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Biol Psychiatry. 1998 Feb 1;43(3):236-7.

Basal activity of the hypothalamic-pituitary-adrenal axis in patients with the chronic fatigue syndrome (neurasthenia).

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  • 1University Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom.



Impairments in both basal activity and activation of the hypothalamic-pituitary-adrenal axis (HPA) have been reported in chronic fatigue syndrome (CFS; neurasthenia). We sought to replicate these findings and examined basal activity of the HPA in a carefully selected sample of patients with CFS.


Basal activity of the HPA was assessed using salivary and urinary cortisol collection over a 24-hour period in 22 (12 male; 10 female) patients meeting criteria for CFS and appropriate controls.


Salivary and urinary cortisol measures did not differ between CFS patients and controls.


Basal activity of the HPA was not reduced in CFS patients. Reasons for the failure to replicate previous findings are discussed.

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