Psychiatry Research EG

Background Patients suffering from major depressive disorder and different types of anxiety disorders sometimes present to nonpsychiatrists complaining of atypical presentations, for example, fatigue, which leads us to the question: does chronic fatigue represent another clinical presentation for depression and anxiety? Design and methods This study was a cross-sectional comparative study that included 100 adults presenting with fatigue without an evident medical cause and 50 controls presenting with fatigue associated with anemia to a general internal medicine outpatient clinic. All patients underwent a detailed clinical medical evaluation and were assessed by the Multidimensional Fatigue Inventory (MFI), the Mini International Neuropsychiatric Interview (MINI), the Hamilton Anxiety Rating Scale, and the Hamilton Depression Rating Scale. Results The most common primary psychiatric diagnoses of the ‘nonorganic fatigue’ group were depressive disorders (43%), somatization/hypochondriasis (31%), and anxiety disorders (27%). Physical fatigue, reduced activity, and mental fatigue were higher among the patients having organic fatigue than in those having nonorganic fatigue. The severity of depressive disorders was significantly correlated to reduced motivation and mental fatigue. Conclusion Fatigue is a presentation not uncommonly pointing to an underlying psychiatric condition. Sometimes psychiatric complaints cannot be expressed verbally by the patient although he is suffering from different psychiatric symptoms, usually those of depressive disorders. Keywords: anxiety, depression, Egypt, fatigue, major depressive disorder