David, A S, Wessely, S, Pelosi, A J · British medical journal (Clinical research ed.) · 1988 · DOI
This 1988 review examined how ME/CFS was being studied and discussed in medical literature, finding significant problems with how research was being conducted. The authors argued that the condition should not be viewed as simply 'all in your head' or 'purely physical,' but rather as involving multiple factors affecting the body and mind. They called for better research methods and clearer definitions before doctors could effectively help patients.
This early systematic critique established important methodological standards for ME/CFS research that remain relevant today. By highlighting the inadequacy of the 'organic versus functional' dichotomy, it provided conceptual groundwork for more sophisticated research approaches and legitimized the need for rigorous case definitions—issues that continue to impact patient care and research funding.
This review does not establish the underlying cause, mechanism, or pathophysiology of ME/CFS, nor does it provide evidence for specific diagnostic tests or treatments. It identifies research flaws without generating new empirical data; it critiques existing evidence rather than presenting novel findings. It also does not prove that better-designed studies will necessarily find organic abnormalities.
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
David, A S, Wessely, S, & Pelosi, A J (1988). Postviral fatigue syndrome: time for a new approach.. British medical journal (Clinical research ed.). https://doi.org/10.1136/bmj.296.6623.696
BibTeX
@article{mecfsatlas-david-1988-postviral-fatigue,
author = {David, A S and Wessely, S and Pelosi, A J},
title = {Postviral fatigue syndrome: time for a new approach.},
journal = {British medical journal (Clinical research ed.)},
year = {1988},
doi = {10.1136/bmj.296.6623.696},
note = {PubMed: 3128374},
url = {https://www.mecfsatlas.com/evidence/david-1988-postviral-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/david-1988-postviral-fatigue
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