Warren, John W, Langenberg, Patricia, Clauw, Daniel J · Journal of psychosomatic research · 2013 · DOI
This study found that people who have multiple overlapping illnesses like fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and others are more likely to develop additional new conditions over time. The more conditions someone already had, the higher their risk of developing a new one. This suggests these conditions may share common underlying causes rather than being completely separate diseases.
For ME/CFS patients, this research demonstrates that having CFS alongside other conditions like fibromyalgia or IBS is not coincidental but reflects underlying biological connections between these syndromes. Understanding this polysyndromic relationship may help guide future research toward identifying shared disease mechanisms that could lead to more effective treatments addressing multiple conditions simultaneously.
This study does not establish causation—having one FSS does not necessarily cause another. The cross-sectional and case-control design cannot definitively identify whether a shared biological mechanism drives all FSSs or whether having one condition increases detection/reporting of others. The study also cannot identify what that common mechanism might be.
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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