Open Access Highly Accessed Research article

The hidden cost of chronic fatigue to patients and their families

Ramon Sabes-Figuera1*, Paul McCrone1, Mike Hurley2, Michael King3, Ana Nora Donaldson4 and Leone Ridsdale5

Author Affiliations

1 Centre for the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, King's College, London, UK

2 Academic Department of Physiotherapy Health and Social Care Research Division King's College London, London, UK

3 Department of Mental Health Sciences, Hampstead Campus, University College London, London, UK

4 King's College London Dental Institute, King's College, London, UK

5 Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, UK

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BMC Health Services Research 2010, 10:56  doi:10.1186/1472-6963-10-56

Published: 4 March 2010



Nearly 1 in 10 in the population experience fatigue of more than six months at any one time. Chronic fatigue is a common reason for consulting a general practitioner, and some patients report their symptoms are not taken seriously enough. A gap in perceptions may occur because doctors underestimate the impact of fatigue on patients' lives. The main aim of the study is to explore the economic impact of chronic fatigue in patients seeking help from general practitioners and to identify characteristics that explain variations in costs.


The design of study was a survey of patients presenting to general practitioners with unexplained chronic fatigue. The setting were 29 general practice surgeries located in the London and South Thames regions of the English National Health Service. Use of services over a six month period was measured and lost employment recorded. Regression models were used to identify factors that explained variations in these costs.


The mean total cost of services and lost employment across the sample of 222 patients was £3878 for the six-month period. Formal services accounted for 13% of this figure, while lost employment accounted for 61% and informal care for 26%. The variation in the total costs was significantly related to factors linked to the severity of the condition and social functioning.


The economic costs generated by chronic fatigue are high and mostly borne by patients and their families. Enquiry about the functional consequences of fatigue on the social and occupational lives of patients may help doctors understand the impact of fatigue, and make patients feel better understood.