Krupp, L B, Mendelson, W B, Friedman, R · The Journal of clinical psychiatry · 1991
This review examined research on ME/CFS to understand whether the illness is caused by psychological factors, immune system problems, or both. Researchers found that ME/CFS patients experience more disabling fatigue than people with other chronic illnesses, and some have immune system abnormalities. However, many ME/CFS patients have no psychiatric illness, suggesting ME/CFS is a real medical condition separate from depression.
This early comprehensive review challenged the notion that ME/CFS is primarily a psychological disorder by demonstrating that many patients lack identifiable psychiatric illness while still manifesting severe, disabling fatigue and immune abnormalities. For patients, this provided important validation that ME/CFS is not simply depression or a psychosomatic condition.
This review does not establish the causal mechanisms underlying immune dysfunction in ME/CFS or prove that psychological factors play no role in some patients. The heterogeneity identified means these findings may not apply equally to all CFS patients, and the review cannot distinguish correlation from causation in the relationship between depression and ME/CFS onset.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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