THURSDAY, Nov. 13 (HealthDay News) -- A longitudinal relationship exists between fatigue severity, impaired functioning and psychological symptoms among patients presenting to a primary care physician with a chief complaint of fatigue, researchers report in the November/December issue of the Annals of Family Medicine.

Iris Nijrolder, of the VU University Medical Centre in Amsterdam, the Netherlands, and colleagues performed an observational cohort study examining the clinical course and outcomes in patients from 147 primary care practices seeking care for a main complaint of fatigue. Patients completed a large battery of questions at one, four, eight and 12 months after baseline, and were divided into four subgroups based on fatigue severity scores.

Response rates for the 642 patients ranged between 82 percent and 88 percent over the study period. While missing data prevented time analysis for 22 percent of enrollees, four distinctive patterns over the year-long study were identified for the 482 remaining participants: 26 percent had chronic fatigue; 17 percent had a fast recovery; 25 percent had a slow recovery; and 32 percent initially improved but then relapsed. Fatigue severity scores were greatest in the chronic fatigue group and lowest in the fast recovery group, with similar scores in the slow recovery and recurrent groups, the researchers report.

"The findings of this study suggest a longitudinal relationship between the severity of fatigue, impaired functioning, psychological symptoms and poor sleep. Physicians should be aware that a substantial proportion of patients seeking care for fatigue have these additional health and psychosocial problems," the authors conclude.

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