Petersen, Marie Weinreich, Carstensen, Tina Birgitte Wisbech, Frostholm, Lisbeth et al. · Clinical epidemiology · 2023 · DOI
This study of over 9,600 Danish people examined whether stress and confidence in one's abilities are connected to functional somatic disorders—conditions like chronic fatigue, widespread pain, and irritable bowel syndrome where symptoms are real but don't have a clear physical cause. The researchers found that people with these conditions tend to feel more stressed and have lower confidence in their abilities compared to healthy people, though their stress levels were not necessarily higher than people with serious physical diseases.
This large, randomly selected population study strengthens evidence that psychological factors like stress and self-efficacy are genuinely associated with functional somatic disorders including chronic fatigue. For ME/CFS patients, this highlights that stress and reduced confidence are recognized features of the condition—not character flaws—and supports the relevance of resilience-based approaches to understanding disease mechanisms.
This cross-sectional design cannot determine whether high stress and low self-efficacy cause functional somatic disorders, result from having the condition, or both. The association between self-efficacy and FSD was largely explained by the personality trait neuroticism, suggesting the relationship may be more complex than direct causation. The study does not establish what role these psychological factors play in disease onset, severity, or maintenance.
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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