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White, P.D., Goldsmith, K.A., Johnson, A.L., Potts, L., Walwyn, R., DeCesare, J.C., Sharpe, M., et al. (2011) Comparison of Adaptive Pacing Therapy, Cognitive Behaviour Therapy, Graded Exercise Therapy, and Specialist Medical Care for Chronic Fatigue Syndrome (PACE): A Randomised Trial. The Lancet, 377, 823-836.
http://dx.doi.org/10.1016/S0140-6736(11)60096-2
has been cited by the following article:
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TITLE:
Persistent Burnout Theory of Chronic Fatigue Syndrome
AUTHORS:
David Jameson
KEYWORDS:
CFS, Burnout, Fatigue, HPA Axis
JOURNAL NAME:
Neuroscience and Medicine,
Vol.7 No.2,
June
8,
2016
ABSTRACT: There is no agreement on the etiology of chronic fatigue syndrome (CFS), and the main theories (behavioural and viral/immune) do not satisfactorily explain the condition. A growing body of evidence suggests that CFS may be caused by a dysfunction of the stress system—and the hypothalamic-pituitary-adrenal (HPA) axis in particular—as a result of chronic stress. CFS shares many similarities to occupational burnout, including similar symptoms, physiological abnormalities and triggers. After a brief review of the science of stress, burnout, central fatigue and CFS, I propose a model of CFS based on a state of persistent burnout that remains after the initial stressors have been removed. This persistence may be due to a combination of a dysregulation of the HPA axis, and behavioural factors. A novel treatment approach based on self-efficacy and positive goals is proposed.