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February 3, 1989

Chronic Fatigue

Author Affiliations

Kaiser Permanente Gardena, Calif

Kaiser Permanente Gardena, Calif

JAMA. 1989;261(5):696-697. doi:10.1001/jama.1989.03420050044019

To the Editor. —  As a busy family physician, I see patients complaining of chronic fatigue almost daily, so I was encouraged to see the article in the Aug 19 issue by Kroenke et al1 regarding chronic fatigue in primary care. Since I agree that depression is one of the most common causes of chronic fatigue, I was glad to see that the physicians in the study used the Beck Depression Inventory, which I give to all of my patients complaining of fatigue. However, I was disappointed to note that despite the fact that 57 patients had psychometric testing scores suggestive of depression, only four patients were treated with antidepressants.The National Institute of Mental Health has recognized that primary care physicians are notoriously poor at diagnosing and treating depression, and this study suggests that the physicians involved were uncomfortable giving a trial of antidepressants to determine if it