This can perhaps be partly attributed to the lack of knowledge among physicians about the nature of unexplainable chronic fatigue as well as to the limited number of current treatments.

Study participants diagnosed with chronic fatigue syndrome had to have experienced medically unexplainable fatigue that limited their daily activities for at least six months with four of the following symptoms: headache, muscle pain, joint pain, sore throat, tender lymph nodes, significant impairment of memory or concentration, unrefreshing sleep, and unusual postexertional malaise.

The study, published in , found that chronic fatigue syndrome victims scored higher in neuroticism, a measure of vulnerability to negative emotional states such as anxiety or depression, than both people without fatigue and people with medically unexplainable fatigue.

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A past study followed sets of twins for 25 years and found that high stress and emotional instability, which are both causes and results of maladaptive behavior patterns, increased the risk for developing chronic fatigue-like illness.

Interestingly, another study examined patients with multiple sclerosis, a fatiguing illness which, like chronic fatigue syndrome, has an unknown cause, and found that the multiple sclerosis patients had about as many personality disorders as the chronic fatigue syndrome patients.

The study also found that a disproportionately large number of chronic fatigue victims had personality disorders, or maladaptive behavior patterns.

Twenty-nine percent of people with unexplainable fatigue and 28 percent of people with chronic fatigue syndrome had at least one personality disorder.

On a psychological level, chronic fatigue may lead to greater emotional burden due to feelings such as worry, frustration, and aloneness that victims of chronic unexplainable fatigue often experience.

This emotional burden might, in turn, lead to higher neuroticism scores.

Maladaptive behavior patterns thus may be risk factors for both chronic fatigue and multiple sclerosis.