Van Houdenhove, B., Eede, F.V.D. and Luyten, P. (2009) Does Hypothalamic-Pituitary-Adrenal Axis Hypofunction in Chronic Fatigue Syndrome Reflect a Crash in the Stress System? Medical Hypotheses, 72, 701-705.
http://dx.doi.org/10.1016/j.mehy.2008.11.044

has been cited by the following article:

• 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.