Van Duyse, A, Mariman, A, Poppe, C et al. · Acta neuropsychiatrica · 2002 · DOI
This review examines how psychiatric symptoms interact with ME/CFS. Many people with ME/CFS also experience depression, anxiety, or sleep problems, and doctors often miss these conditions. The study found that while antidepressant medications help with mood and social functioning, they don't improve fatigue itself. Cognitive behavioral therapy and graded exercise were the only treatments shown to actually improve fatigue and other ME/CFS symptoms.
This review highlights that psychiatric assessment is essential for comprehensive ME/CFS care and that psychiatric comorbidities are frequently overlooked in general medical practice. Understanding that antidepressants target specific psychiatric symptoms rather than core fatigue helps patients and clinicians set realistic treatment expectations and pursue evidence-based interventions like cognitive behavioral therapy and graded exercise.
This editorial does not establish that psychiatric illness causes ME/CFS or that CFS is fundamentally a psychiatric disorder. The HPA-axis findings, while suggestive, do not prove dysregulation is the primary cause of fatigue, and the high rate of psychiatric comorbidity may reflect shared underlying biological mechanisms rather than causation. The study also does not evaluate the long-term efficacy or optimal implementation of cognitive behavior therapy and graded exercise.
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
Van Duyse, A, Mariman, A, Poppe, C, Michielsen, W, & Rubens, R (2002). Chronic fatigue syndrome in the psychiatric practice.. Acta neuropsychiatrica. https://doi.org/10.1034/j.1601-5215.2002.140306.x
BibTeX
@article{mecfsatlas-van-duyse-2002-chronic-fatigue,
author = {Van Duyse, A and Mariman, A and Poppe, C and Michielsen, W and Rubens, R},
title = {Chronic fatigue syndrome in the psychiatric practice.},
journal = {Acta neuropsychiatrica},
year = {2002},
doi = {10.1034/j.1601-5215.2002.140306.x},
note = {PubMed: 26984154},
url = {https://www.mecfsatlas.com/evidence/van-duyse-2002-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/van-duyse-2002-chronic-fatigue
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