PSYCHIATRIC FINDINGS IN FATIGUE
ROBERT S. SCHWAB M. D.1, and
THOMAS DELORME M. D.
1 Director of Electroencephalographic Laboratory, Massachusetts General Hospital. Clinical assistant professor in neurology, Harvard Medical School, Boston.
We have studied fatigue curves in 65 normal subjects, 50 patients with myasthenia gravis, 25 patients with Parkinson's disease, 50 patients with miscellaneous neurological conditions such as poliomyelitis, arthritis, and dystrophy, and 40 patients who did not have any structural disease of their muscular or nervous systems but whose complaint was chronic fatigue and who had symptoms of nervousness, indicating that their fatigue was of psychogenic origin.
The site of pathology of the fatigue in the neurological cases mentioned may be in the muscle, the end-plate, or in the peripheral nerve. However, the source of the fatigue complaint in patients with chronic fatigue of nonneurological nature and not due to medical diseases lies in the brain. Treatment of this type of disease must be directed toward determining the psychological causes of the fatigue and correcting them. The prescribing of muscular rest with the idea that the muscles are at fault is a waste of time.
