This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Heim, C. Articles by Reeves, W. C. Search for Related Content PubMed PubMed Citation Articles by Heim, C. Articles by Reeves, W. C. Related Collections Other Epidemiology Musculoskeletal PTSD Stress and Coping

Regional Prevalence of Fatiguing Illnesses in the United States Before and After the Terrorist Attacks of September 11, 2001

From the Division of Viral and Rickettsial Diseases, Viral Exanthems and Herpesvirus Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (C.H., C.B., R.N., D.W., W.C.R.); and the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia (C.H.).

Address correspondence and reprint requests to Christine Heim, PhD, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 101 Woodruff Circle, WMB, Suite 4000, Atlanta, GA 30322. E-mail: cmheim{at}emory.edu

OBJECTIVE: Stress or emotional traumas are considered risk factors for unexplained fatiguing illnesses. From July to December 2001, the Centers for Disease Control and Prevention conducted a multigeographical pilot study to test the feasibility of a survey to estimate the prevalence of fatiguing illnesses in the United States. We used data obtained during this survey to estimate the effect of the coincidentally occurring terrorist attacks of September 11, 2001, on the regional prevalence of fatiguing illnesses.

METHODS: Identified by random-digit dialing, 2,728 households in eight regional strata were interviewed, and 7,317 respondents were screened for severe fatigue of at least 1 month duration. Identified fatigued people of age 18 to 69 years (N = 440) and a sample of nonfatigued people of the same age range (N = 444) were interviewed in detail concerning fatigue, other symptoms, and medical and psychiatric histories.

RESULTS: Weighted prevalence estimates based on interviews performed after the attacks were significantly lower compared with estimates based on interviews performed before the attacks (prolonged fatigue: 5,450 vs. 1,530/100,000, p = .010; chronic fatigue: 18,510 vs. 10,070/100,000, p = .002; chronic fatigue syndrome-like illness: 2,510 vs. 960/100,000, p = .014).

CONCLUSION: Our findings suggest decreased regional prevalence of fatiguing illnesses in the aftermath of the terrorist attacks. The causes of this effect are unknown but might involve acute psychological and physiological adaptations that modify the perception or manifestation of fatigue. Future studies should be specifically designed to scrutinize the relationship between stress and fatiguing illnesses and the mediating mechanisms of such a relationship.

Key Words: chronic fatigue syndrome, • stress, • trauma, • epidemiology.

Abbreviations: CFS = chronic fatigue syndrome;; PTSD = posttraumatic stress disorder;; CDC = Centers for Disease Control and Prevention;; PSU = primary sampling unit;; MSA = metropolitan statistical area;; SF-12 = 12-Item Short Form Health Survey.

This article has been cited by other articles:

				T. A. Glass, K. Bandeen-Roche, M. McAtee, K. Bolla, A. C. Todd, and B. S. Schwartz Neighborhood Psychosocial Hazards and the Association of Cumulative Lead Dose With Cognitive Function in Older Adults Am. J. Epidemiol., March 15, 2009; 169(6): 683 - 692. [Abstract] [Full Text] [PDF]

				M. E. Detsky, M. L. A. Sivilotti, A. Kopp, P. C. Austin, and D. N. Juurlink Deliberate Self-Poisoning in Ontario Following the Terrorist Attacks of September 11, 2001 JAMA, October 19, 2005; 294(15): 1900 - 1901. [Full Text] [PDF]