Annals of Behavioral Medicine

, Volume 21, Issue 3, pp 258–271

Chronic fatigue syndrome: Reviewing the research findings

  • Susan K. Johnson
  • John DeLuca
  • Benjamin H. Natelson
Article

Abstract

This article reviews the current state of research in chronic fatigue syndrome (CFS). The evolving definition, prevalence, and prognosis of this controversial illness are presented. We review studies examining psychiatric, personality, and psychosocial etiology for CFS. The evidence for pathophysiology in CFS is also presented, and studies investigating viral, immune, neuroimaging, neuroendocrine, and central and autonomic nervous system abnormalities in CFS are assessed. Current evidence indicates that CFS is multidetermined and heterogeneous and that subgrouping patients according to factors such as psychiatric state and symptom onset may be fruitful. The current state of treatment for CFS is reviewed, and the challenges for research aimed at resolving this prototypical mind/body problem are discussed.

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References

  1. (1).
    Greenberg DB: Neurasthenia in the 1980s: Chronic mononucleosis, chronic fatigue syndrome, and anxiety and depressive disorders.Psychosomatics. 1990,31:129–137.PubMedGoogle Scholar
  2. (2).
    Sharpe MC, Archrd LC, Bantavala JE, et al: A report—Chronic fatigue syndrome: Guidelines for research.Journal of the Royal Society of Medicine. 1991,84:118–121.PubMedGoogle Scholar
  3. (3).
    Wessely S: Old wine and new bottles: Neurasthenia and ‘ME’.Psychological Medicine. 1990,20:35–53.PubMedGoogle Scholar
  4. (4).
    Wessely S: The history of chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, 1994, 3–44.Google Scholar
  5. (5).
    Holmes GP, Kaplan JE, Gantz NM, et al: Chronic fatigue syndrome: A working case definition.Annals of Internal Medicine. 1988,108:387–389.PubMedGoogle Scholar
  6. (6).
    Schluederberg A, Straus SE, Peterson P, et al: Chronic fatigue syndrome research. Definition and medical outcome assessment.Annals of Internal Medicine. 1992,117:325–331.PubMedGoogle Scholar
  7. (7).
    Fukuda K, Straus SE, Hickie I, et al: The chronic fatigue syndrome: A comprehensive approach to its definition and study.Annals of Internal Medicine. 1994,121:953–959.PubMedGoogle Scholar
  8. (8).
    Goldenberg DL: Fibromyalgia and its relation to chronic fatigue syndrome, viral illness and immune abnormalities.Journal of Rheumatology. 1989,16:91–93.Google Scholar
  9. (9).
    Lloyd AR, Wakefield D, Boughton C, Dwyer J: Prevalence of chronic fatigue syndrome in an Australian population.Medical Journal of Australia. 1990,153:522–528.PubMedGoogle Scholar
  10. (10).
    Lewis G, Wessely S: The epidemiology of fatigue: More questions than answers.Journal of Epidemiology and Community Health. 1992,46:92–97.PubMedGoogle Scholar
  11. (11).
    Smets EMA, Garssen B, Bonke B, de Haes JCMJ: The Multidimensional Fatigue Inventory (MFI): Psychometric qualities of an instrument to assess fatigue.Journal of Psychosomatic Research. 1995,39:315–319.PubMedGoogle Scholar
  12. (12).
    Ray C, Weir WRC, Phillips S, Cullen S: Development of a measure of symptoms in chronic fatigue syndrome: The Profile of Fatigue-Related Symptoms.Psychology and Health. 1992,7:27–43.Google Scholar
  13. (13).
    Komaroff AL: Clinical presentation and evaluation of fatigue and chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, 1994, 61–84.Google Scholar
  14. (14).
    Shafran SD: The chronic fatigue syndrome.American Journal of Medicine. 1991,90:730–739.PubMedGoogle Scholar
  15. (15).
    Euba R, Chadler T, Deale A, Wessely S: A comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care.British Journal of Psychiatry. 1996,168:121–126.PubMedGoogle Scholar
  16. (16).
    Buchwald D, Umali P, Umali J, et al: Chronic fatigue and chronic fatigue syndrome: Prevalence in a Pacific Northwest health care system.Annals of Internal Medicine. 1995,123:81–88.PubMedGoogle Scholar
  17. (17).
    CDC surveillance summary for chronic fatigue syndrome—Four U.S. cities.Morbidity and Mortality Weekly Report. 1997,46(SS-2).Google Scholar
  18. (18).
    Bates DW, Schmitt W, Buchwald D, et al: Prevalence of fatigue and chronic fatigue syndrome in a primary care practice.Archives of Internal Medicine. 1993,153:2759.PubMedGoogle Scholar
  19. (19).
    Jason LA, Taylor R, Wagner L, et al: Estimating rates of chronic fatigue syndrome from a community-based sample: A pilot.American Journal of Community Psychiatry. 1995,23:557–568.Google Scholar
  20. (20).
    Jason LA, Wagner L, Rosenthal S, et al: Estimating the prevalence of chronic fatigue syndrome among nurses.American Journal of Medicine. 1998,105:91S-93S.PubMedGoogle Scholar
  21. (21).
    Steele L, Dobbins JG, Fukuda K, et al: The epidemiology of chronic fatigue in San Francisco.American Journal of Medicine. 1998,105:83S-90S.PubMedGoogle Scholar
  22. (22).
    Reyes M, Nisenbaum R, Stewart G, Reeves WC: Update: Wichita population-based study of fatiguing illness. InProceedings of the Fourth International AACFS Research Conference. Cambridge, MA, 1998.Google Scholar
  23. (23).
    McCluskey DR: Pharmacological approaches to the therapy of chronic fatigue syndrome. In Bock BR, Whelan J (eds),Chronic Fatigue Syndrome. New York: Wiley, 1993, 280–297.Google Scholar
  24. (24).
    Vercoulen JHMM, Swanink CMA, Fennis JF, et al: Prognosis in chronic fatigue syndrome: A prospective study on the natural course.Journal of Neurology, Neurosurgery, and Psychiatry. 1996,60:489–494.PubMedGoogle Scholar
  25. (25).
    Joyce J, Hotopf M, Wessely S: The prognosis of chronic fatigue and chronic fatigue syndrome: A systematic review.Quarterly Journal of Medicine. 1997,90:223–233.Google Scholar
  26. (26).
    Hedrick TE: Summary of risk factors for chronic fatigue syndrome is misleading. [Letter to the Editor].Quarterly Journal of Medicine. 1997,90:723–725.Google Scholar
  27. (27).
    Bonner D, Ron M, Chalder T, Butler S, Wessely S: Chronic fatigue syndrome: A follow-up study.Journal of Neurology, Neurosurgery, and Psychiatry. 1994,57:617–621.PubMedGoogle Scholar
  28. (28).
    Ray C, Jefferies S, Weir WR: Coping and other predictors of outcome in chronic fatigue syndrome: A 1-year follow-up.Journal of Psychosomatic Research. 1997,43:405–415.PubMedGoogle Scholar
  29. (29).
    Levine PH, Snow PG, Ranum BA, Paul C, Holmes MJ: Epidemic neuromyasthenia and chronic fatigue syndrome in West Otago, New Zealand. A 10-year follow-up.Archives of Internal Medicine. 1997,157:750–754.PubMedGoogle Scholar
  30. (30).
    Johnson H:Osler’s Web: Inside the Labyrinth of the Chronic Fatigue Syndrome Epidemic. New York: Crown Publishers, 1996.Google Scholar
  31. (31).
    Bates DW, Buchwald D, Lee J, et al: Clinical laboratory findings in patients with chronic fatigue syndrome.Archives of Internal Medicine. 1995,155:97–103.PubMedGoogle Scholar
  32. (32).
    Natelson BH, Ellis SP, O’Braonain PJ, DeLuca J, Tapp WN: Frequency of deviant immunological test values in chronic fatigue syndrome.Clinical and Diagnostic Laboratory Immunology. 1995,2:238–240.PubMedGoogle Scholar
  33. (33).
    Manu P, Lane TJ, Matthews DA: Chronic fatigue and chronic fatigue syndrome: Clinical epidemiology and aetiological classification. In Bock GR, Whelan J (eds).Chronic Fatigue Syndrome. Chichester, UK: Wiley, 1993, 23–42.Google Scholar
  34. (34).
    Stewart DE: Emotional disorders misdiagnosed as physical illness: Environmental hypersensivity, candidiasis hypersensitivity, and chronic fatigue syndrome.International Journal of Mental Health 1990,19:56–68.Google Scholar
  35. (35).
    David AS, Wessely S, Pelosi AJ: Postviral fatigue syndrome: Time for a new approach.British Medical Bulletin. 1988,296:696–699.Google Scholar
  36. (36).
    Solomon GF: Psychoneuroimmunology and chronic fatigue syndrome: Toward new models of disease.Journal of Chronic Fatigue Syndrome. 1995,1:3–7.Google Scholar
  37. (37).
    Manu P, Affleck G, Tennen H, Morse PA, Escobar JI: Hypochondriasis influences quality of life outcomes in patients in chronic fatigue syndrome.Psychotherapy and Psychosomatics. 1996,65:76–81.PubMedCrossRefGoogle Scholar
  38. (38).
    Shorter E:From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. New York: Free Press, 1992.Google Scholar
  39. (39).
    Manu P, Lane TJ, Matthews DA: The frequency of chronic fatigue syndrome in patients with symptoms of persistent fatigue.Annals of Internal Medicine. 1988,109:554–556.PubMedGoogle Scholar
  40. (40).
    Abbey SE, Garfinkle PE: Chronic fatigue syndrome and depression: Cause, effect, or covariate.Reviews of Infectious Diseases. 1991,18(Suppl. 1):S73-S83.Google Scholar
  41. (41).
    Lane TJ, Manu P, Matthews DA: Depression and somatization in the chronic fatigue syndrome.American Journal of Medicine. 1991,91:335–344.PubMedGoogle Scholar
  42. (42).
    Taerk GS, Toner BB, Salit IE, Garfinkel PE, Oersky S: Depression in patients with neuromyasthenia (benign myalgic encephalomyelitis).International Journal of Psychiatry. 1987,17:49–56.Google Scholar
  43. (43).
    Wessely S, Chadler T, Hirsch S, Wallace P, Wright D: Psychological symptoms, somatic symptoms, and psychiatric disorder in chronic fatigue and chronic fatigue syndrome: A prospective study in primary care.American Journal of Psychiatry. 1996,153:1050–1059.PubMedGoogle Scholar
  44. (44).
    Wells KB, Golding JM, Burnam MA: Chronic medical conditions in a sample of the general population with anxiety, affective, and substance use disorders.American Journal of Psychiatry. 1989,146:1440–1446.PubMedGoogle Scholar
  45. (45).
