Inflammatory fatigue and sickness behaviour - lessons for the diagnosis and management of chronic fatigue syndrome

J Affect Disord. 2012 Dec 10;141(2-3):130-42. doi: 10.1016/j.jad.2012.04.004. Epub 2012 May 11.


Persistent and severe fatigue is a common part of the presentation of a diverse range of disease processes. There is a growing body of evidence indicating a common inflammatory pathophysiology underlying many conditions where fatigue is a primary patient concern, including chronic fatigue syndrome. This review explores current models of how inflammatory mediators act on the central nervous system to produce fatigue and sickness behaviour, and the commonality of these processes in conditions as diverse as surgical trauma, infection, various cancers, inflammatory bowel disease, connective tissue diseases and autoimmune diseases. We also discuss evidence indicating chronic fatigue syndrome may have important pathophysiological similarities with cytokine mediated sickness behaviour, and what lessons can be applied from sickness behaviour to chronic fatigue syndrome with regards to the diagnosis and management.

Publication types

  • Review

MeSH terms

  • Autoimmune Diseases / complications
  • Cytokines / physiology*
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / immunology
  • Fatigue Syndrome, Chronic / physiopathology
  • Fatigue* / diagnosis
  • Fatigue* / immunology
  • Fatigue* / physiopathology
  • Humans
  • Illness Behavior / physiology*
  • Inflammation Mediators / physiology*


  • Cytokines
  • Inflammation Mediators