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

Curr Rheumatol Rep. 2019 Feb 11;21(2):5. doi: 10.1007/s11926-019-0804-2.


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.

Keywords: Autonomic; Chronic fatigue syndrome; Fatigue; Function; Myalgic encephalomyelitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cost of Illness*
  • Fatigue Syndrome, Chronic*
  • Humans
  • Quality of Life
  • Residence Characteristics
  • Self Report