NCC- article on Fatigue

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An excellent bit of information on Fatigue. Also gives the diagnostic

criteria for Chronic Fatigue

Syndromehttp://bmj.com/cgi/content/full/325/7362/480

for aol users click here <a

href= " http://bmj.com/cgi/content/full/325/7362/480 " > Fatigue</a>

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BMJ 2002;325:480-483 ( 31 August )

Clinical review

ABC of psychological medicine

Fatigue

Sharpe, Wilks.

Fatigue can refer to a subjective symptom of malaise and aversion to

activity

or to objectively impaired performance. It has both physical and mental

aspects. The symptom of fatigue is a poorly defined feeling, and careful

inquiry is needed to clarify complaints of " fatigue, " " tiredness, " or

" exhaustion " and to distinguish lack of energy from loss of motivation or

sleepiness, which may be pointers to specific diagnoses (see below).

PrevalenceLike blood pressure, subjective fatigue is normally distributed in

the population. The prevalence of clinically significant fatigue depends on

the

threshold chosen for severity (usually defined in terms of associated

disability) and persistence. Surveys report that 5-20% of the general

population suffer from such persistent and troublesome fatigue. Fatigue is

twice as common in women as in men but is not strongly associated with age

or

occupation. It is one of the commonest presenting symptoms in primary care,

being the main complaint of 5-10% of patients and an important subsidiary

symptom in a further 5-10%.

Fatigue as a symptomPatients generally regard fatigue as important (because

it

is disabling), whereas doctors do not (because it is diagnostically

non-specific). This discrepancy is a potent source of potential difficulty

in

the doctor-patient relationship. Fatigue may present in association with

established medical and psychiatric conditions or be idiopathic.

Irrespective

of cause, it has a major impact on day to day functioning and quality of

life.

Without treatment, the prognosis of patients with idiopathic fatigue is

surprisingly poor; half those seen in general practice with fatigue are

still

fatigued six months later.

Full text

http://bmj.com/cgi/content/full/325/7362/480