Kenter, E G, Okkes, I M · Nederlands tijdschrift voor geneeskunde · 1999
This study looked at how often people visit their doctor complaining of fatigue and what doctors do about it. Researchers tracked visits from general practitioners across the Netherlands over 10 years, involving over 93,000 patient visits. They found that about 92 out of every 1,000 patients saw their doctor each year because of fatigue, but only about 4% had fatigue lasting 6 months or longer.
This study provides epidemiological context for understanding how common severe, persistent fatigue is in primary care and how it is typically managed—important baseline data for ME/CFS patients trying to understand their condition's prevalence and the historical approach to fatigue in medical practice. It highlights that most fatigue in general practice resolves quickly, helping contextualize why patients with prolonged fatigue (potentially including ME/CFS) may face diagnostic and therapeutic challenges.
This study does not establish ME/CFS prevalence specifically, as it captures all fatigue presentations without formal ME/CFS diagnostic criteria applied systematically. It does not prove that a 'wait and see' approach is optimal for any particular fatigue disorder, nor does it clarify the underlying causes of fatigue or long-term outcomes for patients with persistent symptoms. The study is observational and cannot demonstrate causation or evaluate treatment effectiveness.
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
Kenter, E G & Okkes, I M (1999). [Patients with fatigue in family practice: prevalence and treatment].. Nederlands tijdschrift voor geneeskunde. https://pubmed.ncbi.nlm.nih.gov/10347643/
BibTeX
@article{mecfsatlas-kenter-1999-patients-fatigue,
author = {Kenter, E G and Okkes, I M},
title = {[Patients with fatigue in family practice: prevalence and treatment].},
journal = {Nederlands tijdschrift voor geneeskunde},
year = {1999},
note = {PubMed: 10347643},
url = {https://www.mecfsatlas.com/evidence/kenter-1999-patients-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kenter-1999-patients-fatigue
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