What causes chronic fatigue syndrome?

doi:10.1136/bmj.329.7472.928

BMJ 2004;329:928-929 (23 October), doi:10.1136/bmj.329.7472.928

Editorial

What causes chronic fatigue syndrome?

Infections, physical inactivity, and enhanced interoceptionmay all play a part

The first 150 words of the full text of this article appear below.

Chronic fatigue syndrome, also known as myalgic encephalomyelitis,is an illness of unknown nature and cause, but most medicalauthorities now accept its existence.^1-3 Research about itscause has been hampered by the absence of a biological marker,the heterogeneous nature of the illness, and difficulties indifferentiating cause from effect.^2
3 Yet, some progress hasbeen made, particularly when causes are divided into predisposing,triggering, and maintaining factors.

Women get chronic fatigue syndrome more commonly than men forunknown reasons, although increasing evidence suggests a geneticinfluence on the illness.^1
3 Premorbid mood disorders are replicatedrisk markers for chronic fatigue syndrome;^1
3 the risks maybe inflated by shared symptoms or they may be markers for thosepatients with comorbid mood disorders.^1
3-5 Another replicatedpremorbid risk marker is increased consulting of a doctor forminor illnesses up to 15 years before diagnosis,^{w1 w2} suggestinga general vulnerability for either ill health or . . . [Full text of this article]

Peter D White, professor of psychological medicine

Barts and the London, Queen Mary School of Medicine and Dentistry, St Bartholomew's Hospital, London EC1A 7BE (p.d.white@qmul.ac.uk)

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Patients with chronic fatigue syndrome are being ignored: Charles Shepherd
BMJ 2004 329: 1405. [Extract] [Full Text]

Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study: Russell Viner and Matthew Hotopf
BMJ 2004 329: 941. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Van Houdenhove, B., Verheyen, L., Pardaens, K., Luyten, P., Van Wambeke, P. (2007). Rehabilitation of decreased motor performance in patients with chronic fatigue syndrome: should we treat low effort capacity or reduced effort tolerance?. Clin Rehabil 21: 1121-1142 [Abstract]
Sharpe, M. (2006). The symptom of generalised fatigue. PN 6: 72-77 [Full text]
Crawley, E., Chambers, T. (2005). It's not all in ME mind, doc. EDUCATION AND PRACTICE 90: ep92-ep97 [Full text]
Shepherd, C. (2004). Patients with chronic fatigue syndrome are being ignored. BMJ 329: 1405-1405 [Full text]
(2004). Hit parade. BMJ 329: 1350-1350 [Full text]

Rapid Responses:

