title: Chronic fatigue syndrome in an ethnically diverse population: the influence of psychosocial adversity and physical inactivity.
abstract: BACKGROUND
  Chronic fatigue syndrome (CFS) is a complex multifactorial disorder. This paper reports the prevalence of chronic fatigue (CF) and CFS in an ethnically diverse population sample and tests whether prevalence varies by social adversity, social support, physical inactivity, anxiety and depression.
  
  
  METHODS
  Analysis of survey data linking the Health Survey for England (1998 and 1999) and the Ethnic Minority Psychiatric Illness Rates in the Community (EMPIRIC) study undertaken in 2000. The study population comprised a national population sample of 4,281 people ages 16 to 74 years. CF and CFS were operationally defined on the basis of an interview in the EMPIRIC study, alongside questions about psychosocial risk factors. Previous illnesses were reported in the Health Survey for England during 1998 and 1999, as was physical inactivity.
  
  
  RESULTS
  All ethnic minority groups had a higher prevalence of CFS than the White group. The lowest prevalence was 0.8% in the White group, and it was highest at 3.5% in the Pakistani group (odds ratio (OR), 4.1; 95% confidence interval (95% CI), 1.6 to 10.4). Anxiety (OR, 1.8; 95% CI, 1.4 to 2.2), depression (OR, 1.4; 95% CI, 1.1 to 1.8), physical inactivity (OR, 2.0; 95% CI, 1.1 to 3.8), social strain (OR, 1.24; 95% CI, 1.04 to 1.48) and negative aspects of social support (OR, 2.12; 95% CI, 1.4 to 3.3) were independent risk factors for CFS in the overall sample. Together these risk factors explained ethnic differences in the prevalence of CFS, but no single risk factor could explain a higher prevalence in all ethnic groups.
  
  
  CONCLUSIONS
  The prevalence of CFS, but not CF, varies by ethnic group. Anxiety, depression, physical inactivity, social strain and negative aspects of social support together accounted for prevalence differences of CFS in the overall sample.
authors.affiliation: Centre for Psychiatry, Wolson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. k.s.bhui@qmul.ac.uk
authors.forename: Kamaldeep S
authors.initials: KS
authors.lastname: Bhui
authors.forename: Sokratis
authors.initials: S
authors.lastname: Dinos
authors.forename: Deborah
authors.initials: D
authors.lastname: Ashby
authors.forename: James
authors.initials: J
authors.lastname: Nazroo
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Peter D
authors.initials: PD
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications; D003863:Depression / Q000150:complications; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D015995:Prevalence; D012307:Risk Factors; D057545:Social Stigma; D055815:Young Adult