Whether it is of psychological or physical origin or both, chronic fatigue syndrome can cause substantial morbidity and disability, and its management in primary care involves the whole team
It is most uncommon for patients to present in primary care because of too much energy or vitality. Tiredness, on the other hand, is a very common complaint. Tiredness is an ill-defined subjective symptom of malaise, aversion to activity and of impaired performance.1 It has physical and psychological dimensions. A distinction should be made between lack of energy, lack of motivation, and sleepiness - all of these can be described as 'tiredness', but will suggest different diagnoses.
