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Benjamin H. Natelson, MD

JAMA. 2001;285:2557-2559.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Chronic fatigue syndrome (CFS), like fibromyalgia and multiple chemical sensitivity, comprises a number of poorly understood signs and symptoms, and whether a patient receives the diagnosis for one or another of these symptom clusters may depend on the specialty of the physician making the diagnosis.¹ Patients with CFS also often fulfill case definitions for these other illnesses.¹ This overlap suggests that these "functional somatic illnesses" may be variants of one another.² However, this does not necessarily mean that these syndromes share the same pathobiological processes or causes. For example, patients with fibromyalgia have been found to have elevated levels of substance P in spinal fluid³ and reduced pain thresholds, while patients with CFS have not.⁴ Similarly, the fatigue reported by patients with fibromyalgia may be secondary to chronic sleep disruption because of pain, while fatigue may be primary in CFS.

The case definitions for CFS^5-6 reflect . . . [Full Text of this Article]

Viral and Immunological Factors

Psychiatric and Social Factors

Orthostatic Intolerance

Covert Encephalopathy

Future Directions

Author Affiliations: Chronic Fatigue Syndrome Cooperative Research Center, Department of Neurosciences, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark; and Veterans Affairs Medical Center, East Orange, NJ.

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