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Original Article

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Clinical Working Case Definition, Diagnostic and Treatment Protocols

Pages 7-115 | Received 12 Feb 2002, Accepted 17 May 2002, Published online: 04 Dec 2011

Keep up to date with the latest research on this topic with citation updates for this article.

Read on this site (91)

Sally Casson, Matthew D. Jones, Joanne Cassar, Natalie Kwai, Andrew R. Lloyd, Benjamin K. Barry & Carolina X. Sandler. (2023) The effectiveness of activity pacing interventions for people with chronic fatigue syndrome: a systematic review and meta-analysis. Disability and Rehabilitation 45:23, pages 3788-3802.
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Leonard A. Jason, Sage Benner, Jacob Furst & Paul Cathey. (2023) Developing and validating a brief screening scale for ME/CFS. Fatigue: Biomedicine, Health & Behavior 0:0, pages 1-12.
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Shin Jie Yong, Alice Halim, Michael Halim, Long Chiau Ming, Khang Wen Goh, Mubarak Alfaresi, Bashayer M. AlShehail, Mona A. Al Fares, Mohammed Alissa, Tarek Sulaiman, Zainab Alsalem, Ameen S. S. Alwashmi, Faryal Khamis, Nawal A. Al Kaabi, Hawra Albayat, Ahmed Alsheheri, Mohammed Garout, Jameela Alsalman, Amal H. Alfaraj, Mashael Alhajri, Kuldeep Dhama, Lamees M. Alburaiky, Ahlam H. Alsanad, Abdelmunim T. AlShurbaji & Ali A. Rabaan. (2023) Experimental drugs in randomized controlled trials for long-COVID: what’s in the pipeline? A systematic and critical review. Expert Opinion on Investigational Drugs 32:7, pages 655-667.
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Elisabeth K. Steinsvik, Trygve Hausken, Øystein Fluge, Olav Mella & Odd Helge Gilja. (2023) Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome. Scandinavian Journal of Gastroenterology 58:7, pages 718-725.
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Kensei I. Maeda, Mohammed F. Islam, Karl E. Conroy & Leonard Jason. (2023) Health outcomes of sensory hypersensitivities in myalgic encephalomyelitis/chronic fatigue syndrome and multiple sclerosis. Psychology, Health & Medicine 0:0, pages 1-12.
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Karl E. Conroy, Mohammed F. Islam & Leonard A. Jason. (2023) Evaluating case diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): toward an empirical case definition. Disability and Rehabilitation 45:5, pages 840-847.
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Merethe Eide Gotaas, Tormod Landmark, Anne S. Helvik & Egil A. Fors. (2023) Characteristics associated with physical functioning and fatigue in patients with chronic fatigue syndrome (CFS): secondary analyses of a randomized controlled trial. Fatigue: Biomedicine, Health & Behavior 0:0, pages 1-17.
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Leonard A. Jason, Suvetha Ravichandran, Ben Z. Katz, Benjamin H. Natelson & Hector Fabio Bonilla. (2023) Establishing a consensus on ME/CFS exclusionary illnesses. Fatigue: Biomedicine, Health & Behavior 11:1, pages 1-13.
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Charmaine van Eeden, Mohammed S. Osman & Jan Willem Cohen Tervaert. (2022) Fatigue in ANCA-associated vasculitis (AAV) and systemic sclerosis (SSc): similarities with Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A critical review of the literature. Expert Review of Clinical Immunology 18:10, pages 1049-1070.
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Leonard A. Jason, John Kalns, Alicia Richarte, Ben Z. Katz & Chelsea Torres. (2021) Saliva fatigue biomarker index as a marker for severe myalgic encephalomyelitis/chronic fatigue syndrome in a community based sample. Fatigue: Biomedicine, Health & Behavior 9:4, pages 189-195.
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Leonard A. Jason, Joseph Cotler, Mohammed F. Islam, Jacob Furst, Matthew Sorenson & Ben Z. Katz. (2021) Cytokine networks analysis uncovers further differences between those who develop myalgic encephalomyelitis/chronic fatigue syndrome following infectious mononucleosis. Fatigue: Biomedicine, Health & Behavior 9:1, pages 45-57.
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Leonard A. Jason & Madeline Johnson. (2020) Solving the ME/CFS criteria and name conundrum: the aftermath of IOM. Fatigue: Biomedicine, Health & Behavior 8:2, pages 97-107.
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Anne Marit Mengshoel, Ingrid Bergliot Helland, Mira Meeus, Jesus Castro-Marrero, Derek Pheby & Elin Bolle Strand. (2020) Patients’ experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome – a scoping mixed methods review. International Journal of Qualitative Studies on Health and Well-being 15:1.
