Greenberg, D B · Psychosomatics · 1990 · DOI
In the 1980s, doctors thought chronic fatigue syndrome might be caused by a virus called Epstein-Barr virus (the virus that causes mononucleosis). This editorial explains that while this seemed like a logical explanation, the virus is not actually the cause of chronic fatigue syndrome. The author points out that many people with chronic fatigue also have depression or anxiety, and notes that these mental health conditions should be carefully evaluated and treated rather than overlooked.
This work is historically important because it highlights how diagnostic framing shapes patient care and research priorities in ME/CFS. The article reminds clinicians and researchers that psychiatric comorbidities in ME/CFS are common and require rigorous evaluation, helping prevent the assumption that ruling out one organic cause means psychiatric factors are irrelevant.
This editorial does not provide new experimental data proving whether Epstein-Barr virus involvement is completely absent in all CFS cases. It also does not establish that psychiatric symptoms are the primary cause of CFS, only that they commonly co-occur and deserve clinical attention. The piece is opinion-based commentary rather than a controlled study, so causal relationships are not directly tested.
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 →
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