Depression and chronic fatigue. Indications for psychiatric consultation

Symptoms of fatigue and the fatigue syndrome itself are familiar complaints heard by nonpsychiatric physicians in the general hospital. The nature of these complaints is often diffuse and frequently conceals atypical psychiatric disorders. In the general hospital setting, consultation psychiatry, which functions as the interface between psychiatry and these medical practitioners, is ideally situated to assist in the assessment and management of these patients. This article reviews the methods of approach that psychiatric consultants can use to assist their nonpsychiatric colleagues in identification and referral for problems involving fatigue. In addition, a brief review of diagnosis, management, and treatment of such patients is given.