    Rao SM, Huber SJ, Bornstein RA: Emotional changes with multiple sclerosis and Parkinson’s disease.Journal of Consulting and Clinical Psychology. 1992,60:369–377.PubMedGoogle Scholar
  46. (46).
    Johnson SK, DeLuca J, Natelson BH: Assessing somatization disorder in chronic fatigue syndrome.Psychosomatic Medicine. 1996,58:50–57.PubMedGoogle Scholar
  47. (47).
    Katon W, Russo J: Somatic symptoms and depression.Journal of Family Practice. 1989,29:65–69.PubMedGoogle Scholar
  48. (48).
    Kirmayer LJ, Robbins JM, Drorkird M, Yaffe MJ: Somatization and the recognition of depression and anxiety in primary care.American Journal of Psychiatry. 1993,150:734–740.PubMedGoogle Scholar
  49. (49).
    Johnson SK, DeLuca J, Natelson BH: Depression in fatiguing illness: Comparing patients with chronic fatigue syndrome, multiple sclerosis, and depression.Journal of Affective Disorders. 1996,39:21–30.PubMedGoogle Scholar
  50. (50).
    Huber S, Freidenberg D, Paulson G, Shuttleworth E, Christy J: The pattern of depressive symptoms varies with progression of Parkinson’s disease.Journal of Neurology, Neurosurgery, and Psychiatry. 1990,53:275–278.PubMedGoogle Scholar
  51. (51).
    Stone AA, Broderick JE, Porter LS, et al: Fatigue and mood in chronic fatigue syndrome patients: Results of a momendatary assessment protocol examining fatigue and mood levels and diurnal patterns.Annals of Behavioral Medicine. 1994,16(3):228–234.Google Scholar
  52. (52).
    Ray C, Weir WR, Cullen S, Phillips S: Illness perception and symptom components in chronic fatigue syndrome.Journal of Psychosomatic Research. 1992,36:243–256.PubMedGoogle Scholar
  53. (53).
    Powell R, Dolan R, Wessely S: Attributions and self-esteem in depression and chronic fatigue syndrome.Journal of Psychosomatic Research. 1990,21:665–673.Google Scholar
  54. (54).
    Bearn J, Wessey S: Neurobiological aspects of the chronic fatigue syndrome.European Journal of Clinical Investigation. 1994,24:79–90.PubMedGoogle Scholar
  55. (55).
    David AS, Wessely S, Pelosi AJ: Postviral fatigue syndrome: Time for a new approach.British Medical Bulletin. 1988,296:696–699.Google Scholar
  56. (56).
    Ray C: Chronic fatigue syndrome and depression: Conceptual and methodological ambiguities.Psychological Medicine. 1991,21: 1–9.PubMedGoogle Scholar
  57. (57).
    Millon C, Salvato F, Blaney N, et al: A psychological assessment of chronic fatigue syndrome/chronic Epstein-Barr virus patients.Psychology and Health 1989,3:131–141.Google Scholar
  58. (58).
    Stricklin A, Sewell M, Austad C: Objective measurement of personality variables in epidemic neuromyasthenia patients.South African Medical Journal. 1988,77:31–34.Google Scholar
  59. (59).
    Blakely AA, Howard RC, Sosich RM, et al: Psychiatric symptoms, personality, and ways of coping in chronic fatigue syndrome.Psychological Medicine. 1991,21:347–362.PubMedGoogle Scholar
  60. (60).
    Pepper CM, Krupp LB, Friedberg F, Doscher C, Coyle PK: A comparison of neuropsychiatric characteristics in chronic fatigue syndrome, multiple sclerosis, and major depression.Journal of Neuropsychiatry and Clinical Neurosciences. 1993,5:200–205.PubMedGoogle Scholar
  61. (61).
    Johnson SK, DeLuca J, Natelson BH: Personality dimensions in the chronic fatigue syndrome: A comparison with multiple sclerosis and depression.Journal of Psychiatric Research. 1996,30:9–20.PubMedGoogle Scholar
  62. (62).
    Costa PT, McCare RR: Neuroticism, somatic complaints and disease: Is the bark worse than the bite?Journal of Personality. 1987,55:299–316.PubMedGoogle Scholar
  63. (63).
    David AS, Wessely S, Pelosi AJ: Chronic fatigue syndrome: Signs of a new approach.British Journal of Hospital Medicine. 1991,45:158–159.PubMedGoogle Scholar
  64. (64).
    Cope H, Mann A, Pelosi A, David A: Psychosocial risk factors for chronic fatigue and chronic fatigue syndrome following presumed viral illness: A case-control study.Psychological Medicine. 1996,26:1197–1209.PubMedGoogle Scholar
  65. (65).
    Robins L, Helzer J, Cottler L, Goldring E:National Institute of Mental Health Diagnostic Interview Schedule, Version Three Revised: DSM-III-R. St. Louis, MO: Washington University School of Medicine, 1989.Google Scholar
  66. (66).
    Spitzer RL, Williams JBW, Gibbon M:Instruction Manual for the Structural Clinical Interview for DSM-III-R. New York: New York State Psychiatric Institute, 1988.Google Scholar
  67. (67).
    Hickie I, Lloyd A, Wakefield D, Parker G: The psychiatric status of patients with chronic fatigue syndrome.British Journal of Psychiatry. 1990,156:534–540.PubMedGoogle Scholar
  68. (68).
