The differential diagnosis of tiredness: a systematic review

Stadje, Rebekka; Dornieden, Katharina; Baum, Erika; Becker, Annette; Biroga, Tobias; Bösner, Stefan; Haasenritter, Jörg; Keunecke, Christian; Viniol, Annika; Donner-Banzhoff, Norbert

doi:10.1186/s12875-016-0545-5

Cited by 56 publications

(46 citation statements)

References 35 publications

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“…Etiyolojisinin kabaca %70 oranında belirlenebildiği söylenebilir. Avrupa'da 6000'e yakın kişiyle yapılan bir çalışmada; nedenler olarak en ön sıralarda depresyon, viral üst solunum yolu enfeksiyonu, anemi, akut bronşit, ilaç yan etkileri ve malignitenin yer aldığı anlaşılmıştır (4…”

Section: Introductionunclassified

The Clinical Approach of Asthenia and Fatigue

Çayakar

2019

Ege Tıp Bilimleri Dergisi

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Fatigue or asthenia are nonspecific complaints that can be described as subjective lack of energy, feeling of exhaustion and weakness. It constitutes about 20% of the symptoms applied to the family physicians and affects family life, work performance and social relations negatively over time. The symptom lasting for six months is considered chronic fatigue. The ratio was calculated as 15% in the society and was reported that it has more frequently observed in poor female group with low education level at 30-50 years. Detection rates can be up to 40% if there is a accompanying medical discomfort. The disease called chronic fatigue syndrome on the other hand is a complex disease that affects women in particular and has its own criteria. One out of every seven patients suffering from chronic fatigue is involved in this syndrome and the incidence can be up to 10-15% in tertiary health care facilities. Most frequent cause of the chronic fatigue etiology is the change in psychological status with the rates of 80%. Other causes include chronic fatigue syndrome, rheumatologic and oncologic scenes, infections, neurological, hematological and endocrine diseases as well as end-stage organ diseases. Chronic fatigue is often accompanied by symptoms of general pain or weakness, and the present situation may become more complex. In this article, a clinical approach for practical life is tried to be presented..

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Section: Introductionunclassified

The Clinical Approach of Asthenia and Fatigue

Çayakar

2019

Ege Tıp Bilimleri Dergisi

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“…This is not an unexpected finding, but the VT scale rendered a higher percentage, i.e., 21% scored 40, which is a troubling result, since tiredness is an indicator that something is not right. In a recent review of patients in primary care complaining of tiredness, it was reported that about every fifth patient had a depressive disorder [41]. Therefore, history taking, targeted at mental health and well-being, is of great importance, especially since young women with depression and stress symptoms have been reported to be at risk of using less effective contraceptive methods over time [19].…”

Section: Confounding Factorsmentioning

confidence: 99%

Health-related quality of life in young women starting hormonal contraception: a pilot study

Kristjánsdóttir

Sundelin

Naessén

2018

The European Journal of Contraception & Reproductive Health

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Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n ¼ 193) and a selected control group (n ¼ 238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p ¼ .000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported. ARTICLE HISTORY

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“…Necessary investigations include full blood count, urea, electrolyte and creatinine levels, liver and thyroid function tests, C‐reactive protein levels or erythrocyte sedimentation rate, and fasting blood glucose tests . Reassuringly, a systematic review of 26 studies examining CFS diagnosis in patients attending primary care with tiredness revealed a low prevalence of underlying medical conditions, including anaemia (2.8%), malignancy (0.6%), and other serious physical illnesses (4.3%) . Depression was diagnosed in 18.5% of patients.…”

Section: Diagnosing Cfsmentioning

confidence: 99%

Chronic fatigue syndrome: progress and possibilities

Sandler

Lloyd

2020

Medical Journal of Australia

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Summary Chronic fatigue syndrome (CFS) is a prevalent condition affecting about one in 100 patients attending primary care. There is no diagnostic test, validated biomarker, clear pathophysiology or curative treatment. The core symptom of fatigue affects both physical and cognitive activities, and features a prolonged post‐activity exacerbation triggered by tasks previously achieved without difficulty. Although several different diagnostic criteria are proposed, for clinical purposes only three elements are required: recognition of the typical fatigue; history and physical examination to exclude other medical or psychiatric conditions which may explain the symptoms; and a restricted set of laboratory investigations. Studies of the underlying pathophysiology clearly implicate a range of different acute infections as a trigger for onset in a significant minority of cases, but no other medical or psychological factor has been reproducibly implicated. There have been numerous small case–control studies seeking to identify the biological basis of the condition. These studies have largely resolved what the condition is not: ongoing infection, immunological disorder, endocrine disorder, primary sleep disorder, or simply attributable to a psychiatric condition. A growing body of evidence suggests CFS arises from functional (non‐structural) changes in the brain, but of uncertain character and location. Further functional neuroimaging studies are needed. There is clear evidence for a genetic contribution to CFS from family and twin studies, suggesting that a large scale genome‐wide association study is warranted. Despite the many unknowns in relation to CFS, there is significant room for improvement in provision of the diagnosis and supportive care. This may be facilitated via clinician education.

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The differential diagnosis of tiredness: a systematic review

Cited by 56 publications

References 35 publications

The Clinical Approach of Asthenia and Fatigue

The Clinical Approach of Asthenia and Fatigue

Health-related quality of life in young women starting hormonal contraception: a pilot study

Chronic fatigue syndrome: progress and possibilities

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