Neuropsychology of chronic fatigue syndrome in civilian population in war conditions

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This study examines the impact of chronic fatigue on cognitive, neurocognitive, and mental functioning in civilians living in Ukraine under the prolonged stress of the current war. The study involved 487 people aged 27 to 38 years, 63 % women and 37 % men. The Fatigue Assessment Scale was used to measure fatigue, while cognitive activity, passive neurocognitive activity, and mental abilities were evaluated using three validated scales that allow for the analysis of critical aspects of mental functioning. In our study, correlation analysis revealed important gender differences. In women, the strongest relationship was observed between fatigue and mental capacity. Women with higher levels of fatigue also demonstrated a decrease in cognitive abilities. A weaker but still significant correlation was found between fatigue and passive neurocognitive activity, suggesting that passive cognitive processes, such as introspection, are somewhat less affected by fatigue. Men showed a similar pattern, but with slightly different emphases. The correlation between fatigue and cognitive performance was moderate, indicating that men’s cognitive function declines with increasing fatigue, but not as much as women’s. The relationship between fatigue and passive neurocognitive activity was stronger in men than in women. These findings are consistent with previous research on the differential impact of fatigue and stress on cognitive and mental functions, especially in conflict-affected people. Theories of the neuropsychological response to prolonged trauma suggest that the default mode network, which is responsible for passive cognitive processes, is highly sensitive to stress and fatigue, especially in men, while women tend to experience more significant impairments in the frontoparietal network, which supports executive functioning and emotional regulation. These findings emphasize the need for gender-sensitive therapeutic interventions. Our findings suggest that fatigue interventions should be tailored to the unique needs of men and women, with a focus on improving mental resilience and cognitive function. For women, interventions aimed at emotional regulation and stress management may be appropriate, while men may need help maintaining passive cognitive functioning and reflective thinking. Future research should examine the neurobiological mechanisms underlying these gender differences in order to develop more effective therapeutic strategies for populations experiencing chronic fatigue under high stress conditions.