Chronic Fatigue Syndrome: Diagnostic Enigma

Patients with unexplained fatigue often have secondary anxiety and depressive symptoms. The symptoms are unlikely to resolve unless their primary illness is diagnosed and treated. Many patients labeled with treatment-resistant depressionare misdiagnosed. Chronic fatigue syndrome may simulate depression and hence is under recognised and under treated. It presents with a cluster of neurological and gastrointestinal symptoms that evade routine diagnoses. Multiple referrals to several specialists are aimed at uncovering the diagnosis. The following case report demonstrates how consultation liaison psychiatry may play a role in conceptualising patient’s illness and legitimising the symptoms; thereby alleviating anxiety and restricting use of anti depressants.