title: Psychosocial diagnoses occurring after patients present with fatigue.
abstract: OBJECTIVE
  To discover the frequency of psychosocial and other diagnoses occurring at the end of a visit when patients present to their FPs with concerns about fatigue.
  
  
  METHODS
  Cross-sectional study of patient-FP encounters for fatigue.
  
  
  METHODS
  Ten FP practices in southwestern Ontario.
  
  
  METHODS
  A total of 259 encounters involving 167 patients presenting to their FPs between March 1, 2006, and June 30, 2010, with concerns about fatigue.
  
  
  METHODS
  The frequency of psychological and social diagnoses made at the end of visits, and whether diagnoses were made by FPs at the end of the visits versus whether the code for fatigue remained. The associations between patient age, sex, fatigue presenting with other symptoms, or the presence of previous chronic conditions and the outcomes was tested.
  
  
  RESULTS
  Psychosocial diagnoses were made 23.9% of the time. Among psychosocial diagnoses made, depressive disorder and anxiety disorder or anxiety state were diagnosed more often in women (P = .048). Slightly less than 30% of the time, the cause of patients' fatigue remained undiagnosed at the end of the encounter. A diagnosis was made more often in men.
  
  
  CONCLUSIONS
  Causes of fatigue frequently remain undiagnosed; however, when there is a diagnosis, psychosocial diagnoses are common. Therefore, it would be appropriate for FPs to screen for psychosocial issues when their patients present with fatigue, unless some other diagnosis is evident. Depression and anxiety could be considered particularly among female patients with fatigue.
authors: Family physician practising in Kensington, PEI, and Assistant Professor in the Department of Family Medicine at the Prince Edward Island site of Dalhousie University. pmackean@pei.sympatico.ca.
authors: Peter Reagh
authors: PR
authors: MacKean
authors: Distinguished University Professor in the Centre for Studies in Family Medicine in the Department of Family Medicine, and in the Department of Epidemiology and Biostatistics in the Schulich School of Medicine and Dentistry at Western University in London, Ont, and is the Dr Brian W. Gilbert Canada Research Chair in Primary Health Care Research.
authors: Moira
authors: M
authors: Stewart
authors: Scientist in the Centre for Studies in Family Medicine in the Schulich School of Medicine and Dentistry at Western University.
authors: Heather L
authors: HL
authors: Maddocks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology*; D001008:Anxiety Disorders / Q000453:epidemiology*; D002908:Chronic Disease / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult