Depressive and anxiety symptoms in current, previous, and no history of ME/CFS: NHIS 2022 analysis.
Sirotiak, Zoe, Adamowicz, Jenna L, Thomas, Emily B K · Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025 · DOI
Quick Summary
This study looked at anxiety and depression in people with ME/CFS using data from a large U.S. health survey. Researchers found that people currently living with ME/CFS reported much higher rates of anxiety and depression compared to people without ME/CFS. Interestingly, people who previously had ME/CFS but have since recovered still reported higher anxiety and depression rates than those who never had the illness, though the rates were lower than for those with current ME/CFS.
Why It Matters
This research highlights that psychological symptoms are a persistent feature of ME/CFS that warrant clinical attention and support. Understanding that anxiety and depression remain elevated even after recovery suggests these symptoms should be monitored and treated as part of comprehensive ME/CFS care.
Observed Findings
Current ME/CFS: 37.6% with clinically significant anxiety and 49.0% with clinically significant depression
Previous ME/CFS: 26.5% with clinically significant anxiety and 33.4% with clinically significant depression
No ME/CFS history: 6.1% with clinically significant anxiety and 6.7% with clinically significant depression
Both current and previous ME/CFS groups showed substantially higher psychological symptom burden than the no-history group
Average participant age was 48.1 years; 51.3% female; 76.6% white; 82.8% not Hispanic or Latine
Inferred Conclusions
Psychological symptoms are a significant burden in ME/CFS that persist even after recovery from the illness
ME/CFS status (current or previous) is independently associated with anxiety and depressive symptom severity after controlling for sociodemographic and health behavior factors
Psychological symptoms should be considered an important clinical feature of ME/CFS regardless of disease duration or recovery status
Remaining Questions
What mechanisms explain why anxiety and depression remain elevated in people who have recovered from ME/CFS?
How do psychological symptoms change over time during the course of ME/CFS illness, and what predicts recovery of both physical and psychological symptoms?
What This Study Does Not Prove
This study cannot determine whether depression and anxiety cause ME/CFS, result from ME/CFS, or both—it only shows they are associated. The cross-sectional design means we cannot know the temporal sequence of symptom development. Additionally, the study cannot explain why psychological symptoms persist in some people after ME/CFS recovery.
Are psychological interventions effective at improving anxiety and depression in ME/CFS patients, and does treating these symptoms improve other ME/CFS outcomes?
Do specific subgroups of ME/CFS patients (based on symptom severity, onset type, or demographics) experience different patterns of psychological symptom burden?