The prognosis of chronic fatigue and chronic fatigue syndrome: a systematic review

QJM. 1997 Mar;90(3):223-33. doi: 10.1093/qjmed/90.3.223.


The prognosis of chronic fatigue syndrome and chronic fatigue has been studied in numerous small case series. We performed a systematic review of all studies to determine the proportion of individuals with the conditions who recovered at follow-up, the risk of developing alternative physical diagnoses, and the risk factors for poor prognosis. A literature search of all published studies which included a follow-up of patients with chronic fatigue syndrome or chronic fatigue were performed. Of 26 studies identified, four studied fatigue in children, and found that 54-94% of children recovered over the periods of follow-up. Another five studies operationally defined chronic fatigue syndrome in adults and found that < 10% of subjects return to pre-morbid levels of functioning, and the majority remain significantly impaired. The remaining studies used less stringent criteria to define their cohorts. Among patients in primary care with fatigue lasting < 6 months, at least 40% of patients improved. As the definition becomes more stringent the prognosis appears to worsen. Consistently reported risk factors for poor prognosis are older age, more chronic illness, having a comorbid psychiatric disorder and holding a belief that the illness is due to physical causes.

Publication types

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

MeSH terms

  • Adult
  • Child
  • Fatigue / epidemiology
  • Fatigue / psychology
  • Fatigue Syndrome, Chronic / epidemiology*
  • Fatigue Syndrome, Chronic / mortality
  • Fatigue Syndrome, Chronic / psychology
  • Follow-Up Studies
  • Humans
  • Prognosis
  • Self-Help Groups