The Invisible Burden of Chronic Fatigue in the Community: a Narrative Review

  • Scott J. FattEmail author
  • Erin Cvejic
  • Andrew R. Lloyd
  • Ute Vollmer-Conna
  • Jessica Elise BeilharzEmail author
Chronic Pain (R Staud, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Chronic Pain


Purpose of Review

Unexplained fatigue is commonly reported in the general population, with varying severity. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) sits at the extreme of the fatigue continuum, yet more individuals experience unexplained prolonged fatigue (1–6-month duration) or chronic fatigue (> 6 months) that, although debilitating, does not fulfil ME/CFS criteria. This review examines the empirical literature comparing symptoms for those with prolonged fatigue, chronic fatigue and ME/CFS.

Recent Findings

Substantial overlap of self-reported psychological, physical and functional impairments exists between chronic fatigue and ME/CFS. The conversion rate from prolonged or chronic fatigue to ME/CFS is not understood. Current research has failed to uncover factors accounting for differences in fatigue trajectories, nor incorporate comprehensive, longitudinal assessments extending beyond self-reported symptoms.


Distinguishing factors between prolonged fatigue, chronic fatigue and ME/CFS remain poorly understood, highlighting a need for longitudinal studies integrating biopsychosocial approaches to inform early management and targeted rehabilitation strategies.


Myalgic encephalomyelitis Chronic fatigue syndrome Fatigue Autonomic Function 



This work was supported by a grant from the Mason Foundation (National Medical Program: MAS2017F033).

Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Human Behaviour, School of PsychiatryUniversity of New South WalesSydneyAustralia
  2. 2.School of Public Health, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
  3. 3.Viral Immunology Systems Program, The Kirby InstituteUniversity of New South WalesSydneyAustralia

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