Personality features and personality disorders in chronic fatigue syndrome: a population-based study
Open accessAbstract
BACKGROUND: Chronic fatigue syndrome (CFS) presents unique diagnostic and management challenges. Personality may be a risk factor for CFS and may contribute to the maintenance of the illness. METHODS: 501 study participants were identified from the general population of Georgia: 113 people with CFS, 264 with unexplained unwellness but not CFS (insufficient fatigue, ISF) and 124 well controls. We used the Personality Diagnostic Questionnaire, 4th edition, to evaluate DSM-IV personality disorders. We used the NEO Five-Factor Inventory to assess personality features (neuroticism, extraversion, openness, agreeableness and conscientiousness). The Multidimensional Fatigue Inventory measured 5 dimensions of fatigue, and the Medical Outcomes Survey Short Form 36 measured 8 dimensions of functional impairment. RESULTS: Twenty-nine percent of the CFS cases had at least 1 personality disorder, compared to 28% of the ISF cases and 7% of the well controls. The prevalence of paranoid, schizoid, avoidant, obsessive-compulsive and depressive personality disorders were significantly higher in CFS and ISF compared to the well controls. The CFS cases had significantly higher scores on neuroticism, and significantly lower scores on extraversion than those with ISF or the well controls. Personality features were correlated with selected composite characteristics of fatigue. CONCLUSIONS: Our results suggest that CFS is associated with an increased prevalence of maladaptive personality features and personality disorders. This might be associated with being noncompliant with treatment suggestions, displaying unhealthy behavioral strategies and lacking a stable social environment. Since maladaptive personality is not specific to CFS, it might be associated with illness per se rather than with a specific condition.
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Neuroticism is presumed to be one of the predisposing factors of CFS in biopsychosocial accounts.
“neuroticism is presumed to be one of the predisposing factors of CFS in [4-5,34] in biopsychosocial accounts.”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [34]
The Discussion proposes that neuroticism might mediate the relationship between stress and CFS symptoms, supporting a possible predisposing role. It also says whether personality predisposes to CFS or results from it awaits empirical evaluation. Our copy does not identify this proposal as part of a biopsychosocial account; page numbers are unavailable. (LLM, conf=0.82)
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- Authors
- Nater, U. M., Jones, J. F., Lin, J.-M. S., Maloney, E., Reeves, W. C., & Heim, C.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Emory University (US)
- Corresponding author
- Reeves, William C.
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2010
- Volume
- 79
- Issue
- 5
- Pages
- 312-318
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- PMC
- PMC2939994
- OpenAlex
- W2024817081
- Cited by
- 57
- References
- 29
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2019: 1 · 2017: 1 · 2016: 6 · 2015: 5 · 2014: 4 · 2013: 7 · 2012: 14
- FWCI
- 6.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- U.S. Department of Energy
- Centers for Disease Control and Prevention
- Oak Ridge Institute for Science and Education
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- chronic fatigue syndrome, personality disorders, personality traits, neuroticism, extraversion, paranoid personality disorder, schizoid personality disorder, avoidant personality disorder, obsessive-compulsive personality disorder, depressive personality disorder, fatigue behavior, functional disability, treatment non-adherence
- MeSH terms
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Personality, Personality Assessment, Personality Disorders, Psychiatric Status Rating Scales, Fatigue Syndrome, Chronic, Statistics, Nonparametric, Young Adult
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