Unexplained fatigue and irritability - differential diagnosis and practical procedures for signs of exhaustion

Abstract

Chronic fatigue is a frequent complaint, but only leads to a medical consultation when consequences like sleep disturbance and reduced productivity become debilitating. Fear of a somatic disorder is usually prominent. However, the symptoms are usually physical and psychological signs of chronic stress. There is often a lack of awareness of stressors or conflicts, which would allow such a conclusion. Therefore, a few somatic investigations are recommended, since the list of possible somatic causes is long. Otherwise the patient should be prepared and motivated for a psychosocial counselling.