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Investigating Selected Symptoms |

Chronic Fatigue: Symptom and Syndrome

Simon Wessely, FRCP
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From Guy's, King's, and St Thomas's School of Medicine and Institute of Psychiatry, London, United Kingdom. Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled “ Investigating Symptoms: Frontiers in Primary Care Research—Perspectives from The Seventh Regenstrief Conference ” To see a complete list of the articles included in this supplement, please view its Table of Contents.


Copyright ©2004 by the American College of Physicians

Requests for Single Reprints: Simon Wessely, FRCP, Academic Department of Psychological Medicine, Guy's, King's, and St Thomas's School of Medicine and Institute of Psychiatry, 103 Denmark Hill, London, SE5 8AF, United Kingdom; e-mail, s.wessely@iop.kcl.ac.uk.


Ann Intern Med. 2001;134(9_Part_2):838-843. doi:10.7326/0003-4819-134-9_Part_2-200105011-00007
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Chronic fatigue is common, is difficult to measure, can be associated with considerable morbidity, and is rarely a subject of controversy. The chronic fatigue syndrome also presents problems in definition and measurement, is associated with even more morbidity than chronic fatigue itself, and is often controversial. Particularly unclear is the way in which chronic fatigue and the chronic fatigue syndrome relate to each other: Is one the severe form of the other, or are they qualitatively and quantitatively different? We know that many things can cause chronic fatigue, and this is probably true for the chronic fatigue syndrome, too. We can anticipate that discrete causes of the chronic fatigue syndrome will be found in the future, even if these causes are unlikely to fall neatly along the physical–psychological divide that some expect. The causes of chronic fatigue are undoubtedly many, both in a population and in any individual person, even when a discrete cause, such as depression or cancer, is identified. Social, behavioral, and psychological variables are important in both chronic fatigue and the chronic fatigue syndrome. Interventions that address these general variables can be successful, and currently they are often more successful than interventions directed at specific causes.

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