Kawakami, N, Iwata, N, Fujihara, S et al. · The Tohoku journal of experimental medicine · 1998 · DOI
This Japanese study looked at how common ME/CFS is in everyday communities by interviewing 137 people. Researchers found that about 1 in 67 people had severe, persistent fatigue that met ME/CFS criteria and significantly disrupted their daily life. The findings suggested ME/CFS might be more common in Japan than in Western countries studied previously.
This study provides rare international prevalence data for ME/CFS outside Western populations, highlighting that the disease occurs globally and may manifest differently across cultures. Understanding cross-cultural differences in disease prevalence and presentation is crucial for developing culturally-informed diagnostic approaches and ensuring ME/CFS is recognized in diverse populations.
This study does not establish causation for ME/CFS or identify why prevalence might differ between Japan and Western countries. The small sample size (n=137) and single-site Japanese sample limit generalizability, and the study cannot distinguish between true epidemiological differences versus differences in diagnostic criteria application, healthcare-seeking behavior, or symptom interpretation across cultures.
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
Kawakami, N, Iwata, N, Fujihara, S, & Kitamura, T (1998). Prevalence of chronic fatigue syndrome in a community population in Japan.. The Tohoku journal of experimental medicine. https://doi.org/10.1620/tjem.186.33
BibTeX
@article{mecfsatlas-kawakami-1998-prevalence-chronic,
author = {Kawakami, N and Iwata, N and Fujihara, S and Kitamura, T},
title = {Prevalence of chronic fatigue syndrome in a community population in Japan.},
journal = {The Tohoku journal of experimental medicine},
year = {1998},
doi = {10.1620/tjem.186.33},
note = {PubMed: 9915105},
url = {https://www.mecfsatlas.com/evidence/kawakami-1998-prevalence-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kawakami-1998-prevalence-chronic
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