Kapfhammer, H P, Rothenhäusler, H B · MMW Fortschritte der Medizin · 2004
ME/CFS involves fatigue and exhaustion that can look different from person to person. These symptoms can happen after infections like viruses or alongside mood and anxiety problems. The authors suggest that cognitive-behavioral therapy (a type of talk therapy focused on thoughts and behaviors) combined with antidepressant medication may help some patients.
Understanding that ME/CFS fatigue is heterogeneous—occurring through different biological and psychological pathways—helps patients and clinicians appreciate that one-size-fits-all treatment approaches may be insufficient. Recognition of overlapping psychiatric comorbidities informs more comprehensive diagnostic and therapeutic strategies. This framing encourages investigation of multifactorial causation rather than purely somatic or purely psychiatric models.
This review does not establish causal mechanisms linking viral infection, psychiatric disorders, or cognitive patterns to ME/CFS fatigue. It does not present original research data or controlled trials proving efficacy of cognitive-behavioral therapy in ME/CFS populations. The emphasis on psychiatric overlap does not prove psychological factors are primary causes rather than secondary consequences of the illness.
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
Kapfhammer, H P & Rothenhäusler, H B (2004). [Chronic fatigue syndrome].. MMW Fortschritte der Medizin. https://pubmed.ncbi.nlm.nih.gov/15540556/
BibTeX
@article{mecfsatlas-kapfhammer-2004-chronic-fatigue,
author = {Kapfhammer, H P and Rothenhäusler, H B},
title = {[Chronic fatigue syndrome].},
journal = {MMW Fortschritte der Medizin},
year = {2004},
note = {PubMed: 15540556},
url = {https://www.mecfsatlas.com/evidence/kapfhammer-2004-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kapfhammer-2004-chronic-fatigue
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