PATIENTS WHO CONSULT WITH TIREDNESS - FREQUENCY OF CONSULTATION, PERCEIVED CAUSES OF TIREDNESS AND ITS ASSOCIATION WITH PSYCHOLOGICAL DISTRESS

Background. Few prospective studies have been carried out in primary c are on patients presenting with tiredness. Aim. A study was undertaken to describe patients whose main complaint was fatigue or of being 'ti red all the time'. Method. Over one year, doctors in four practices in Lancashire, Mid-Glamorgan, Suffolk and Surrey recruited 220 patients aged 16 years or more presenting with fatigue, and matched them with a comparison group from their lists. The general health questionnaire, a fatigue questionnaire and an attribution questionnaire were used to measure outcomes over six months. General practice records of consulta tions were also examined. Results. Patients consulting for tiredness a ttended the doctor significantly more frequently than the comparison g roup both in the six months before and after entering the study. The f requency of attending could not be related to the duration or severity of fatigue alone. The majority consulting with tiredness scored highl y on the general health questionnaire but so also did patients with eq uivalent fatigue scores in the comparison group. The correlation betwe en fatigue and general health questionnaire scores was closer for thos e patients who still had high fatigue scores six months later than it was for patients on entry to the study. Six months following study ent ry 61% of patients perceived the cause of the tiredness to be physical , while 57% of doctors viewed the problem as psychological. A small nu mber of patients changed their views during the six months follow up f rom physical to psychological attributions. Conclusion. Patients consu lting for tiredness are likely to report symptoms of psychological dis tress and attend more frequently than other patients. They tend to vie w their problem as physical while their doctors view the problem as ps ychological. Having established that there is no physical problem, doc tors may need to focus more on sharing ideas and explanations when pat ients complain of being 'tired all the time'.