[Chronic fatigue syndrome: psychiatric perspectives]

Chronic fatigue syndrome (CFS) is a common illness of unknown etiology and pathogenesis characterized by severe disabling fatigue and a variety of musculoskeletal, neurocognitive, mood symptoms and sleep disorders lasting at least six months. A significant proportion of patients fulfilling operative criteria for a diagnosis of CFS will also meet criteria for a psychiatric disorder such as depression, somatization or anxiety disorders. Premorbid lifestyle may play a predisposing, and/or perpetuating role in CFS. Some patients improve with time but most remain functionally impaired for several years. A variety of interventions have been used in the treatment and management of CFS. Interventions which have shown promising results include cognitive behavioural therapy and graded exercise therapy. Antidepressants can be useful particularly in the case of comorbid affective disorders. Development of good therapeutic doctor-patient alliance with empathic care is central to the effective management of CFS. In this article we overview the nature and definition of CFS. The prevalence, the prognosis and the psychopathological issues are presented. The management of this controversial syndrome is discussed.