Huibers, M J H, Beurskens, A J H M, Prins, J B et al. · Occupational and environmental medicine · 2003 · DOI
This study compared three types of fatigue conditions in workers on sick leave: general persistent fatigue, burnout, and ME/CFS. Researchers found that workers whose fatigue matched ME/CFS patterns tended to blame physical causes for their illness, while workers with burnout tended to blame psychological causes. Interestingly, workers with fatigue shared many similarities with diagnosed ME/CFS patients, but how they explained their illness differed between groups.
This study addresses a critical gap by directly comparing ME/CFS with burnout and persistent fatigue—three conditions often confused clinically. Understanding how patient attributions differ across these conditions may help clinicians distinguish between them and inform treatment approaches. The findings suggest that how patients interpret their symptoms may be an important factor in illness presentation and outcomes.
This cross-sectional study cannot determine whether causal attributions cause different illness outcomes or whether experiencing fatigue shapes how patients explain their condition. It also does not prove that fatigued employees actually have ME/CFS, only that they meet some research criteria; symptom duration and other diagnostic requirements were not fully verified. The study cannot establish the direction of causality between any observed associations.
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
Huibers, M J H, Beurskens, A J H M, Prins, J B, Kant, I J, Bazelmans, E, Van Schayck, C P, et al. (2003). Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?. Occupational and environmental medicine. https://doi.org/10.1136/oem.60.suppl_1.i26
BibTeX
@article{mecfsatlas-huibers-2003-fatigue-burnout,
author = {Huibers, M J H and Beurskens, A J H M and Prins, J B and Kant, I J and Bazelmans, E and Van Schayck, C P and Knottnerus, J A and Bleijenberg, G},
title = {Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference?},
journal = {Occupational and environmental medicine},
year = {2003},
doi = {10.1136/oem.60.suppl_1.i26},
note = {PubMed: 12782744},
url = {https://www.mecfsatlas.com/evidence/huibers-2003-fatigue-burnout},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/huibers-2003-fatigue-burnout
Contribute
Private, reviewed by a human. Not a public comment thread.