The role of stress in chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is an important public health problem with unique diagnostic and management challenges. Insight into the pathophysiology of CFS is elusive and treatment options are limited. With the advent of the biopsychosocial model in medicine, more recent research efforts have focused on interactions of biological and psychological factors in the development and maintenance of CFS. Stressful experiences have been identified as important risk factors of CFS, particularly when experienced early in life. In addition, psychobiological processes that may translate stress into CFS risk have been considered. In this chapter, we will summarize the current state of research on the role of stress in CFS. We propose that CFS reflects a disorder of adaptation of neural and regulatory physiological systems in response to challenge. Stress likely interacts with other vulnerability factors in determining CFS risk. Understanding the role of stress in CFS may lead towards novel strategies for prevention and treatment of this debilitating disorder.