Rollnik, Jens D · Fortschritte der Neurologie-Psychiatrie · 2017 · DOI
This review examines whether ME/CFS is a distinct disease or if its symptoms overlap significantly with depression and other conditions. The authors found that while ME/CFS affects less than 1% of the population, there is no clear biological explanation for what causes it, and there are no universally agreed-upon diagnostic criteria. They recommend trying exercise, antidepressants, and talk therapy, but caution against using aggressive immune therapies without stronger evidence.
This critical review highlights ongoing diagnostic and conceptual challenges in ME/CFS that directly affect how patients are recognized and treated. Understanding debates about disease classification helps patients navigate variable clinical responses and explains why diagnostic criteria and treatment approaches differ across specialists and countries.
This review does not establish that ME/CFS is psychosomatic or 'all in the head'—symptom overlap with psychiatric conditions does not disprove biological mechanisms. It also does not prove the absence of neuroinflammation; rather, it notes insufficient evidence at the time of publication. This critique does not invalidate individual patient experiences or preclude future discovery of distinct biomarkers.
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 →
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Primary citation
Rollnik, Jens D (2017). [Chronic Fatigue Syndrome: A Critical Review].. Fortschritte der Neurologie-Psychiatrie. https://doi.org/10.1055/s-0042-121259
BibTeX
@article{mecfsatlas-rollnik-2017-chronic-fatigue,
author = {Rollnik, Jens D},
title = {[Chronic Fatigue Syndrome: A Critical Review].},
journal = {Fortschritte der Neurologie-Psychiatrie},
year = {2017},
doi = {10.1055/s-0042-121259},
note = {PubMed: 28235209},
url = {https://www.mecfsatlas.com/evidence/rollnik-2017-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/rollnik-2017-chronic-fatigue
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