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Olli Polo, Pia Pesonen & Essi Tuominen. (2019) Low-dose naltrexone in the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Fatigue: Biomedicine, Health & Behavior 7:4, pages 207-217.
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Helen Bedree, Madison Sunnquist & Leonard A. Jason. (2019) The DePaul Symptom Questionnaire-2: a validation study. Fatigue: Biomedicine, Health & Behavior 7:3, pages 166-179.
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Samantha Scartozzi, Madison Sunnquist & Leonard A. Jason. (2019) Myalgic encephalomyelitis and chronic fatigue syndrome case definitions: effects of requiring a substantial reduction in functioning. Fatigue: Biomedicine, Health & Behavior 7:2, pages 59-68.
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Andrew R. Devendorf, Carly T. Jackson, Madison Sunnquist & Leonard A. Jason. (2019) Defining and measuring recovery from myalgic encephalomyelitis and chronic fatigue syndrome: the physician perspective. Disability and Rehabilitation 41:2, pages 158-165.
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Santiago Herrera, Wilfred C. de Vega, David Ashbrook, Suzanne D. Vernon & Patrick O. McGowan. (2018) Genome-epigenome interactions associated with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Epigenetics 13:12, pages 1174-1190.
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Daniel Maroti & Indre Bileviciute-Ljungar. (2018) Similarities and differences between health-related quality of life in patients with exhaustion syndrome and chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 6:4, pages 208-219.
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Willy Eriksen. (2018) ME/CFS, case definition, and serological response to Epstein-Barr virus. A systematic literature review. Fatigue: Biomedicine, Health & Behavior 6:4, pages 220-234.
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L. A. Jason, S. L. McManimen, M. Sunnquist & C. S. Holtzman. (2018) Patient perceptions of post exertional malaise. Fatigue: Biomedicine, Health & Behavior 6:2, pages 92-105.
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Leonard A. Jason, Pamela A. Fox & Kristen D. Gleason. (2018) The importance of a research case definition. Fatigue: Biomedicine, Health & Behavior 6:1, pages 52-58.
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Frank Twisk. (2018) Letter to the Editor. Fatigue: Biomedicine, Health & Behavior 6:1, pages 59-60.
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Thomas Meinertz Dantoft, Jeanette Frost Ebstrup, Allan Linneberg, Sine Skovbjerg, Anja Lykke Madsen, Jesper Mehlsen, Louise Brinth, Lene Falgaard Eplov, Tina Wisbech Carstensen, Andreas Schroder, Per Klausen Fink, Erik Lykke Mortensen, Torben Hansen, Oluf Pedersen & Torben Jørgensen. (2017) Cohort description: The Danish study of Functional Disorders. Clinical Epidemiology 9, pages 127-139.
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Tom Warnecke. (2017) Chronic fatigue phenomena – somatic and relational perspectives. Body, Movement and Dance in Psychotherapy 12:4, pages 269-283.
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Jacob B. Lindheimer, Jacob D. Meyer, Aaron J. Stegner, Ryan J. Dougherty, Stephanie M. Van Riper, Morgan Shields, Amanda Reisner, Sanjay K. Shukla, Alan R. Light, Steven Yale & Dane B. Cook. (2017) Symptom variability following acute exercise in myalgic encephalomyelitis/chronic fatigue syndrome: a perspective on measuring post-exertion malaise. Fatigue: Biomedicine, Health & Behavior 5:2, pages 69-88.
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Leonard A. Jason, Stephanie McManimen, Madison Sunnquist, Julia L. Newton & Elin Bolle Strand. (2017) Clinical criteria versus a possible research case definition in chronic fatigue syndrome/myalgic encephalomyelitis. Fatigue: Biomedicine, Health & Behavior 5:2, pages 89-102.
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Martin A. Jonsjö, Rikard K. Wicksell, Linda Holmström, Anna Andreasson, Indre Bileviciute-Ljungar & Gunnar L. Olsson. (2017) Identifying symptom subgroups in patients with ME/CFS – relationships to functioning and quality of life. Fatigue: Biomedicine, Health & Behavior 5:1, pages 33-42.
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Luis Nacul, Caroline C. Kingdon, Erinna W. Bowman, Hayley Curran & Eliana M. Lacerda. (2017) Differing case definitions point to the need for an accurate diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 5:1, pages 1-4.
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Elizabeth A. Kendrick & Denise Beesley. (2016) Perceived stress, illness invalidation, and symptom severity in myalgic encephalomyelitis/chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 4:4, pages 217-225.
