Axe, E, Satz, P · Annals of epidemiology · 2000 · DOI
This study looked at whether people with ME/CFS have higher rates of depression and other psychiatric conditions. Researchers found that psychiatric disorders were common in people with fatiguing illnesses, but surprisingly, depression was not linked to having worse ME/CFS symptoms. The study suggests that when psychiatric conditions do occur alongside ME/CFS, they often start around the same time as the illness itself.
This study challenges the assumption that psychiatric conditions like depression are primary drivers of ME/CFS symptoms, potentially reducing stigma around the illness. Understanding the timing and relationship between psychiatric comorbidities and ME/CFS is crucial for developing appropriate treatment strategies and recognizing ME/CFS as a distinct medical condition rather than a psychiatric disorder.
This study does not prove that depression causes ME/CFS or that ME/CFS causes depression—it only shows they co-occur. The cross-sectional design means we cannot determine whether psychiatric disorders preceded the illness, developed simultaneously, or resulted from living with the illness. The study also does not establish the biological mechanisms linking psychiatric conditions and ME/CFS.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Axe, E & Satz, P (2000). Psychiatric correlates in chronic fatigue syndrome.. Annals of epidemiology. https://doi.org/10.1016/s1047-2797(00)00083-1
BibTeX
@article{mecfsatlas-axe-2000-psychiatric-correlates,
author = {Axe, E and Satz, P},
title = {Psychiatric correlates in chronic fatigue syndrome.},
journal = {Annals of epidemiology},
year = {2000},
doi = {10.1016/s1047-2797(00)00083-1},
note = {PubMed: 11018367},
url = {https://www.mecfsatlas.com/evidence/axe-2000-psychiatric-correlates},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/axe-2000-psychiatric-correlates
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