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Cited by 288Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesFibromyalgia and Chronic Fatigue Syndrome Research

The many faces of fatigue in major depressive disorder

Open access
Demyttenaere, Koen, De Fruyt, Jürgen, Stahl, Stephen M.·2005·The International Journal of Neuropsychopharmacology
DOI 10.1017/s1461145704004729
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Abstract

Fatigue is a common complaint in the community and medical care settings. Different studies show a high comorbidity between fatigue and depressive disorder. Furthermore, fatigue is an important somatic symptom of depressive disorder and one of the main depressive presentations in primary-care medicine. Fatigue shows a slow response to antidepressant treatment and psychotherapy. Improved work performance is strongly correlated to improvement in energy. However, the assessment and treatment of fatigue in depressive disorder remains understudied. Different definitions of fatigue in depressive disorder are applied in DSM-IV and ICD-10, and depression rating scales all show a different coverage of this core depressive symptom, thereby hampering scientific research. Serotonin, norepinephrine, dopamine and histamine mediate symptoms of fatigue in depressive disorder. Although few data address the effect of antidepressants or augmentation strategies on fatigue-related symptoms, there is a pharmacological rationale for using antidepressant monotherapies, such as venlafaxine, bupropion, sertraline, fluoxetine, or augmentation of first-line treatment with stimulants or modafinil.

Integrity signals

Registry

Crossref · 10.1017/s1461145704004729

Cites

149 of 149 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 122 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Fatigue is frequently reported in community and primary-care populations.

    “Fatigue is a common complaint in the community and medical care settings.”
    • Also stated in: § Fatigue in the community and medical settings · plain
      “It is a common complaint in the community and in primary-care settings.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Walker et al., 1993

      Not checked in the free run.

    • cites Kroenke and Price, 1993

      Not checked in the free run.

  • Interpretationcitation

    Fatigue improves slowly with both antidepressant medication and psychotherapy.

    “Fatigue shows a slow response to antidepressant treatment and psychotherapy.”
    • Also stated in: § Fatigue in MDD 99 · plain
      “Fatigue abates less frequently and more slowly than other depressive symptoms.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Opdyke et al., 1996/1997

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    • cites Barkham et al., 1996

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    • cites Kopta et al., 1994

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  • Premisecitation

    Fatigue and depressive disorder co-occur at high rates.

    “Different studies show a high comorbidity between fatigue and depressive disorder.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Addington et al., 2001

      Not checked in the free run.

    • cites Kroenke and Price, 1993

      Not checked in the free run.

  • Premisecitation

    The higher current major depression prevalence in fatigued subjects remained after excluding fatigue from depression criteria.

    “The higher prevalence of current major depression [odds ratio (OR) 14.7 for men, 6.3 for women] persisted even when fatigue was excluded as a criterion for the diagnosis of depression.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Walker et al., 1993

      Not checked in the free run.

  • Interpretationcitation

    Serotonin, norepinephrine, dopamine, and histamine mediate fatigue symptoms in depressive disorder.

    “Serotonin, norepinephrine, dopamine and histamine mediate symptoms of fatigue in depressive disorder.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Stahl et al., 2003

      Not checked in the free run.

    • The authors state this as an assumption: Fatigue in major depressive disorder is mediated by malfunctioning neuronal circuits that are distinct from those mediating sadness or depressed mood.
  • May combine two claims. 28
  • The quote only partly states this claim. 2
  • Classified as probably not a substantial claim. 10

  • May combine two claims.

    Premisenone given

    Fatigue is a major somatic symptom of depressive disorder and a common depressive presentation in primary care.

    “Furthermore, fatigue is an important somatic symptom of depressive disorder and one of the main depressive presentations in primary-care medicine.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Depression rating scales cover fatigue differently, which impedes scientific research.

    “depression rating scales all show a different coverage of this core depressive symptom, thereby hampering scientific research.”
    • Also stated in: § Fatigue in MDD · plain
      “The HDRS, BDI-II and MADRS not only differ in their coverage/wordings of fatigue but also in their perspective of observer”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hamilton, 1960

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    • cites Beck et al., 1996

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    • cites Montgomery and Åsberg, 1979

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  • May combine two claims. The quote only partly states this claim.

