical case vignette of CFS. We also surveyed 3914 and 2435 consecutive attenders in Brazilian and British primary care clinics, respectively, concerning their awareness of CFS.
  
  
  RESULTS
  When given a typical case vignette of CFS, only 30.8% [95% confidence interval (CI), 22.7-39.9%] of Brazilian specialist doctors mentioned chronic fatigue or CFS as a possible diagnosis, a proportion substantially lower than that observed in Western affluent countries. Similarly, only 16.2% (95% CI, 15.1-17.4%) of Brazilian primary care attenders were aware of CFS, in contrast to 55.1% (95% CI, 53.1-57.1%) of their British counterparts (P<.001). This difference remained highly significant after controlling for patients' sociodemographic and socioeconomic characteristics (P<.001).
  
  
  CONCLUSIONS
  The awareness of CFS was substantially lower in Brazil than the United Kingdom. The observed difference may influence patients' help-seeking behavior and both doctors' and patients' beliefs and attitudes in relation to fatigue-related syndromes. Attempts to promote the awareness of CFS should be considered in Brazil, but careful plans are required to ensure the delivery of sound evidence-based information.
authors: Department of Psychological Medicine, Institute of Psychiatry, King's College London, United Kingdom. h.cho@iop.kcl.ac.uk
authors: Hyong Jin
authors: HJ
authors: Cho
authors: Paulo Rossi
authors: PR
authors: Menezes
authors: Dinesh
authors: D
authors: Bhugra
authors: Simon
authors: S
authors: Wessely
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001364:Awareness; D001938:Brazil; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003469:Culture; D003906:Developing Countries; D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013038:Specialization; D006113:United Kingdom