The Neuropsychiatric and Neuropsychological Features of Chronic Fatigue Syndrome: Revisiting the Enigma

  • Yvonne Christley
  • Tim Duffy
  • Ian Paul Everall
  • Colin R. Martin
Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Complex Medical-Psychiatric Issues


The aim of this article is to provide a comprehensive and updated review of the key neuropsychiatric and neuropsychological complaints associated with chronic fatigue syndrome (CFS). Neuropsychiatric and neuropsychological difficulties are common in CFS and are linked primarily to disorders of mood, affect and behaviour. The neuropsychiatric complaint most frequently encountered amongst CFS patients is depression and in particular major depressive disorder (MDD). Despite decades of research, the precise aetiological relationship between CFS and MDD remains poorly understood. This has resulted in the development of a number of interesting and polarised hypotheses regarding the aetiological nature of CFS. Recent scientific advances have however begun to unravel a number of interesting inflammatory and immunological explanations that suggest CFS and MDD are distinct yet interrelated conditions. The possibility that the overlap between CFS and MDD might be explained in terms of shared oxidative and nitrosative (IO&NS) pathways is an area of intense research interest and is reviewed in detail in this article. The overlap between CFS and MDD is further differentiated by variations in HPA axis activity between the two disorders. Important immunological differences between MDD and CFS are also reviewed with particular emphasis on antiviral RNase L pathways in CFS. In addition to the presence of neuropsychiatric complaints, CFS is also associated with neuropsychological symptoms such as impaired attention, memory and reaction time. The key neuropsychological problems reported by CFS patients are also included in the review in an effort to understand the significance of cognitive impairment in CFS.


Chronic fatigue syndrome CFS Depression Generalised anxiety disorder Neuropsychiatric Neuropsychological Major depressive disorder MDD Somatoform disorder Personality disorder Attention Memory Reaction time 



Y. Christley declares that she has no conflict of interest.

T. Duffy declares that he has no conflict of interest.

I. P. Everall has received compensation for lectures including service on speakers’ bureaus from Abbot and AstraZeneca.

C. R. Martin declares that he has no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Yvonne Christley
    • 1
  • Tim Duffy
    • 1
  • Ian Paul Everall
    • 2
  • Colin R. Martin
    • 1
    • 3
  1. 1.School of Health, Nursing and MidwiferyUniversity of the West of ScotlandAyrUK
  2. 2.Department of PsychiatryUniversity of MelbourneMelbourneAustralia
  3. 3.School of Health, Nursing and MidwiferyUniversity of the West of ScotlandBeech GroveUK

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