    Premisecitation

    Baseline depression predicted recurrent/chronic and incident fatigue; recurrent/chronic fatigue had a 28-fold greater risk of major depression.

    “Baseline depression was predictive of both recurrent/ chronic fatigue (reporting fatigue in their lifetime at baseline and again sometime during the follow-up interval) and incident fatigue (reporting fatigue occurring for the first time during the follow-up interval).”
    • Also stated in: § Fatigue in the community and medical settings · plain
      “Participants with recurrent/chronic fatigue had a 28-fold greater risk of developing major depression than those without fatigue.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Addington et al., 2001

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    DSM-IV treats fatigue/loss of energy as an A6 criterion rather than a core MDE symptom, while ICD-10 treats reduced energy as a core feature.

    “Fatigue or loss of energy nearly every day is the A6 criterion -and not a core symptom -in the DSM-IV diagnosis of MDE.”
    • Also stated in: § Fatigue in MDD · plain
      “However, in the definition of depressive episode according to ICD-10 (WHO, 1992), reduced energy is described as a core feature besides depressed mood and loss of interest and enjoyment.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites APA, 1994

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    • cites WHO, 1992

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  • May combine two claims.

    Premisecitation

    Nierenberg et al. found more than 80% of full responders had residual MDD symptoms, with fatigue at 38.8% one of the three most common.

    “More than 80 % of full responders had one or more residual symptoms of MDD: fatigue (38.8 % prevalence) being one of the three most common symptoms.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nierenberg et al., 1999

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Maurice-Tison et al. found fatigue/loss of energy was the most common depressive symptom in general practice patients (38.2%), and 93.6% in the depressed subsample.

    “Maurice-Tison et al. (1998) found fatigue/loss of energy to be the most common depressive symptom (38.2 % prevalence) in general practice patients.”
    • Also stated in: § Fatigue in MDD · plain
      “In the depressed subsample fatigue was prevalent in 93.6 % of cases.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Maurice-Tison et al., 1998

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Assessment and treatment of fatigue in depressive disorder are under-researched.

    “However, the assessment and treatment of fatigue in depressive disorder remains understudied.”
    • Also stated in: § Treating fatigue in depression · plain
      “There are few data for any antidepressant that specifically address the effects on fatigue-related symptoms.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Gullion and Rush found self-rated lack of energy and observer-rated fatigue loaded on different factors, suggesting distinct concepts.

    “In a factor analysis of depressive symptoms (measured by different observer-rating and self-rating scales), the authors identified a factor 'lack of energy' which was mainly composed of self-rated items.”
    • Also stated in: § Fatigue in MDD · hedged
      “These results suggest different concepts of self-rated vs. observer-rated fatigue in major depression”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gullion and Rush, 1998

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Kroenke and Price found a 13.8% lifetime prevalence of fatigue, associated with increased lifetime risk of depression and dysthymia.

    “Kroenke and Price (1993) found a 13.8 % lifetime prevalence of fatigue, classified as medically unexplained or potentially due to psychiatric illness.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kroenke and Price, 1993

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Addington et al. found 14.0% lifetime unexplained fatigue and an 11-fold greater risk of lifetime major depression.

    “At baseline, similar findings were made as in the study by Kroenke and Price (1993) : 14.0 % of individuals reporting unexplained fatigue for 2 wk or more in their lifetimes, with an 11-fold greater risk of a lifetime diagnosis of major depression compared to non-fatigued participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Addington et al., 2001

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    HDRS, BDI-II, and MADRS differ in fatigue coverage and in observer versus self-rating perspective.

    “The HDRS, BDI-II and MADRS not only differ in their coverage/wordings of fatigue but also in their perspective of observer (HDRS and MADRS being observer-rating scales, BDI-II being a self-rating scale).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hamilton, 1960

      Not checked in the free run.

    • cites Beck et al., 1996

      Not checked in the free run.

