Article October 1, 2003

The Differential Diagnosis of Fatigue and Executive Dysfunction in Primary Care

Joseph A. Lieberman, III, MD, MPH

J Clin Psychiatry 2003;64(suppl 14):40-43

Article Abstract

The diagnosis of the patient reporting fatigue or the signs of executive dysfunction can be perplexingfor the primary care physician. Both symptoms are associated with a wide range of both somaticand psychiatric symptoms and often occur together, although they can exist independently. Usingsome simple diagnostic and mnemonic tools, such as BATHE, SIG E CAPS, and SWIKIR, may aidthe clinician in differentiating possible causes of fatigue and executive dysfunction and determiningwhether they are signs of physical or mental disease.