Pooling was not appropriate for CFS.In studies with control groups of patients without the symptom of tiredness , prevalence of somatic disease was identical to those complaining of tiredness .
Depression , however , was more frequent among those with tiredness .
Conclusions Serious somatic disease is rare in patients complaining of tiredness .
Since prevalence is similar in patients without tiredness , the association may not be causal .
Background Tiredness is one of the most frequent complaints in primary care .
Although often self-limiting and frequently associated with psychosocial stress , patients but also their physicians are often uncertain regarding a serious cause and appropriate diagnostic work-up .
We conducted a systematic review and meta- analysis of studies reporting on differential diagnosis of fatigue in primary care .
Diagnoses during follow-up of patients presenting with fatigue in primary care
Background : Little is known about the distribution of diagnoses that account for fatigue in patients in primary care . We evaluated the diagnoses established within 1 year after presentation with fatigue in primary care that were possibly associated with the fatigue . Methods : We conducted a prospect i ve observational cohort study with 1-year follow-up . We included adult patients who presented with a new episode of fatigue between June 2004 and January 2006 . We extracted data on diagnoses during the follow-up period from the patients ’ medical records as well as data on pre-existing chronic diseases . Results : Of the 571 patients for whom diagnostic data were available , 268 ( 46.9 % ) had received one or more diagnoses that could be associated with fatigue . The diagnoses were diverse and mostly included symptom diagnoses , with main categories being musculoskeletal ( 19.4 % ) and psychological problems ( 16.5 % ) . Clear somatic pathology was diagnosed in 47 ( 8.2 % ) of the patients . Most diagnoses were not made during the consultation when fatigue was presented . Interpretation : Only a minority of patients were diagnosed with serious pathology . Half of the patients did not receive any diagnosis that could explain their fatigue . Nevertheless , because of the wide range of conditions and symptoms that may explain or co-occur with the fatigue , fatigue is a complex problem that deserves attention not only as a symptom of underlying specific disease
Pooling was not appropriate for CFS.In studies with control groups of patients without the symptom of tiredness , prevalence of somatic disease was identical to those complaining of tiredness .
Depression , however , was more frequent among those with tiredness .
Conclusions Serious somatic disease is rare in patients complaining of tiredness .
Since prevalence is similar in patients without tiredness , the association may not be causal .
Background Tiredness is one of the most frequent complaints in primary care .
Although often self-limiting and frequently associated with psychosocial stress , patients but also their physicians are often uncertain regarding a serious cause and appropriate diagnostic work-up .
We conducted a systematic review and meta- analysis of studies reporting on differential diagnosis of fatigue in primary care .