Depression and chronic fatigue in the workplace. Workers' compensation and occupational issues.

There is ample evidence that some forms of depression can be caused or aggravated by work. The relationship of work and chronic fatigue syndrome is questionable, but elements at work can aggravate the symptoms of chronic fatigue syndrome. The role of physicians who can support or discourage beliefs about physical illness is all important, both by what they say and how they treat. In the process of interaction, they can promote or discourage disability. The role of the physician in the workplace is to determine if an illness is work related, if it is disabling, if it requires treatment, and what treatment. The physician must advise if the worker can continue in his or her usual and customary employment and, if not, if he or she can be vocationally rehabilitated from a medical standpoint. Conditions in which physical symptoms are unsupported by physical findings and have diagnostic labels that describe the disorder without indicating either cause or pathology are especially troubling for the physician who must decide if the patient's job caused the symptoms.