    Taylor R, Jason LA: The effects of psychiatric instrumentation and scoring on psychiatric diagnoses for individuals with CFS.Psychology and Health: An International Journal. 1998,13:1087–1104.Google Scholar
  69. (69).
    Ware NC, Kleinman A: Culture and somatic experience: The social course of illness in neurasthenia and chronic fatigue syndrome.Psychosomatic Medicine. 1992,54:546–560.PubMedGoogle Scholar
  70. (70).
    Van Houdenhove B, Onghena P, Neerinckx E, Hellin J: Does high ‘action-proneness’ make people more vulnerable to chronic fatigue syndrome? A controlled psychometric study.Journal of Psychsomatic Research. 1995,39:633–640.Google Scholar
  71. (71).
    Magnusson AE, Nias DK, White PD: Is perfectionism associated with fatigue?Journal of Psychosomatic Research. 1996,41:377–383.PubMedGoogle Scholar
  72. (72).
    Surawy C, Hackman A, Hawton K, Sharpe M: Chronic fatigue syndrome: A cognitive approach.Behavioral Research Therapy. 1995,33:535–544.Google Scholar
  73. (73).
    Cope H, David A, Pelosi A, Mann A: Predictors of chronic ‘post viral’ fatigue.Lancet. 1994,344:864–868.PubMedGoogle Scholar
  74. (74).
    Shorter E: Sucker-punched again! Physicians meet the disease of the month syndrome.Journal of Psychiatric Research. 1995,39:115–118.Google Scholar
  75. (75).
    Schweitzer R, Robertson DL, Kelly B, Whiting J: Illness behavior of patients with chronic fatigue syndrome.Journal of Psychosomatic Research. 1993,38:41–49.Google Scholar
  76. (76).
    Lawrie SM, Manders DN, Geddes JR, Pelosi AJ: A population-based incidence study of chronic fatigue.Psychological Medicine. 1997,27:343–353.PubMedGoogle Scholar
  77. (77).
    Natelson BH, Johnson SK, DeLuca J, et al: Reducing heterogeneity in chronic fatigue syndrome: A comparison with depression and multiple sclerosis.Clinical Infectious Diseases. 1995,21:1204–1210.PubMedGoogle Scholar
  78. (78).
    Deale A, Chalder T, Marks I, Wessely S: Cognitive behavior therapy for chronic fatigue syndrome: A randomized controlled trial.American Journal of Psychiatry. 1997,154:408–414.PubMedGoogle Scholar
  79. (79).
    Buchwald D, Pearlman T, Umali J, Schmaling K, Katon W: Functional status in patients with chronic fatigue syndrome, other fatiguing illnesses, and healthy individuals.American Journal of Medicine. 1996,101:364–370.PubMedGoogle Scholar
  80. (80).
    Bombardier CH, Buchwald D: Chronic fatigue, chronic fatigue syndrome, and fibromyalgia. Disability and health care use.Medical Care. 1996,34:924–930.PubMedGoogle Scholar
  81. (81).
    Petrie K, Moss-Morris R, Weinman J: The impact of catastrophic beliefs on functioning in chronic fatigue syndrome.Journal of Psychosomatic Research. 1995,39:31–37.PubMedGoogle Scholar
  82. (82).
    Cristodoulo C, DeLuca J, Lange G, Johnson SK, Natelson BH: Relationship between neuropsychological impairment and functional disability in patients with CFS.Journal of Neurology, Neurosurgery, and Psychiatry, 1998,64:431–434.Google Scholar
  83. (83).
    Komaroff AL: Clinical presentation and evaluation of fatigue and chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 61–84.Google Scholar
  84. (84).
    Altay HT, Toner BB, Brooker H, et al: The neuropsychological dimensions of post-infectious neuromyasthenia (chronic fatigue syndrome): A preliminary report.International Journal of Psychiatry in Medicine. 1990,20(2):141–149.PubMedGoogle Scholar
  85. (85).
    DeLuca J, Johnson SK, Beldowicz D, Natelson BH: Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression.Journal of Neurology, Neurosurgery, and Psychiatry. 1995,58:38–43.PubMedGoogle Scholar
  86. (86).
    Grafman J: Neuropsychological features of chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 263–283.Google Scholar
  87. (87).
    Smith AP, Behan PO, Bell W, Millar K, Bakheit M: Behavioral problems associated with the chronic fatigue syndrome.British Journal of Psychology. 1993,84:411–423.PubMedGoogle Scholar
  88. (88).
    Riccio M, Thompson C, Wilson B, Morgan RD, Lant AF: Neuropsychological and psychiatric abnormalities in myalgic encephalomyelitis: A preliminary report.British Journal of Clinical Psychology. 1992,31:111–120.PubMedGoogle Scholar
  89. (89).
    Sandman CA, Barron JL, Nackoul K, Goldstein J, Fidler F: Memory deficits associated with chronic fatigue syndrome.Biological Psychiatry. 1993,33:618–623.PubMedGoogle Scholar
  90. (90).
    Grafman J, Schwartz V, Dale JK, et al: Analysis of neuropsychological functioning in patients with chronic fatigue syndrome.Journal of Neurology, Neurosurgery, and Psychiatry. 1993,56:684–689.PubMedGoogle Scholar
  91. (91).
