Psychiatric Assessment and Treatment for Chronic Fatigue Syndrome in Japan

  • Masao Iwase
  • Shoji Okajima
  • Rei Takahashi
  • Tamiko Mogami
  • Nahoko Kusaka
  • Hirohiko Kuratsune
  • Masatoshi Takeda
  • Akira Shimizu


Chronic fatigue syndrome (CFS) is an intractable pathological state characterized by chronic fatigue for 6 months or more with unknown cause. For its diagnosis, it is necessary to exclude any physical or psychiatric conditions which could cause chronic fatigue. Psychiatric co-morbidity is commonly observed in cases diagnosed as CFS, and we propose a classification of the therapeutic role of physicians and psychiatrists according to the psychiatric classification of the chronic fatigue episode. Recently, a series of studies proved the effectiveness of cognitive behavioral therapy (CBT) for CFS. In CBT for CFS, it is considered to be important not to seek physical causes, to accept the pathological state as it is, to monitor and record the patient’s daily activity and recognize the cognitive and behavioral patterns which might prolong fatigue, to maintain a constant activity level, and to make planned increases in daily activity. In CFS, our data showed that the rate of complete recovery was about 20% at the 2-year follow-up, and 40% at the 5-year follow-up, and that the prognosis of patients with psychiatric co-morbidity from the onset of a fatigue episode was far poorer than that of patients with no psychiatric co-morbidity or with psychiatric co-morbidity subsequent to a fatigue episode. We conclude that the psychiatric classification of the course of chronic fatigue is important for planning a therapeutic strategy and predicting the outcome of this state.


Chronic Fatigue Syndrome Personality Disorder Major Depressive Disorder Panic Disorder Cognitive Behaviour Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer 2008

Authors and Affiliations

  • Masao Iwase
    • 1
  • Shoji Okajima
    • 1
  • Rei Takahashi
    • 1
  • Tamiko Mogami
    • 2
  • Nahoko Kusaka
    • 3
  • Hirohiko Kuratsune
    • 2
  • Masatoshi Takeda
    • 1
  • Akira Shimizu
    • 2
  1. 1.Psychiatry and Behavioral ScienceOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Kansai University of Welfare SciencesOsakaJapan
  3. 3.Doshisha Women’s College of Liberal ArtsKodo, Kyotanabe, KyotoJapan

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