Read all Rapid Responses

Re: What causes chronic fatigue syndrome?: Douglas T Fraser
bmj.com, 22 Oct 2004 [Full text]
Wrong...AGAIN!!!!!!!!!: Paul Taylor
bmj.com, 22 Oct 2004 [Full text]
Wrong!: Evert Potgieter
bmj.com, 22 Oct 2004 [Full text]
ME/CFS and Sedentary Children: Krysko Karl
bmj.com, 22 Oct 2004 [Full text]
Prof. White's paper fails to recognise true nature of CFS: David J. Nicholls
bmj.com, 22 Oct 2004 [Full text]
Incline Village CFS demographics: Erik R Johnson
bmj.com, 22 Oct 2004 [Full text]
The Last Resort ?: Duncan Cox
bmj.com, 22 Oct 2004 [Full text]
Result of infection which plays on weaknesses?: Nigel J W Hall
bmj.com, 22 Oct 2004 [Full text]
Continental Ignorance: Joerg Wiesenfeldt
bmj.com, 23 Oct 2004 [Full text]
Pigs Might Fly.: Barry Savage
bmj.com, 24 Oct 2004 [Full text]
Re: Continental Ignorance: Dr Charles Bernard Shepherd
bmj.com, 24 Oct 2004 [Full text]
Re: Continental Ignorance: Ellen Goudsmit
bmj.com, 24 Oct 2004 [Full text]
Re: Continental Ignorance: Serena Jones
bmj.com, 24 Oct 2004 [Full text]
Re: Wrong!: Peter Culdrose
bmj.com, 24 Oct 2004 [Full text]
Dr. White's views far from universally held by those working in the field: Tom P Kindlon
bmj.com, 24 Oct 2004 [Full text]
A formerly active person replies:: Phillip W Pierce
bmj.com, 24 Oct 2004 [Full text]
Hampered: Connie Nelson
bmj.com, 24 Oct 2004 [Full text]
Re: What Causes Chronic Fatigue: Richard A.R. Bruce
bmj.com, 24 Oct 2004 [Full text]
Another infantile theory about ME: Hayley Klinger
bmj.com, 24 Oct 2004 [Full text]
Ask someone who has HAD it.: Marlene C. Tuthill
bmj.com, 24 Oct 2004 [Full text]
Chronic infections in CFS/ME?: Blake Graham
bmj.com, 25 Oct 2004 [Full text]
Re: Re: Wrong!: john s marshall
bmj.com, 25 Oct 2004 [Full text]
I believe this is a cop-out: Aimee Fay
bmj.com, 25 Oct 2004 [Full text]
Enforced physical exertion: John Sayer
bmj.com, 25 Oct 2004 [Full text]
childhood trauma association with CFS: Vivien J Pomfrey
bmj.com, 26 Oct 2004 [Full text]
I beg to differ...: Wendy E Douglas
bmj.com, 25 Oct 2004 [Full text]
Re: Continental Ignorance: Regina Clos
bmj.com, 25 Oct 2004 [Full text]
Low DHEA, again?: James M. Howard
bmj.com, 25 Oct 2004 [Full text]
Re: Continental Ignorance: Owen Beith
bmj.com, 25 Oct 2004 [Full text]
Not much variety in the BMJ's coverage of the (heterogeneous) condition, CFS: Tom P Kindlon
bmj.com, 25 Oct 2004 [Full text]
Outdated and simply wrong: Yuliya Dobrydneva
bmj.com, 25 Oct 2004 [Full text]
It's only a virus! CBT will help, won't it!: martin pilinovics
bmj.com, 26 Oct 2004 [Full text]
Immune system disorder causes chronic fatigue syndrome.: Ellen C G grant
bmj.com, 26 Oct 2004 [Full text]
Continuing deception by the psychs!: Simon Lawrence
bmj.com, 26 Oct 2004 [Full text]
Peter White the missionary: Jane C Colby, et al.
bmj.com, 26 Oct 2004 [Full text]
Nobody is listening to the patients: Charles B Shepherd
bmj.com, 28 Oct 2004 [Full text]
we do not know the cause of CFS/ME-so what now?: Stephen F Hayes
bmj.com, 29 Oct 2004 [Full text]
troubles with chronic fatigue syndrome: Herman J. Oterdoom
bmj.com, 29 Oct 2004 [Full text]
Biochemistry as part of neurology: Ellen C G Grant
bmj.com, 29 Oct 2004 [Full text]
Re: we do not know the cause of CFS/ME-so what now?: Douglas T Fraser
bmj.com, 29 Oct 2004 [Full text]
There is ample evidence of organic disease in ME/CFS: Angela Kennedy
bmj.com, 29 Oct 2004 [Full text]
Progress determination in ME / CFS: Derek Enlander
bmj.com, 29 Oct 2004 [Full text]
Address the symptoms and the syndrome will become clear: Craig Coady
bmj.com, 31 Oct 2004 [Full text]
Yet another 'atypical' sufferer: Karen Glanville
bmj.com, 9 Nov 2004 [Full text]
Blaming the victim: Denise M. Swanteck
bmj.com, 14 Dec 2004 [Full text]
Translation for the layman: Philippa V Sutton
bmj.com, 30 Jun 2007 [Full text]
Wrong!: Trudy A Allen
bmj.com, 24 Oct 2007 [Full text]