Psychological Medicine

Review Article

Cognitive functioning in chronic fatigue syndrome: a meta-analysis

S. J. Cockshella1 and J. L. Mathiasa1 c1

a1 School of Psychology, The University of Adelaide, South Australia, Australia


Background Cognitive problems are commonly reported in persons with chronic fatigue syndrome (CFS) and are one of the most disabling symptoms of this condition. A number of cognitive deficits have been identified, although the findings are inconsistent and hindered by methodological differences. The current study therefore conducted a meta-analysis of research examining cognitive functioning in persons with CFS in order to identify the pattern and magnitude of any deficits that are associated with this condition.

Method A comprehensive search of the PubMed and PsycINFO databases for studies that examined cognitive functioning in CFS between 1988 and 2008 identified 50 eligible studies. Weighted Cohen's d effect sizes, 95% confidence intervals and fail-safe Ns were calculated for each cognitive score.

Results Evidence of cognitive deficits in persons with CFS was found primarily in the domains of attention, memory and reaction time. Deficits were not apparent on tests of fine motor speed, vocabulary, reasoning and global functioning.

Conclusions Persons with CFS demonstrate moderate to large impairments in simple and complex information processing speed and in tasks requiring working memory over a sustained period of time.

(Received June 09 2009)

(Revised November 03 2009)

(Accepted November 07 2009)

(Online publication January 05 2010)


c1 Address for correspondence: Dr J. L. Mathias, School of Psychology, The University of Adelaide, Adelaide SA 5005, Australia (Email: