Rimbaut, Steven, Van Gutte, Céline, Van Brabander, Lina et al. · Acta clinica Belgica · 2016 · DOI
This review examined research on ME/CFS published over 25 years and found that despite extensive scientific study, no single cause of the condition has been definitively proven. Currently, the best-supported treatments are cognitive behavioral therapy (a talk therapy) and graded exercise therapy (gradually increasing activity), though these show only moderate benefits. The study highlights how common ME/CFS is and how significantly it affects people's ability to work and participate in daily life.
This comprehensive review underscores the complexity of ME/CFS and the absence of a definitive biomarker or single-cause explanation, validating patient experiences of diagnostic uncertainty. It identifies CBT and GET as the only moderately effective treatments available, which is important for patients and clinicians navigating treatment options while highlighting the urgent need for research into disease mechanisms.
This review does not establish the safety or appropriateness of graded exercise therapy for all ME/CFS patients, nor does it prove that psychological factors cause the condition—only that psychosocial interventions have moderate effectiveness. The absence of strong evidence for any etiological factor does not mean none exists; it reflects current scientific limitations and the heterogeneity of ME/CFS.
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
Rimbaut, Steven, Van Gutte, Céline, Van Brabander, Lina, & Vanden Bossche, Luc (2016). Chronic fatigue syndrome - an update.. Acta clinica Belgica. https://doi.org/10.1080/17843286.2016.1196862
BibTeX
@article{mecfsatlas-rimbaut-2016-chronic-fatigue,
author = {Rimbaut, Steven and Van Gutte, Céline and Van Brabander, Lina and Vanden Bossche, Luc},
title = {Chronic fatigue syndrome - an update.},
journal = {Acta clinica Belgica},
year = {2016},
doi = {10.1080/17843286.2016.1196862},
note = {PubMed: 27362742},
url = {https://www.mecfsatlas.com/evidence/rimbaut-2016-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/rimbaut-2016-chronic-fatigue
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