Psychological and psychiatric causes of fatigue. Assessment and management

Fatigue is a common presentation in general practice and its diagnosis and management can be a source of frustration to both doctor and patient. Although it may exist independently of other diagnoses, and in conjunction with physical disorders, fatigue is strongly associated with psychological disorders.

We propose an approach to the diagnosis and management of the psychological and psychiatric causes of fatigue, and present two clinical cases to highlight some of the discriminating features.

Psychological causes should be considered in all patients with fatigue. Awareness of the range of causes of fatigue, experience in using readily available screening tests to detect psychological disorders, and knowledge of the recommended management regimens will facilitate the delivery of quality care to patients and the reduction of the morbidity associated with the underlying conditions.