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=== Risk factors ===
All ethnic groups and income levels are susceptible to the illness. The CDC states that CFS is "at least as common" in African Americans and [[Hispanic]]s as Caucasians.<ref name="CDCRisk"/> A 2009 meta-analysis, however, showed that compared with the White American majority, African Americans and Native Americans have a higher risk of CFS, though it acknowledged that studies and data were limited.<ref>{{cite journal | title = A systematic review of chronic fatigue, its syndromes and ethnicity: prevalence, severity, co-morbidity and coping | journal = International Journal of Epidemiology | volume = 38 | issue = 6 | pages = 1554–70 | year = 2009 | pmid = 19349479 | doi = 10.1093/ije/dyp147 | last1 = Dinos | first1 = S | last2 = Khoshaba | first2 = B | last3 = Ashby | first3 = D | last4 = White | first4 = PD | last5 = Nazroo |first5 = J |authorlink5= James Nazroo | last6 = Wessely | first6 = S | last7 = Bhui | first7 = KS}}</ref> More women than men get CFS — between 60 and 85% of cases are women; however, there is some indication that the prevalence among men is underreported. The illness is reported to occur more frequently in persons between the ages of 40 and 59.<ref name="PMID_15574853"/> CFS is less prevalent among children and adolescents than among adults.<ref name="CDCBasic">{{cite web |title = Chronic Fatigue Syndrome Basic Facts|publisher = Centers for Disease Control and Prevention|date = May 9, 2006|url = https://www.cdc.gov/cfs/general/index.html|accessdate = 2008-02-07}}</ref>
Blood relatives of those who have CFS appear to be more predisposed.<ref>{{cite journal | author = Walsh CM, Zainal NZ, Middleton SJ, Paykel ES | title = A family history study of chronic fatigue syndrome | journal = Psychiatr Genet | volume = 11 | issue = 3 | pages = 123–8 | year = 2001 | pmid = 11702053 | doi = 10.1097/00041444-200109000-00003 | last2 = Zainal | last3 = Middleton | last4 = Paykel }}</ref> There is no direct evidence that CFS is [[Contagious disease|contagious]].<ref name="CDCRisk"/>
Psychological stress, childhood trauma, perfectionist personalities, old age, lower middle education, low physical fitness, preexisting psychological illness, and allergies may be risk factors for developing chronic fatigue. This has led some to believe that stress-related visceral responses underlie CFS.<ref>{{cite journal|last1=Van Houdenhove|first1=Boudewijn|last2=Kempke|first2=Stefan|last3=Luyten|first3=Patrick|title=Psychiatric aspects of chronic fatigue syndrome and fibromyalgia|journal=Current Psychiatry Reports|date=1 June 2010|volume=12|issue=3|pages=208–214|doi=10.1007/s11920-010-0105-y|pmid=20425282}}</ref><ref name="ReferenceB">{{cite journal|last1=Hempel|first1=S.|last2=Chambers|first2=D.|last3=Bagnall|first3=A.-M.|last4=Forbes|first4=C.|title=Risk factors for chronic fatigue syndrome/myalgic encephalomyelitis: a systematic scoping review of multiple predictor studies|journal=Psychological Medicine|date=1 July 2008|volume=38|issue=7|pages=915–926|doi=10.1017/S0033291707001602|pmid=17892624}}</ref> Pre-existing depressive and anxiety disorders, as well as high expectation of parents and family history were predisposing factors identified in another review.<ref>{{cite journal|last1=Lievesley|first1=Kate|last2=Rimes|first2=Katharine A.|last3=Chalder|first3=Trudie|title=A review of the predisposing, precipitating and perpetuating factors in Chronic Fatigue Syndrome in children and adolescents|journal=Clinical Psychology Review|date=1 April 2014|volume=34|issue=3|pages=233–248|doi=10.1016/j.cpr.2014.02.002|issn=1873-7811|pmid=24632047}}</ref>
People with CFS and their relatives tend to attribute their illness to physical causes (such as a virus or pollution) rather than to psychological causes.<ref name="pmid:12562565"/><ref name=Cho2005>{{cite journal |vauthors=Cho HJ, Hotopf M, Wessely S | title = The placebo response in the treatment of chronic fatigue syndrome: A systematic review and meta-analysis| journal = Psychosom Med | volume = 67 | issue = 2 | pages = 301–13| publisher = | year = 2005 | pmid =15784798| url = http://www.psychosomaticmedicine.org/cgi/content/full/67/2/301 | accessdate = 2008-12-12 | doi = 10.1097/01.psy.0000156969.76986.e0}}</ref> Such attributions are associated with increased symptoms and impairment, and worse outcomes over time.<ref name="pmid:12562565"/>
== Pathophysiology ==
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