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Stephanie L. McManimen, Andrew R. Devendorf, Abigail A. Brown, Billie C. Moore, James H. Moore & Leonard A. Jason. (2016) Mortality in patients with myalgic encephalomyelitis and chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 4:4, pages 195-207.
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Steven Rimbaut, Céline Van Gutte, Lina Van Brabander & Luc Vanden Bossche. (2016) Chronic fatigue syndrome – an update. Acta Clinica Belgica 71:5, pages 273-280.
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Els Tobback, Ignace Hanoulle, An Mariman, Liesbeth Delesie, Dirk Pevernagie & Dirk Vogelaers. (2016) Factors determining fatigue in the chronic fatigue syndrome: a path analysis. Acta Clinica Belgica 71:5, pages 284-289.
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Taylor Thorpe, Stephanie McManimen, Kristen Gleason, Jamie Stoothoff, Julia L. Newton, Elin Bolle Strand & Leonard A. Jason. (2016) Assessing current functioning as a measure of significant reduction in activity level. Fatigue: Biomedicine, Health & Behavior 4:3, pages 175-188.
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Fred Friedberg, Jenna Adamowicz, Indre Caikauskaite, Viktoria Seva & Anthony Napoli. (2016) Efficacy of two delivery modes of behavioral self-management in severe chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 4:3, pages 158-174.
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Elin B. Strand, Kristine Lillestøl, Leonard A. Jason, Kari Tveito, Lien My Diep, Simen Strand Valla, Madison Sunnquist, Ingrid B. Helland, Ingrid Herder & Toril Dammen. (2016) Comparing the DePaul Symptom Questionnaire with physician assessments: a preliminary study. Fatigue: Biomedicine, Health & Behavior 4:1, pages 52-62.
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Leonard A. Jason, Stephanie McManimen, Madison Sunnquist, Abigail Brown, Jacob Furst, Julia L. Newton & Elin Bolle Strand. (2016) Case definitions integrating empiric and consensus perspectives. Fatigue: Biomedicine, Health & Behavior 4:1, pages 1-23.
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Meredyth Evans & Leonard A. Jason. (2015) The impact of symptom stability on time frame and recall reliability in CFS. Cogent Psychology 2:1.
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Leonard A. Jason, Madison Sunnquist, Abigail Brown & Jordan Reed. (2015) Defining Essential Features of Myalgic Encephalomyelitis and Chronic Fatigue Syndrome. Journal of Human Behavior in the Social Environment 25:6, pages 657-674.
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Irma Pinxsterhuis, Elin Bolle Strand, Eva Stormorken & Unni Sveen. (2015) From chaos and insecurity to understanding and coping: experienced benefits of a group-based education programme for people with chronic fatigue syndrome. British Journal of Guidance & Counselling 43:4, pages 463-475.
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Leonard A. Jason, Madison Sunnquist, Abigail Brown, Julia L. Newton, Elin Bolle Strand & Suzanne D. Vernon. (2015) Chronic fatigue syndrome versus systemic exertion intolerance disease. Fatigue: Biomedicine, Health & Behavior 3:3, pages 127-141.
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Stephanie L. McManimen, Leonard A. Jason & Yolonda J. Williams. (2015) Variability in symptoms complicates utility of case definitions. Fatigue: Biomedicine, Health & Behavior 3:3, pages 164-172.
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David M. Patrick, Ruth R. Miller, Theodore Steiner, Jennifer L. Gardy, Shoshana M. Parker & Patrick Tang. (2015) Brain-derived neurotrophic factor concentration may not be depressed in chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 3:2, pages 122-125.
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Fred Friedberg. (2015) Institute of medicine report on chronic fatigue syndrome: case definition issues and future directions. Fatigue: Biomedicine, Health & Behavior 3:2, pages 59-62.
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N.G. Klimas, G. Ironson, A. Carter, E. Balbin, L. Bateman, D. Felsenstein, S. Levine, D. Peterson, K. Chiu, A. Allen, K. Cunningham, C.G. Gottschalk, M. Fletcher, M. Hornig, C. Canning & A.L. Komaroff. (2015) Findings from a clinical and laboratory database developed for discovery of pathogenic mechanisms in myalgic encephalomyelitis/chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 3:2, pages 75-96.
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Leonard A. Jason, Bobby Kot, Madison Sunnquist, Abigail Brown, Jordan Reed, Jacob Furst, Julia L. Newton, Elin Bolle Strand & Suzanne D. Vernon. (2015) Comparing and contrasting consensus versus empirical domains. Fatigue: Biomedicine, Health & Behavior 3:2, pages 63-74.