    Scheffers MK, Johnson R, Grafman J, Dale JK, Straus SE: Attention and short-term memory in chronic fatigue syndrome patients: An event-related potential analysis.Neurology. 1992,42:1667–1675.PubMedGoogle Scholar
  92. (92).
    Smith AP: Cognitive changes in myalgic encephalomyelitis. In Jenkins R, Mowbray JF (eds),Post-Viral Fatigue Syndrome. New York: Wiley, 1991, 179–194.Google Scholar
  93. (93).
    DeLuca J, Johnson SK, Natelson BH: Information processing efficiency in chronic fatigue syndrome and multiple sclerosis.Archives of Neurology. 1993,50:301–304.PubMedGoogle Scholar
  94. (94).
    Johnson SK, DeLuca J, Fiedler N, Natelson BH: Cognitive functioning in patients with chronic fatigue syndrome.Clinical Infectious Diseases. 1994,18:S84-S85.PubMedGoogle Scholar
  95. (95).
    Krupp LB, Sliwinski M, Masur DM, Friedberg F, Coyle PK: Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis.Archives of Neurology. 1994,51:705–710.PubMedGoogle Scholar
  96. (96).
    Ray C, Phillips L, Weir WR: Quality of attention in chronic fatigue syndrome: Subjective reports of everyday attention and cognitive difficulty, and performance on tasks of focused attention.British Journal of Clinical Psychology. 1993,32:357–364.PubMedGoogle Scholar
  97. (97).
    Johnson SK, DeLuca J, Diamond BJ, Natelson BH: Selective impairment of auditory processing in chronic fatigue syndrome: A comparison with multiple sclerosis and healthy controls.Perceptual Motor Skills. 1996,83:51–62.Google Scholar
  98. (98).
    Johnson SK, DeLuca J, Diamond BJ, Natelson B: Memory dysfunction in fatiguing illness: Interference and distraction in short-term memory.Cognitive Neuropsychiatry. 1998,3:269–285.Google Scholar
  99. (99).
    Wearden A, Appleby L: Cognitive performance and complaints of cognitive impairment in chronic fatigue syndrome (CFS).Psychological Medicine. 1997,27:81–90.PubMedGoogle Scholar
  100. (100).
    DeLuca J, Johnson SK, Ellis SP, Natelson BH: Cognitive functioning is impaired in chronic fatigue syndrome patients devoid of psychiatric disease.Journal of Neurology, Neurosurgery, and Psychiatry. 1997,62:151–155.PubMedGoogle Scholar
  101. (101).
    McDonald E, Cope H, David A: Cognitive impairment in patients with chronic fatigue: A preliminary study.Journal of Neurology, Neurosurgery, and Psychiatry. 1993,56:812–815.PubMedGoogle Scholar
  102. (102).
    Cope H, Pernet A, Kendall B, David A: Cognitive functioning and magnetic resonance imaging in chronic fatigue.British Journal of Psychiatry. 1995,167:86–94.PubMedCrossRefGoogle Scholar
  103. (103).
    Johnson SK, Lange G, DeLuca J, Korn L, Natelson BH: The effects of fatigue on neuropsychological performance in patients with chronic fatigue syndrome, multiple sclerosis, and depression.Applied Neuropsychology. 1997,4:145–153.PubMedGoogle Scholar
  104. (104).
    LaManca J, Sisto SA, DeLuca J, et al: The influence of exhaustive treadmill exercise on cognitive functioning in chronic fatigue syndrome.American Journal of Medicine. 1998,105:59S-65S.PubMedGoogle Scholar
  105. (105).
    DeLuca J, Johnson SK, Natelson BH: Sudden vs. gradual onset of chronic fatigue syndrome differentiates individuals on cognitive and psychiatric measures.Journal of Psychiatric Research. 1997,31:83–90.PubMedGoogle Scholar
  106. (106).
    Lutgendorf S, Klimas NG, Antoni M, Brickman A, Fletcher MA: Relationships of cognitive difficulties to immune measures, depression, and illness burden in chronic fatigue syndrome.Journal of Chronic Fatigue Syndrome. 1995,1:23–41.Google Scholar
  107. (107).
    Mawle AC, Steele L, Reyes M, Dobbins JG, Reeves WC:A Case-Control Study of Immunologic Parameters in Chronic Fatigue Syndrome (CFS) Patients. First Annual Meeting of the American Association for Chronic Fatigue. Miami, FL: 1994.Google Scholar
  108. (108).
    Mawle AC, Nisenbaum R, Dobbins JG, et al: Immune responses associated with chronic fatigue syndrome: A case control study.Journal of Infectious Diseases. 1997,175:136–141.PubMedGoogle Scholar
  109. (109).
    Hickie I, Lloyd A, Hadzi-Pavlovic D, et al: Can chronic fatigue syndrome be defined by distinct clinical features?Psychological Medicine. 1995,25:925–935.PubMedGoogle Scholar
  110. (110).
    Natelson BH, Ellis SP, O’Braonain PJ, DeLuca J, Tapp WN: Frequency of deviant immunological test values in chronic fatigue syndrome.Clinical and Diagnostic Lab Immunology. 1994,2:238–240.Google Scholar
  111. (111).
    Hay J, Jenkins FJ: Human herpes viruses and chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 181–197.Google Scholar
  112. (112).
    Komaroff AL: Chronic fatigue syndromes: Relationship to chronic viral infections.Journal of Virology Research. 1988,21:3–10.Google Scholar
  113. (113).
    Komaroff AL: Clinical presentation and evaluation of fatigue and chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 61–84.Google Scholar
  114. (114).
    Krueger G, Klueppelberg U, Hoffmann A, Ablashi DV: Clinical correlates of infection with human herpesvirus-6.In Vivo. 1994,8:457–486.PubMedGoogle Scholar
  115. (115).
    Patnaik M, Komaroff AL, Conley E, Ojo-Amize EA, Peter JB: Prevalence of IgM antibodies to human herpesvirus 6 early antigen (p41/38) in patients with chronic fatigue syndrome.Journal of Infectious Diseases. 1995,172:1364–1367.PubMedGoogle Scholar
  116. (116).
    Fekety R: Infection and chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 101–179.Google Scholar
  117. (117).
    Mawle AC, Reyes M, Schmid DS: Is chronic fatigue syndrome an infectious disease?Infectious Agents and Disease. 1994,2:333–341.Google Scholar
  118. (118).
    Mawle AC, Nisenbaum R, Dobbins JG, et al: Seroepidemiology of chronic fatigue syndrome: A case-control study.Clinical Infectious Diseases. 1995,21:1386–1389.PubMedGoogle Scholar
  119. (119).
    Hotopf M, Noah N, Wessely S: Chronic fatigue and minor psychiatric morbidity after viral meningitis: A controlled study.Journal of Neurology, Neurosurgery, and Psychiatry. 1996,60:504–509.PubMedGoogle Scholar
  120. (120).
    Wessely S, Chalder T, Hirsch S, et al: Postinfectious fatigue: Prospective cohort study in primary care.Lancet. 1995,345:1333–1338.PubMedGoogle Scholar
  121. (121).
    Ayres JG, Flint N, Smith EG, et al: Post-infection fatigue syndrome following Q fever.Quarterly Journal of Medicine. 1998,91:105–123.Google Scholar
  122. (122).
    Suhadolnik RJ, Peterson DL, O’Brien K, et al: Biochemical evidence for a novel low molecular weight 2-5A-Dependent Rnase L in chronic fatigue syndrome.Journal of Interferon and Cytokine Research. 1997,17:377–385.PubMedGoogle Scholar
  123. (123).
    Suhadolnik RJ, Reichenbach NL, Hitzges P, et al: Changes in the 2–5A synthetase/RNase L antiviral pathway in a controlled clinical trial with Poly(I)-Poly(C12U) in chronic fatigue syndrome.In Vivo. 1994,8:599–604.PubMedGoogle Scholar
  124. (124).
    Vojdani A, Ghoneum M, Choppa PC, Magtoto L, Lapp CW: Elevated apoptotic cell population in patients with chronic fatigue syndrome: The pivotal role of protein kinase RNA.Journal of Internal Medicine. 1997,242:465–478.PubMedGoogle Scholar
  125. (125).
    Bell DS: Chronic fatigue syndrome update.Postgraduate Medicine. 1994,96:73–80.PubMedGoogle Scholar
  126. (126).
    Ablashi DV, Ablashi KL, Kramarsky B, et al: Viruses and chronic fatigue syndrome: Current status.Journal of Chronic Fatigue Syndrome. 1995,1:3–22.Google Scholar
  127. (127).
    Landay AL, Jessop C, Lenette ET, et al: Chronic fatigue syndrome: Clinical condition associated with immune activation.Lancet. 1991,338:707–712.PubMedGoogle Scholar
  128. (128).
    Klimas NG, Salvato FR, Morgan R, et al: Immunologic abnormalities in chronic fatigue syndrome.Journal of Clinical Microbiology. 1990,28:1403–1410.PubMedGoogle Scholar
  129. (129).
    Caligiuri M, Murray C, Buchwald D: Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome.Journal of Immunology. 1987,139:3306–3313.Google Scholar
  130. (130).
    Cannon JG, Angel JB, Abad LW, et al: Interleukin-1 beta, interleukin-1 receptor antagonist, and soluble interleukin-1 receptor type II secretion in chronic fatigue syndrome.Journal of Clinical Immunology. 1997,17:253–261.PubMedGoogle Scholar
  131. (131).
    Natelson BH, LeManca J, Denny T, et al: Immunological parameters in chronic fatigue syndrome, major depression, and multiple sclerosis.American Journal of Medicine. 1998,105:43S-49S.PubMedGoogle Scholar
  132. (132).
    Buchwald D, Wener MH, Pearlman T, Kith P: Markers of inflammation and immune activation in chronic fatigue and chronic fatigue syndrome.Journal of Rheumatology. 1997,24:372–376.PubMedGoogle Scholar
  133. (133).
    Strober W: Immunological functioning chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 207–237.Google Scholar
  134. (134).
    Buchwald D, Ashley RL, Pearlman T, Kith P, Komaroff AL: Viral serologies in patients with chronic fatigue and chronic fatigue syndrome.Journal of Medical Virology. 1996,50:25–30.PubMedGoogle Scholar
  135. (135).
    Natelson BH, Cohen JM, Brassloff I, Lee HJA: Controlled study of brain magnetic resonance imaging in patients with fatiguing illnesses.Journal of the Neurological Sciences. 1993,120:213–217.PubMedGoogle Scholar
  136. (136).
    Buchwald DPR, Cheney DI, Peterson B, et al: A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus Type 6 infection.Annals of Internal Medicine. 1992,116:103–113.PubMedGoogle Scholar
  137. (137).
    Schwartz RB, Garada BM, Komaroff AL, et al: Detection of intracranial abnormalities in patients with chronic fatigue syndrome: Comparison of MR imaging and SPECT.American Journal of Radiology. 1994,162:935–941.Google Scholar
  138. (138).
    Cope H, David AS: Neuroimaging in chronic fatigue syndrome.Journal of Neurology, Neurosurgery, and Psychiatry. 1996,60:471–477.PubMedGoogle Scholar
  139. (139).
    Lange G, DeLuca J, Lee HJ, Maldjian JA, Natelson BH: Cerebral abnormalities in chronic fatigue syndrome. Society for Neuroscience Conference. Washington, DC: 1997.Google Scholar
  140. (140).
    Ichise M, Salit IE, Abbey SE, et al: Assessment of regional cerebral perfusion by99Tcm-HMPAO SPECT in chronic fatigue syndrome.Nuclear Medicine Communications. 1992,13:767–772.PubMedGoogle Scholar
  141. (141).
    Schwartz RB, Komaroff AL, Garada BM, et al: SPECT imaging of the brain: Comparison of findings in patients with chronic fatigue syndrome, AIDS dementia complex, and major unipolar depression.American Journal of Radiology. 1994,162:943–951.Google Scholar
  142. (142).
    Costa DC, Tannock C, Brostoff J: Brainstem profusion is impaired in chronic fatigue syndrome.Quarterly Journal of Medicine. 1995,88:767–773.Google Scholar
  143. (143).
    Prasher D, Smith A, Findley L: Sensory and cognitive event related potentials in myalgic encephalomyelitis.Journal of Neurology, Neurosurgery, and Psychiatry. 1990,53:247–253.PubMedGoogle Scholar
  144. (144).
    Sisto SA, Tapp W, Drastal S, Bergen M: Vagal tone is reduced during paced breathing in patients with the chronic fatigue syndrome.Clinical Autonomic Research. 1995,5:139–143.PubMedGoogle Scholar
  145. (145).
    Cordero DL, Sisto SA, Tapp WN, et al: Decreased vagal power during treadmill walking in patients with chronic fatigue syndrome.Clinical Autonomic Research. 1996,6:329–333.PubMedGoogle Scholar
  146. (146).
    Bou-Holaigah I, Rowe PC, Kan J, Calkins H: The relationship between neurally mediated hypotension and the chronic fatigue syndrome.Journal of the American Medical Association. 1995,274:961–967.PubMedGoogle Scholar
  147. (147).
    LaManca J, Peckerman A, Walker J, et al: Neurally mediated hypotension and cardiovascular response during head-up tilt in chronic fatigue syndrome.Medicine and Science in Sports and Exercise. 1998,30:S160.Google Scholar
  148. (148).
    Streeten DHP, Bell DS: Circulating blood volume in chronic fatigue syndrome.Journal of Chronic Fatigue Syndrome. 1998,4:3–11.Google Scholar
  149. (149).
    Boda WL, Natelson BH, Sisto SA, Tapp WN: Gait abnormalities in chronic fatigue syndrome.Journal of the Neurological Sciences. 1995,131:156–161.PubMedGoogle Scholar
  150. (150).
    McCully KK, Sisto SA, Natelson BH: Use of exercise for treatment of chronic fatigue syndrome.Sports Medicine. 1996,21:35–48.PubMedGoogle Scholar
  151. (151).
    Rosen SD, King JC, Wilkinson JB, Nixon PG: Is chronic fatigue syndrome synonymous with effort syndrome?Journal of the Royal Society of Medicine. 1990,83:761–764.PubMedGoogle Scholar
  152. (152).
    Lawrie SM, MacHale SM, Power MJ, Goodwin GM: Is chronic fatigue syndrome best understood as a primary disturbance of the sense of effort?Psychological Medicine. 1997,27:995–999.PubMedGoogle Scholar
  153. (153).
    Demitrack MA, Dale JK, Straus SE, et al: Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome.Journal of Clinical Endocrinology and Metabolism. 1991,73:1–11.Google Scholar
  154. (154).
    Demitrack MA: Neuroendocrine aspects of chronic fatigue syndrome. In Straus SE (ed),Chronic Fatigue Syndrome. New York: Marcel Dekker, Inc., 1994, 285–308.Google Scholar
  155. (155).
    Bakheit AMO, Behan PO, Dinan TG, Gray CE, O’Keane V: Possible upregulation of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome.British Medical Journal. 1992,304:1010–1012.PubMedCrossRefGoogle Scholar
  156. (156).
    Cleare AJ, Bearn J, McGregor A, et al: Contrasting neuroendocrine responses in depression and chronic fatigue syndrome.Journal of Affective Disorders. 1995,34:283–289.PubMedGoogle Scholar
  157. (157).
    Sharpe M, Hawton K, Clements A, Cowen PJ: Increased brain serotonin function in men with chronic fatigue syndrome.British Medical Journal. 1997,315:164–165.PubMedGoogle Scholar
  158. (158).
    Yatham LN, Morehouse RL, Chisholm BT, et al: Neuroendocrine assessment of serotonin (5-HT) function in chronic fatigue syndrome.Canadian Journal of Psychiatry. 1995,40:93–96.Google Scholar
  159. (159).
    Ottenweller JE, LaManca JL, Sisto SA, Guo W, Natelson BH: Endocrine hyporesponsiveness to exercise in patients with chronic fatigue syndrome.Integrative Physiological Behavioral Science. 1997,32:189.Google Scholar
  160. (160).
    Vercoulen JHMM, Swanink CMA, Zitman FG, et al: Randomized, double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome.Lancet. 1996,347:858–861.PubMedGoogle Scholar
  161. (161).
    Zubieta JK, Demitrack MA, Shipley JE, et al: Sleep EEG in chronic fatigue syndrome: Comparison with major depression.Biological Psychiatry. 1993,33:74A.Google Scholar
  162. (162).
    Thase ME, Frank E, Kupfer DJ: Biological processes in major depression. In Beckham EE, Leber WR (eds),Handbook of Depression: Treatment, Assessment, and Research. Homewood, IL: Dorsey Press, 1985, 816–819.Google Scholar
  163. (163).
    Blondel-Hill E, Shafran SD: Treatment of the chronic fatigue syndrome.Drugs. 1993,46:639–651.PubMedGoogle Scholar
  164. (164).
    Strayer DR, Carter WA, Brodsky I, et al: A controlled clinical trial with a specifically configured RNA drug, Poly(I):Poly(C12U), in chronic fatigue syndrome.Clinical Infectious Diseases. 1994,18(Suppl. 1):S88-S95.PubMedGoogle Scholar
  165. (165).
    Butler S, Chalder T, Ron M, Wessely S: Cognitive-behavior therapy in the chronic fatigue syndrome.Journal of Neurology, Neurosurgery, and Psychiatry. 1991,54:153–158.PubMedGoogle Scholar
  166. (166).
    Lloyd A, Hickie I, Brockman A, et al: Immunological and psychologic therapy for patients with chronic fatigue syndrome.American Journal of Medicine. 1993,94:197–203.PubMedGoogle Scholar
  167. (167).
    Freidberg F, Krupp LB: A comparison of cognitive behavioral treatment for chronic fatigue syndrome and primary depression.Clinical Infectious Diseases. 1994,18(Suppl. 1):S105-S110.Google Scholar
  168. (168).
    Friedberg F: Chronic fatigue syndrome: A new clinical application.Professional Psychology: Research and Practice. 1996,27:487–494.Google Scholar
  169. (169).
    Sharpe M, Wessely S: Putting the rest cure to rest—again.British Medical Journal. 1998,316:796–800.PubMedGoogle Scholar
  170. (170).
    Sharpe M, Hawton K, Simkin S, et al: Cognitive-behaviour therapy for the chronic fatigue syndrome: A randomized controlled trial.British Medical Journal. 1996,312:22–26.PubMedGoogle Scholar
  171. (171).
    Fulcher KY, White PD: Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome.British Medical Journal. 1997,314:1647–1652.PubMedGoogle Scholar
  172. (172).
    Jason LA, Richman JA, Freidberg F, et al: Politics, science, and the emergence of a new disease: The case of chronic fatigue syndrome.American Psychologist. 1997,9:973–983.Google Scholar
  173. (173).
    Nixon PGF: Exhaustion: Cardiac rehabilitation’s starting point. In Maes S, Speilberger CD, Defares PB, Sarason IG (eds),Topics in Health Psychology. Chicester, England: John Wiley & Sons, 1988, 129–139.Google Scholar
  174. (174).
    Wessely S, David A, Butler S, Chalder T: Management of chronic (postviral) fatigue syndrome.Journal of the Royal College of General Practice. 1989,39:26–29.Google Scholar
  175. (175).
    Maclean G, Wessely S: Professional and popular views of chronic fatigue syndrome.British Medical Journal. 1994,308:776–777.PubMedGoogle Scholar
  176. (176).
    Jason LA, Ropacki MT, Santoro NB, et al: A screening scale for chronic fatigue syndrome: Reliability and validity.Journal of Chronic Fatigue Syndrome. 1997,3:39–59.Google Scholar
  177. (177).
    Hickie I, Hadzi-Pavlovic D, Ricci C: Reviving the diagnosis of neurasthenia.Psychological Medicine. 1997,27:989–994.PubMedGoogle Scholar
  178. (178).
    Wessely S: Chronic fatigue syndrome. Summary of a report of a joint committee of the Royal Colleges of Physicians, Psychiatrists, and General Practitioners.Journal of the Royal College of Physicians. 1996,30(6):497–504.Google Scholar
  179. (179).
    Webster R:Why Freud Was Wrong. New York: Basic Books, 1995.Google Scholar
  180. (180).
    Slater E, Glithero E: A follow-up of patients diagnosed as suffering from “hysteria”.Journal of Psychosomatic Research. 1965,9:9–13.PubMedGoogle Scholar
  181. (181).
    Mace CJ, Trimble MR: Ten-year prognosis of conversion disorder.British Journal of Psychiatry. 1996,169:282–288.PubMedGoogle Scholar
  182. (182).
    Showalter E:Histories: Hysterical Epidemics and Modern Culture. New York: Columbia University Press, 1997.Google Scholar

Copyright information

© The Society of Behavioral Medicine 1999

Authors and Affiliations

  • Susan K. Johnson
    • 1
  • John DeLuca
    • 2
    • 3
  • Benjamin H. Natelson
    • 3
  1. 1.Department of PsychologyUniversity of North CarolinaCharlotte
  2. 2.Kessler Institute for RehabilitationNew JerseyUSA
  3. 3.University of Medicine and Dentistry of New Jersey-New Jersey Medical SchoolNew JerseyUSA

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