, Volume 45, Issue 3, pp 289-298
Date: 30 Jan 2013

Chronic Fatigue and Personality: A Twin Study of Causal Pathways and Shared Liabilities

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The etiology of chronic fatigue syndrome (CFS) remains unknown. Personality traits influence well-being and may play a role in CFS and unexplained chronic fatigue.


This study aimed to examine the association of emotional instability and extraversion with chronic fatigue and CFS in a genetically informative sample.


We evaluated 245 twin pairs for two definitions of chronic fatigue. They completed the Neuroticism and Extraversion subscales of the NEO Five Factor Inventory. Using a co-twin control design, we examined the association between personality and chronic fatigue.


Higher emotional instability was associated with both definitions of chronic fatigue and was confounded by shared genetics. Lower extraversion was also associated with both definitions of fatigue, but was not confounded by familial factors.


Both emotional instability and extraversion are related to chronic fatigue and CFS. Whereas emotional instability and chronic fatigue are linked by shared genetic mechanisms, the relationship with extraversion may be causal and bidirectional.

Brian Poeschla and Eric Strachan contributed equally to this work.