    • cites Montgomery and Åsberg, 1979

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In primary care, Cathebras et al. found 13.6% presented with fatigue; current major depression was 17.2% versus 8.8%.

    “In a primarycare study by Cathe ´bras et al. (1992), 13.6 % of patients presented with a complaint of fatigue; in approximately half of the cases fatigue was their major reason for consultation.”
    • Also stated in: § Fatigue in the community and medical settings · plain
      “The rate of current major depression was 17.2 % for fatigue patients vs. 8.8 % for non-fatigue patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cathebras et al., 1992

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Swindle et al. found tiredness/low energy was the most common baseline depressive symptom (91.3%) and an energy factor was most strongly related to social functioning, absenteeism, and work productivity.

    “At baseline, tiredness/low energy was the most common depressive symptom reported by 91.3 % of patients.”
    • Also stated in: § Fatigue in MDD 95 · plain
      “Among different components of depressive symptoms, an energy factor was most strongly related to social functioning, absenteeism and work productivity, at baseline and at 3-month follow-up.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Swindle et al., 2001

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Current fatigue was linked to higher lifetime and current rates of major depression, dysthymia, panic disorder, and somatization disorder.

    “Subjects with current fatigue had a significantly higher lifetime and current prevalence of major depression, dysthymia, panic disorder and somatization disorder.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Walker et al., 1993

      Not checked in the free run.

  • May combine two claims. The quote only partly states this claim.

    Premisecitation

    Christensen and Duncan found energy measures correctly classified 93% of depressed versus non-depressed participants and outperformed psychosocial variables.

    “A discriminant function analysis using the energy measures as predictors was significant and provided a correct classification of 93 % of the participants.”
    • Also stated in: § Fatigue in MDD · plain
      “When compared with psychosocial variables like negative cognitions and stressors, energy level proved to more effective in classifying depressed individuals.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Christensen and Duncan, 1995

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Fuhrer and Wessely found fatigue prevalence varied by construct: 3.7% diagnosis, 7.6% presenting complaint, and 31.3% symptom.

    “The prevalence ranged between 3.7 % (fatigue as a diagnosis), 7.6 % (fatigue as presenting complaint) and 31.3 % (symptom of fatigue/loss of energy during the preceding 2 wk).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fuhrer and Wessely, 1995

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    CNS stimulants block norepinephrine and dopamine reuptake and increase release by interfering with vesicular transport.

    “CNS stimulants not only block NE and DA reuptake but also increase the release of these two neurotransmitters by interfering with the transport of these agents into synaptic vesicles (Tanda et al., 1997;Xu et al., 2000).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Tanda et al., 1997

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    • cites Xu et al., 2000

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  • May combine two claims.

    Premisecitation

    CNS stimulants increase dopamine and norepinephrine in cortex and subcortical limbic areas such as nucleus accumbens, which accounts for abuse potential.

    “However, CNS stimulants can not only increase the release of DA and NE in the cortex, but also in subcortical limbic areas such as nucleus accumbens, which is responsible for the significant abuse potential of these drugs”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Everitt and Wolf, 2002

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    • cites Worsley et al., 2000

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Fatigue appears to be a core depressive symptom and is classified as such in ICD-10.

    “Fatigue appears to be a core depressive symptom and”
    • Also stated in: § Fatigue in MDD 99 · plain
      “is classified as such in the ICD-10.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites WHO, 1992

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Bupropion may improve energy, fatigue, and executive function.

    “Bupropion may be effective in improving energy and fatigue (Bodkin et al., 1997), as well as executive function (Bodkin et al., 1997;Moron et al., 2002).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bodkin et al., 1997

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    • cites Moron et al., 2002

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The monoamine hypothesis proposes that depression relates to a deficit of norepinephrine and serotonin at critical synapses.

    “The classical theory to explain depression is the ' monoamine hypothesis ' which proposes that depression is related to a deficit of monoamines, particularly norepinephrine (NE) and serotonin (5-HT), at critical synapses (Schildkraut, 1965).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schildkraut, 1965

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Modafinil relieves sleepiness and fatigue in myotonic dystrophy and multiple sclerosis, suggesting a common fatigue pathway.

