Erschöpfung und chronisches erschöpfungssyndrom: Relevanz für die arbeitsmedizin

Exhaustion and fatigue are known to almost everybody as a phenomenon of daily life. Both physical as well as mental labour lead to exhaustion, although there is high inter-individual variability. Exhaustion is often reported in the context of work, where characteristics of the occupation itself as well as work-related psychosocial aspects play an important role. Chronic fatigue typically occurs already after low levels of physical or mental strain. Furthermore, fatigue often does not remit at all or only to some extent after a recreational phase. This medical condition, which is frequently observed in occupational medicine, is typically classified as Chronic Fatigue Syndrome (CFS). However, it could also be assigned to the diagnosis of Neurasthenia according to the ICD-10 criteria, as there is a high overlap in diagnostic criteria. The diagnosis is based on the clinical assessment of symptoms and their duration. The diagnosis requires thorough somatic investigation beforehand to exclude underlying organic causes of fatigue. Biological, social and psychological factors are supposed to be relevant for the aetiology of CFS. Cognitive-behavioural psychotherapy and graded exercise are efficacious, evidence-based methods for the treatment of CFS. A merely symptom-oriented, pharmacological anti-depressive therapy is recommended due to the high comorbidity of chronic fatigue with anxiety and/or depressive symptoms.