Farrar, D J, Locke, S E, Kantrowitz, F G · Behavioral medicine (Washington, D.C.) · 1995 · DOI
ME/CFS is a serious illness that causes extreme tiredness and many other symptoms, but doctors don't yet fully understand what causes it or how to treat it best. This review looks at research about what might be happening in the body—including problems with the immune system and stress hormone regulation—but notes that no single explanation has been proven. Right now, treatment approaches are based on guesses rather than solid evidence, and we need better ways to identify which patients have which type of ME/CFS.
This systematic review highlights a fundamental gap in ME/CFS medicine: despite decades of research, the underlying cause remains unknown, leaving patients without evidence-based treatments. By documenting the scientific uncertainty while pointing toward immune and neurological dysfunction as promising areas, this work underscores why continued research investment is critical and why patients may experience variable responses to different treatments.
This review does not prove that any single cause or mechanism explains ME/CFS, nor does it validate any specific treatment as effective. It reflects 1995-era understanding and does not establish whether observed immunologic or neuroendocrine changes are primary causes, secondary effects, or correlates of the disease. The inclusive nature of early research meant it did not yet distinguish between heterogeneous patient subgroups, limiting the strength of conclusions.
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 →
Contribute
Private, reviewed by a human. Not a public comment thread.