Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.
Xu, Qing, Zhao, Mengyu, Wang, Qin et al. · Journal of psychiatric research · 2026 · DOI
Quick Summary
This review article summarizes current knowledge about ME/CFS, a long-lasting illness characterized by extreme fatigue that rest doesn't improve, along with muscle pain, sore throat, and mood problems. The article examines what might cause ME/CFS, how doctors can better diagnose it, and what treatments may help. The authors note that ME/CFS cases are increasing worldwide, especially since COVID-19, and that current treatments have limited effectiveness.
Why It Matters
This comprehensive review is timely given the surge in ME/CFS cases following the COVID-19 pandemic and the increasing prevalence in younger populations. By synthesizing current understanding of mechanisms, diagnosis, and treatment, it provides a foundation for advancing future research and improving clinical care for a disease that severely impacts patients' quality of life and work capacity.
Observed Findings
ME/CFS incidence is rising annually with increasing prevalence in younger populations
Post-COVID-19, ME/CFS prevalence has significantly surged
Patients experience extreme fatigue lasting over six months, accompanied by physical symptoms (sore throat, muscle/joint pain) and neuropsychiatric symptoms (anxiety, distress)
Current treatments have limited success rates
ME/CFS etiology remains uncertain despite extensive research efforts
Inferred Conclusions
ME/CFS represents a significant and growing 21st-century health threat, particularly post-pandemic
The unknown etiology of ME/CFS limits development of effective treatments
Comprehensive multidisciplinary approaches integrating pathogenesis, diagnostic, and therapeutic knowledge are needed to advance understanding and clinical outcomes
Future research should prioritize identifying biomarkers and mechanisms to enable better diagnosis and targeted treatments
Remaining Questions
What is the underlying biological cause or causes of ME/CFS?
Are there reliable biomarkers that can be used to diagnose ME/CFS or predict treatment response?
What This Study Does Not Prove
As a systematic review rather than a primary research study, this article does not prove any new causal mechanisms or test novel therapies. It synthesizes existing knowledge but cannot establish definitive cause-and-effect relationships for ME/CFS etiology. The review's conclusions are limited by the quality and heterogeneity of underlying published studies.
Why has ME/CFS incidence increased, and what specific factors increase risk, particularly in younger populations and post-COVID-19?
Which therapeutic approaches are most effective for different patient subgroups, and how can treatments be optimized to minimize adverse psychological effects?