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19.03.2015

Definition fatigue francais, beat depression and anxiety - For Begninners

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Depression: studies done in the community and in primary care settings have shown a strong association of unexplained chronic fatigue with general psychiatric disorders, mainly depression. In addition to depression, anxiety and somatisation disorders, as well as psychosocial stressors may be associated with fatigue.
Chronic myeloid leukaemia, myelodysplastic syndrome, and lymphoma all present with fatigue in addition to other symptoms. In a study undertaken in women diagnosed with acute MI, 71% experienced unusual fatigue as a prodromal symptom, and 43% experienced fatigue as an acute symptom, whereas only 57% suffered chest pain. In addition to heart failure and acute myocardial ischaemia, atrial fibrillation may also present with fatigue along with other symptoms.
Hypothyroidism: in a large cross-sectional study, it was observed that the association between fatigue and hypothyroidism was only marginally significant. Diabetes mellitus: fatigue is viewed as a common presentation of diabetes mellitus type 1, as well as type 2. Fatigue may be a significant symptom (although not always a presenting symptom) of other, more rare endocrine disorders, such as Addison's disease, vitamin D deficiency (osteomalacia), hypopituitarism, acromegaly, growth hormone deficiency, hyperthyroidism, Cushing's syndrome, and diabetes insipidus. HIV infection: fatigue is the most frequent and debilitating complaint affecting those with HIV. Lyme disease: a prospective study showed that fatigue was present in more than half of patients with confirmed early Lyme disease, and that complaint of fatigue was more frequent than arthralgia, myalgia, or headache. Cytomegalovirus, toxoplasmosis, brucellosis, and tuberculosis may all present with fatigue. Pharmacological drugs most frequently associated with fatigue include antihistamines, antihypertensives, anti-arrhythmics, antidepressants, anti-emetics, antiepileptics, corticosteroids, diuretics, and neuroleptic agents. Other pulmonary diseases that may be associated with fatigue include sarcoidosis, [48] asthma, pulmonary HTN, pleural disease, and pneumonitis. Chronic liver disease: fatigue has been well recognised as a complaint of patients with chronic liver disease including viral and cholestatic liver disease. Inflammatory bowel disease (IBS): fatigue may be caused by malnutrition, weight loss, and inflammation.
Fatigue and lack of energy are the most important problems hampering the quality of life for haemodialysis patients.


Parkinson's disease: about 40% of patients with Parkinson's disease report fatigue among their main symptoms and it still remains even after adjusted for the presence of depression, dementia, and sleep disturbances. Stroke: investigations demonstrated that two-thirds of patients reported fatigue after stroke and 40% considered fatigue one of the worst sequelae, lasting for some patients for at least 3 years.
Multiple sclerosis: fatigue has been found to be the most disabling symptom in patients suffering from multiple sclerosis. Fatigue is also regarded as a common and often debilitating feature of lateral amyotrophic sclerosis, myasthenia gravis, dystonias, and myopathies. Other rheumatological aetiologies include fibromyalgia and rheumatoid arthritis (although rheumatoid arthritis does not usually present with fatigue). Chronic fatigue syndrome is defined as clinically evaluated, unexplained, persistent or relapsing fatigue plus 4 or more specifically defined associated symptoms.
Criteria of chronic fatigue syndrome (International Chronic Fatigue Syndrome Study Group)Adapted from Fukuda K, Straus SE, Hickie I, et al.
In contrast to the above, idiopathic chronic fatigue is defined as clinically evaluated unexplained chronic fatigue that fails to meet the criteria for chronic fatigue syndrome.
Fatigue has been shown to be the major presenting symptom in 10% to 20% of new cases of heart failure.
Furthermore, the fatigue symptom has a very low sensitivity (16%) for the diagnosis of hypothyroidism. However, data regarding the frequency of fatigue in patients with diabetes are very sparse. Although coxsackie B virus, Chlamydia, and Mycoplasma infections can also cause fatigue, it is not usually the chief complaint.
Fever, headache, myalgia, and fatigue are often associated with upper respiratory symptoms such as sore throat and lower respiratory symptoms of cough.
Thus, when a patient presents with a history of fatigue a careful evaluation of medicine, both prescribed and over-the-counter, should be undertaken and recreational drug use explored. One study showed that intensity of fatigue was higher in patients suffering from primary biliary cirrhosis (PBC) in comparison with age- and sex-matched normal patients. A pilot study suggests that fatigue correlates with the location of brain lesions, with a higher frequency in brainstem lesions.


One study found a correlation between the presence and the severity of fatigue and the localisation of lesions in the brain. Most patients with insomnia do not necessarily complain of disordered sleep but rather of accompanying symptoms such as fatigue. In an attempt to clarify this, one study examined psychosocial variables and unexplained chronic fatigue through a community survey in the UK. Therefore, not reporting a specific symptom such as fatigue does not rule out thyroid disease. The presence of fatigue had a sensitivity of 93%, a specificity of 23%, and a 0.30 negative likelihood ratio, which led to the conclusion that, as a symptom of infectious mononucleosis, the absence of fatigue is helpful in ruling out the diagnosis.
The most frequent presenting symptom in adult coeliac patients is fatigue, emphasising the fact that presentation in this group is often atypical. Fatigue severity was significantly higher in patients with parietal lobe, internal capsule, or peri-ventricular trigone lesions. Fatigue was noted in 52% of children with type 1 diabetes under 15 years of age and was the first symptom experienced in 7%.
No difference was seen between the fatigue scores in the PBC patients with Child-Pugh scores of 5 and those with Child-Pugh scores of >5. However, the question of whether such hypoactivity is a cause or a consequence of chronic fatigue syndrome still remains unanswered. In one study, fatigue was one of the most common symptoms in patients with elevated levels of cobalt and chromium after metal-on-metal hip implant.
In addition, hypothyroidism, deficiency of cortisol, and depression are frequent causes of fatigue that should be excluded.



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