Bob

A 38-year-old man presents to his GP with persistent fatigue affecting his work and family life, with significant work stress and heavy alcohol use. Take a focused history, explore the alcohol use and its impact, examine appropriately, and deliver a brief intervention and management plan.

1. 1Take a focused history of the fatigue and its impact
2. 2Take a thorough, non-judgemental alcohol history including dependence features
3. 3Screen for mood, anxiety and other contributors and exclude organic causes
4. 4Perform a relevant physical and mental state examination
5. 5Order appropriate investigations
6. 6State a working diagnosis with relevant differentials
7. 7Deliver a brief intervention and arrange support, treatment and follow-up