Tiredness as a ticket of entry: The role of patients' beliefs and psychological symptoms in explaining frequent attendance

Abstract

Objectives - To test when patients presented with fatigue whether their beliefs about its cause was related to their frequency of attending; and to measure the association between their fatigue and psychological symptoms and their frequency of attendance during the study year. Design - A cohort study. Setting - Primary health care. Patients - Patients presenting with fatigue as their main symptom. Main outcome measures- A fatigue questionnaire, the general health questionnaire (GHQ), an attribution scale, and measurement of consulting frequency during the 6 months before and after the patient presented. Results - Patients who believed their fatigue was due to a physical or mostly physical cause consult for any reason significantly more frequently than patients who reported that psychological as well as physical problems might have caused their fatigue. Patients' psychological distress measured with the GHQ was more closely associated with frequent attendance than their level of fatigue was. Conclusions - When patients present with fatigue it is important to enquire about their beliefs and psychological symptoms; these factors may be more important than the fatigue itself in explaining their help-seeking behaviour.