What causes chronic fatigue syndrome?

January 26, 2006

Experts believe that chronic fatigue syndrome (CFS) is a complex disorder caused by many different factors. A Review in this week's issue of The Lancet reveals what we currently know about the condition.

CFS is the term generally accepted by scientists and clinicians for a range of complaints that are commonly referred to as ME (myalgic encephalomyelitis). CFS causes persistent and unexplained fatigue resulting in severe impairment to daily functioning.

In their review Judith Prins (Radboud University Nijmegen Medical Centre, Netherlands) and colleagues state that different factors predispose people to CFS, trigger the onset of the condition, or perpetuate the syndrome. The factors currently known to predispose people to CFS include neuroticism, introversion, and inactivity in childhood. Genetics may also have a role, state the authors, as women are more prone to CFS than men. Factors that trigger CFS include sudden severe physical or psychological distress, such as loss of a loved one. A link has also been found between infection caused by the Epstein-Barr virus and chronic fatigue. Psychological processes seem to be involved in the perpetuation of complaints in patients with CFS, state the authors.

Dr Prins comments: "The aetiology and pathogenesis [of CFS] are generally believed to be multifactorial. Distinction between categories of predisposing, precipitating, and perpetuating factors is useful for understanding this complex disorder. The assumption is that one or more factors of each of these categories is conditional but insufficient for the development of CFS."

The authors add that cognitive behaviour therapy (CBT)--a general form of psychotherapy directed at changing condition-related cognitions and behaviours--and exercise therapy are the only interventions that have been found to be beneficial for CFS. CBT teaches patients with CFS how to acquire control over symptoms, state the authors.
Contact: Dr Judith B. Prins, Radboud University Nijmegen Medical Centre, 840 Department of Medical Psychology, P.O Box 9101, 6500 HB Nijmegen, Netherlands. T) +31 24 3613608 j.prins@mps.umcn.nl


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