Winters, E G, Quinet, R J · The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society · 1992
ME/CFS is a complex illness characterized by severe, debilitating fatigue that often starts suddenly with flu-like symptoms. While researchers have investigated viruses and immune system changes in ME/CFS patients, no single cause has been definitively identified. Currently, there is no specific cure, though cognitive behavioral therapy and certain medications may help some patients manage their condition.
This review provides a comprehensive overview of what was understood about ME/CFS in the early 1990s, establishing that the condition involves measurable immune and physiological abnormalities beyond psychiatric causes. It remains relevant for contextualizing how ME/CFS conceptualization has evolved and for understanding why the biomedical versus psychosocial debate has persisted in the field.
This review does not establish causation for any proposed viral etiology—only that some viruses may be present in subsets of patients. It cannot prove whether psychiatric comorbidities are primary causes or secondary consequences of ME/CFS. The evidence level (E3) indicates this is a narrative review without systematic analysis, so conclusions should not be treated as definitive.
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
Winters, E G & Quinet, R J (1992). Chronic fatigue syndrome.. The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society. https://pubmed.ncbi.nlm.nih.gov/1619343/
BibTeX
@article{mecfsatlas-winters-1992-chronic-fatigue,
author = {Winters, E G and Quinet, R J},
title = {Chronic fatigue syndrome.},
journal = {The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society},
year = {1992},
note = {PubMed: 1619343},
url = {https://www.mecfsatlas.com/evidence/winters-1992-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/winters-1992-chronic-fatigue
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