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

Abstract

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.

Summary

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.

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Funding

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

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Correspondence to Scott J. Fatt or Jessica Elise Beilharz.

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Fatt, S.J., Cvejic, E., Lloyd, A.R. et al. The Invisible Burden of Chronic Fatigue in the Community: a Narrative Review. Curr Rheumatol Rep 21, 5 (2019). https://doi.org/10.1007/s11926-019-0804-2

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Keywords

  • Myalgic encephalomyelitis
  • Chronic fatigue syndrome
  • Fatigue
  • Autonomic
  • Function