Bombardier, C H, Buchwald, D · Archives of internal medicine · 1995
This study followed 445 patients with chronic fatigue or chronic fatigue syndrome (CFS) for about 1.5 years to see how they recovered. While 64% of patients improved overall, only 2% felt completely better. Patients diagnosed with CFS had more severe symptoms and lower functioning than those with simple chronic fatigue, and depression made recovery less likely.
This study provides rare longitudinal data on natural history and prognosis in both CF and CFS populations, demonstrating that the CDC case definition for CFS identifies a subgroup with poorer prognosis. Identifying modifiable risk factors like dysthymia could inform treatment strategies, though the low complete recovery rate underscores the chronic nature of these conditions.
This study does not establish causation—that depression causes poor outcomes—only association. The tertiary care setting means results may not generalize to primary care or community populations. The study also does not address whether different treatments or interventions could improve these outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Bombardier, C H & Buchwald, D (1995). Outcome and prognosis of patients with chronic fatigue vs chronic fatigue syndrome.. Archives of internal medicine. https://pubmed.ncbi.nlm.nih.gov/7575071/
BibTeX
@article{mecfsatlas-bombardier-1995-outcome-prognosis,
author = {Bombardier, C H and Buchwald, D},
title = {Outcome and prognosis of patients with chronic fatigue vs chronic fatigue syndrome.},
journal = {Archives of internal medicine},
year = {1995},
note = {PubMed: 7575071},
url = {https://www.mecfsatlas.com/evidence/bombardier-1995-outcome-prognosis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/bombardier-1995-outcome-prognosis
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