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Jeffrey A. Jackson, MD
Scott and White Clinic Temple, Tex

JAMA. 1989;261(5):696.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent article by Kroenke et al¹ on chronic fatigue in primary care provides informative data on a common clinical problem. It certainly is no surprise that 56% of their patients had Beck Depression Inventory scores suggestive of depression. What is surprising, however, is that the authors treated only 7% of these (four patients) with antidepressant medication. This lack of prescribing antidepressants may be a major explanation for the overall poor outcome of their patients after one year of follow-up.

While the authors did mention the fact (best stated by Talley²) that depressive illness is often unrecognized in primary care, their cautious interpretation of the psychometric data detracts from the emphasis that this important clinical point should receive. Unfortunately, many primary care physicians do not feel comfortable diagnosing and treating depressive illness. I believe that this is a major reason why many physicians regard such . . . [Full Text PDF of this Article]

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