    “Modafinil also relieves sleepiness and fatigue in patients with myotonic dystrophy (Damian et al., 2001;MacDonald et al., 2002) and in patients with multiple sclerosis (Krupp et al., 1989), suggesting an action to reduce fatigue mediated by a common pathway that may be malfunctioning in a number of neurological and psychiatric disorders in addition to MDD.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Damian et al., 2001

      Not checked in the free run.

    • cites MacDonald et al., 2002

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    • cites Krupp et al., 1989

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  • May combine two claims.

    Premisecitation

    In a double-blind 6-week study, modafinil augmentation significantly improved fatigue and sleepiness scores at weeks 1 and 2 versus placebo; week 6 differences were not significant.

    “In a double-blind, 6-wk study of patients partially responsive to antidepressant treatment, modafinil augmentation significantly improved fatigue and sleepiness scores at weeks 1 and 2 respectively, compared to placebo (DeBattista et al., 2003).Differences at week 6 were not significant.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites DeBattista et al., 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Dopamine depletion in the nucleus accumbens reduces animals' effort to obtain natural stimuli, suggesting a relation to reduced motivation or psychomotor retardation.

    “A novel hypothesis is that DA depletion in the nucleus accumbens reduces the likelihood that animals will exert effort to obtain natural stimuli such as food, suggesting that DA depletion in this area may be related to reduced motivation, psychomotor retardation, or both (Salamone et al., 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Salamone et al., 2003

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Venlafaxine, bupropion, fluoxetine, and sertraline may be most likely to relieve fatigue among first-line antidepressants, but this has not been adequately studied.

    “Thus, the pharmacological profiles of venlafaxine, bupropion, fluoxetine, and sertraline suggest that, of the first-line antidepressants, these agents may be most likely to relieve symptoms of fatigue in depression, but this has never been adequately studied.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stahl et al., 2003

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Modafinil selectively activates orexin-containing and histaminergic hypothalamic neurons, releases histamine, and releases dopamine and norepinephrine in cortex but not notably in nucleus accumbens, and serotonin in cortex.

    “This drug selectively activates orexin-containing and histaminergic neurons in the hypothalamus, and releases histamine in the hypothalamus (Ishizuka et al., 2003) as well as DA and NE in the cortex (Bymaster et al., 2002a;De Saint Hilaire et al., 2001;Li et al., 1998, Zhang et al., 2000) but not notably in the nucleus accumbens (Ferraro et al., 1997).”
    • Also stated in: § Modafinil · plain
      “It also releases 5-HT in the cortex (Ferraro et al., 2000(Ferraro et al., , 2002)).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Ishizuka et al., 2003

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    • cites Bymaster et al., 2002a

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    • cites Ferraro et al., 1997

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  • Classified as probably not a substantial claim.

    Interpretationcitation

    The neurobiological basis of fatigue may be the least understood of all symptoms associated with a major depressive episode.

    “Despite the importance of fatigue, its neurobiological basis may be the least understood and least emphasized of all the symptoms associated with a MDE (Tylee et al., 1993).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Tylee et al., 1993

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationcitation

    The importance of fatigue is not reflected in the DSM-IV description of MDE.

    “However, its importance is not reflected in the DSM-IV description of MDE.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites APA, 1994

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    No studies were found on CNS stimulants for executive dysfunction in depression, but a positive effect could be expected.

    “No studies have been found to examine the role of CNS stimulants as a drug treatment for executive dysfunction in depression, but given their known actions in attention deficit disorder, a positive effect upon residual symptoms of cognitive dysfunction in MDD could be expected.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Among first-line antidepressants, agents that increase norepinephrine, dopamine, or both may be preferable for patients with prominent fatigue.

    “Among the first-line antidepressant monotherapies, agents that increase NE, DA, or both, particularly in pathways associated with physical and mental fatigue, may be preferable for patients with prominent fatigue and lack of energy”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Stahl et al., 2003

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Antidepressants are often more effective for sadness and depressed mood than for fatigue, which is a common residual symptom in responders.