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Anna Krzeczkowska, Thanos Karatzias & Adele Dickson. (2015) Pain in people with chronic fatigue syndrome/myalgic encephalomyelitis: The role of traumatic stress and coping strategies. Psychology, Health & Medicine 20:2, pages 210-216.
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Leonard A. Jason, Suzanna So, Abigail A. Brown, Madison Sunnquist & Meredyth Evans. (2015) Test–retest reliability of the DePaul Symptom Questionnaire. Fatigue: Biomedicine, Health & Behavior 3:1, pages 16-32.
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Charles Schafer, Meredyth Evans, Leonard A. Jason, Suzanna So & Abigail Brown. (2015) Measuring Substantial Reductions in Activity. Journal of Prevention & Intervention in the Community 43:1, pages 5-19.
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Leonard A. Jason, Meredyth Evans, Suzanna So, Jilian Scott & Abigail Brown. (2015) Problems in Defining Post-Exertional Malaise. Journal of Prevention & Intervention in the Community 43:1, pages 20-31.
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Madison Sunnquist, Leonard A. Jason, Abigail Brown, Meredyth Evans & Andrew Berman. (2015) Complications in Operationalizing Lifelong Fatigue as an Exclusionary Criterion. Journal of Prevention & Intervention in the Community 43:1, pages 42-53.
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Leonard A. Jason, Suzanna So, Meredyth Evans, Abigail Brown, Madison Sunnquist, Young Im & Charles Schafer. (2015) An Overview of Operationalizing Criteria for ME, ME/CFS, and CFS Case Definitions. Journal of Prevention & Intervention in the Community 43:1, pages 1-4.
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Suzanna So, Meredyth Evans, Leonard A. Jason & Abigail Brown. (2015) Are Stamina and Fatigue Polar Opposites? A Case Study. Journal of Prevention & Intervention in the Community 43:1, pages 32-41.
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Leonard A. Jason, Meredyth Evans, Abigail Brown, Madison Sunnquist & Julia L. Newton. (2015) Chronic Fatigue Syndrome Versus Sudden Onset Myalgic Encephalomyelitis. Journal of Prevention & Intervention in the Community 43:1, pages 62-77.
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Leonard A. Jason. (2015) Differentiating myalgic encephalomyelitis and chronic fatigue syndrome: a response to Twisk (2015). Health Psychology and Behavioral Medicine 3:1, pages 111-113.
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Leonard A. Jason, Bobby Kot, Madison Sunnquist, Abigail Brown, Meredyth Evans, Rachel Jantke, Yolonda Williams, Jacob Furst & Suzanne D. Vernon. (2015) Chronic fatigue syndrome and myalgic encephalomyelitis: towards an empirical case definition. Health Psychology and Behavioral Medicine 3:1, pages 82-93.
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Leonard A. Jason & Jordan Reed. (2015) The use of mixed methods in studying a chronic illness. Health Psychology and Behavioral Medicine 3:1, pages 40-51.
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Megan A Arroll, Elizabeth A Attree, Clare L Marshall & Christine P Dancey. (2014) Pilot study investigating the utility of a specialized online symptom management program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome as compared to an online meditation program. Psychology Research and Behavior Management 7, pages 213-221.
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Elizabeth A Attree, Megan A Arroll, Christine P Dancey, Charlene Griffith & Amolak S Bansal. (2014) Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome. Psychology Research and Behavior Management 7, pages 67-76.
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Abigail A. Brown & Leonard A. Jason. (2014) Validating a measure of myalgic encephalomyelitis/chronic fatigue syndrome symptomatology. Fatigue: Biomedicine, Health & Behavior 2:3, pages 132-152.
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Megan A. Arroll, Elizabeth A. Attree, John M. O'Leary & Christine P. Dancey. (2014) The delayed fatigue effect in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Fatigue: Biomedicine, Health & Behavior 2:2, pages 57-63.
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Leonard A. Jason, Madison Sunnquist, Abigail Brown, Meredyth Evans, Suzanne D. Vernon, Jacob D. Furst & Valerie Simonis. (2014) Examining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitis. Fatigue: Biomedicine, Health & Behavior 2:1, pages 40-56.
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S.C. Johnston, E.W. Brenu, D.R. Staines & S.M. Marshall-Gradisnik. (2014) The role of clinical guidelines for chronic fatigue syndrome/myalgic encephalomyelitis in research settings. Fatigue: Biomedicine, Health & Behavior 2:1, pages 28-39.
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Emily G. Lattie, Michael H. Antoni, Mary Ann Fletcher, Sara Czaja, Dolores Perdomo, Andreina Sala, Sankaran Nair, Shih Hua Fu, Frank J. Penedo & Nancy Klimas. (2013) Beyond myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptom severity: stress management skills are related to lower illness burden. Fatigue: Biomedicine, Health & Behavior 1:4, pages 210-222.
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Kirsty Best & Stephanie Butler. (2013) THE NECESSITY OF CONTROL FOR COMPUTER AND INTERNET USERS WITH MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME. Information, Communication & Society 16:7, pages 1042-1060.
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Leonard A. Jason, Abigail Brown, Meredyth Evans, Madison Sunnquist & Julia L. Newton. (2013) Contrasting chronic fatigue syndrome versus myalgic encephalomyelitis/chronic fatigue syndrome. Fatigue: Biomedicine, Health & Behavior 1:3, pages 168-183.
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A Revelas & E Baltaretsou. (2013) Chronic fatigue syndrome: diagnosis and treatment. South African Family Practice 55:1, pages 53-55.
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Rebecca Marshall, Lorna Paul & Les Wood. (2011) The search for pain relief in people with chronic fatigue syndrome: A descriptive study. Physiotherapy Theory and Practice 27:5, pages 373-383.
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Todd E. Davenport, Staci R. Stevens, Katie Baroni, J. Mark Van Ness & Christopher R. Snell. (2011) Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue. Disability and Rehabilitation 33:25-26, pages 2596-2604.
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Live Hareide, Arnstein Finset & Vegard Bruun Wyller. (2011) Chronic fatigue syndrome: a qualitative investigation of young patient's beliefs and coping strategies. Disability and Rehabilitation 33:22-23, pages 2255-2263.
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Todd E. Davenport, Staci R. Stevens, Katie Baroni, Mark Van Ness & Christopher R. Snell. (2011) Diagnostic accuracy of symptoms characterising chronic fatigue syndrome. Disability and Rehabilitation 33:19-20, pages 1768-1775.
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Judy A. Mikovits, Vincent C. Lombardi, Max A. Pfost, Kathryn S. Hagen & Francis W. Ruscetti. (2010) Detection of an infectious retrovirus, XMRV, in blood cells of patients with chronic fatigue syndrome. Virulence 1:5, pages 386-390.
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Rebecca Marshall, Lorna Paul, Angus K. McFadyen, Danny Rafferty & Leslie Wood. (2010) Pain Characteristics of People with Chronic Fatigue Syndrome. Journal of Musculoskeletal Pain 18:2, pages 127-137.
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Jody Berland. (2009) The elephant in the classroom. International Journal of Inclusive Education 13:7, pages 699-711.
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Chi-Un Pae, David M Marks, Ashwin A Patkar, Prakash S Masand, Patrick Luyten & Alessandro Serretti. (2009) Pharmacological treatment of chronic fatigue syndrome: focusing on the role of antidepressants. Expert Opinion on Pharmacotherapy 10:10, pages 1561-1570.
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José Ramón Valdizán Usón & María Ángeles Idiazábal Alecha. (2008) Diagnostic and treatment challenges of chronic fatigue syndrome: role of immediate-release methylphenidate. Expert Review of Neurotherapeutics 8:6, pages 917-927.
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Tony Ward, Kevin Hogan, Viki Stuart & Elizabeth Singleton. (2008) The experiences of counselling for persons with ME. Counselling and Psychotherapy Research 8:2, pages 73-79.
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LeonardA. Jason, Karina Corradi & Susan Torresharding. (2007) Toward an Empirical Case Definition of CFS. Journal of Social Service Research 34:2, pages 43-54.
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Suzanne Elizabeth Gray & D. R. Rutter. (2007) Illness representations in young people with Chronic Fatigue Syndrome. Psychology & Health 22:2, pages 159-174.
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Leonard A. Jason & Judith A. Richman. (2007) How Science Can Stigmatize: The Case of Chronic Fatigue Syndrome. Journal Of Chronic Fatigue Syndrome 14:4, pages 85-103.
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Tolu Osoba, Derek Pheby, Selena Gray & Luis Nacul. (2007) The Development of an Epidemiological Definition for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Journal Of Chronic Fatigue Syndrome 14:4, pages 61-84.
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Rosemary A. Underhill & Ruth O'gorman. (2006) Prevalence of Chronic Fatigue Syndrome and Chronic Fatigue Within Families of CFS Patients. Journal Of Chronic Fatigue Syndrome 13:1, pages 3-13.
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Leonard A. Jason, Susan R. Torres-Harding, Amber Jurgens & Jena Helgerson. (2004) Comparing the Fukuda et al. Criteria and the Canadian Case Definition for Chronic Fatigue Syndrome. Journal Of Chronic Fatigue Syndrome 12:1, pages 37-52.
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