title: Psychiatric morbidity and illness experience of primary care patients with chronic fatigue in Hong Kong.
abstract: OBJECTIVE
  The authors' goal was to examine the prevalence and experience of psychiatric morbidity among primary care patients with chronic fatigue in Hong Kong.
  
  
  METHODS
  One hundred adult patients with medically unexplained fatigue for 6 or more months were assessed with the Explanatory Model Interview Catalogue, psychopathological rating scales, and an enhanced version of the Structured Clinical Interview for DSM-III-R.
  
  
  RESULTS
  The lifetime prevalence of DSM-III-R depressive and anxiety disorders was 54%. Current depressive and anxiety disorders were identified in 28 patients, who exhibited more psychopathology and functional impairment than other patients. Thirty-three patients had somatoform pain disorder, and 30 had undifferentiated somatoform disorder, but most of them could also be diagnosed as having shenjing shuairuo (weakness of nerves) and, to a lesser extent, ICD-10 neurasthenia. Chronic fatigue syndrome diagnosed according to the 1988 Centers for Disease Control criteria was rare (3%) and atypical. Generally, patients mentioned fatigue if asked, but pains (36%), insomnia (20%), and worries (13%) were the most troublesome symptoms. Most patients attributed illness onset to psychosocial sources.
  
  
  CONCLUSIONS
  Psychiatric morbidity was common among primary care patients with chronic fatigue. Subthreshold psychiatric morbidity was very common and was more validly represented by the disease construct of shenjing shuairuo or neurasthenia than somatoform disorder.
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin. singlee@cuhk.edu.hk
authors.forename: S
authors.initials: S
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Yu
authors.forename: Y
authors.initials: Y
authors.lastname: Wing
authors.forename: C
authors.initials: C
authors.lastname: Chan
authors.forename: A M
authors.initials: AM
authors.lastname: Lee
authors.forename: D T
authors.initials: DT
authors.lastname: Lee
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Lin
authors.forename: M G
authors.initials: MG
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009440:Neurasthenia / Q000175:diagnosis / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data