    “This may explain observations that antidepressants are often more effective for sadness and depressed mood than they are for fatigue, which is one of the most common residual symptoms in patients who respond but do not remit with antidepressant treatment”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Menza et al., 2003

      Not checked in the free run.

    • cites Nierenberg et al., 1999

      Not checked in the free run.

    • cites Paykel, 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Fatigue is a frequent presenting symptom of MDD.

    “Fatigue is a frequent presenting symptom of MDD.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Rapid relief from fatigue is essential to achieving remission.

    “Rapid relief from fatigue symptoms is, therefore, essential to achieving remission.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationnone given

    Unclear coverage of fatigue in rating scales and ill-defined measurement add confusion and may hamper future research.

    “Unclear coverage of fatigue in different depression rating scales and ill-defined measurement further add to this confusion and may hamper future research.”
    Quote in the paperSubstantial claim
34 of 34

  • The authors state this as an assumption.

    Fatigue in major depressive disorder is mediated by malfunctioning neuronal circuits that are distinct from those mediating sadness or depressed mood.

    “Thus, the symptom of fatigue is hypothetically mediated by entirely different malfunctioning neuronal circuits than those that mediate sadness or depressed mood in MDD (Stahl et al., 2003).”

  • The paper relies on this without support.

    Monoamine input is not necessarily deficient before antidepressant treatment.

    “Monoamine input is not necessarily deficient prior to treatment with an antidepressant.”

  • The paper relies on this without support.

    The neuronal circuits mediating different depressive symptoms all receive innervation from monoamine neurons, so boosting one or two monoamines can reduce multiple symptoms.

    “However, antidepressants that boost just one or two monoamines could reduce a whole portfolio of symptoms, since the circuits mediating those symptoms may all receive innervation from monoamine neurons.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. Delgado PL (2000). Depression: the case for a monoamine deficiency. Journal of Clinical Psychiatry 61, 7-11.
  2. Hamilton M (1967). The development of a scale for primary depressive illness. British Journal of Clinical Psychology 6, 278-296.
  3. Mason P, Wilkinson G (1996). The prevalence of psychiatric morbidity. British Journal of Psychiatry 168, 1-3.
  4. Ni YG, Miledi R (1997). Blockage of 5HT2C serotonin receptors by fluoxetine (Prozac). Proceedings of the National Academy of Sciences USA 94, 2036-2040.

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Related

Authors
Demyttenaere, K., De Fruyt, J., & Stahl, S. M.
Affiliations
  • Universitair Ziekenhuis Leuven (BE)
  • University of California San Diego (US)
Corresponding author
Demyttenaere, Koen
ORCID
Venue
The International Journal of Neuropsychopharmacology
Publisher
Oxford University Press (OUP)
Published
2005-03
Volume
8
Issue
1
Pages
93-105
ISSN
  • 1461-1457 (ISSN-L)
  • 1469-5111
DOI
10.1017/s1461145704004729
OpenAlex
W2150840378
Semantic Scholar
184f1dccd433c12c0129520c511707f28fc1e785
Cited by
288
References
147
Citations by year
2026: 10 · 2025: 11 · 2024: 13 · 2023: 12 · 2022: 13 · 2021: 20 · 2020: 15 · 2019: 16 · 2018: 20 · 2017: 15 · 2016: 19 · 2015: 20 · 2014: 15 · 2013: 15 · 2012: 11
FWCI
1.05
Type
journal article
Language
en
Open access
Locations
  • The International Journal of Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Abbott Laboratories
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • Sanofi
  • Les Laboratories Pierre Fabre
  • H. Lundbeck A/S
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
fatigue, major depressive disorder, somatic symptoms, antidepressant response, psychotherapy, employee performance, energy, DSM-IV, ICD-10, depression rating scales, serotonin, norepinephrine, dopamine, histamine, antidepressant augmentation, modafinil, stimulants, venlafaxine, bupropion, sertraline, fluoxetine
MeSH terms
Central Nervous System Stimulants, Antidepressive Agents, Major Depressive Disorder, Fatigue, Humans, Primary Health Care, Psychophysiologic Disorders, Comorbidity

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