Bernhoff, Gabriella, Rasmussen-Barr, Eva, Bunketorp Käll, Lina · Journal of translational medicine · 2022 · DOI
This study compared 205 people diagnosed with ME/CFS to 57 people with similar symptoms who were not diagnosed with ME/CFS. The researchers found that those with an ME/CFS diagnosis reported greater difficulties with physical and mental effort, more pain, and worse overall health than the undiagnosed group. Interestingly, both groups reported similar levels of anxiety, depression, and weekly physical activity, suggesting that what makes ME/CFS distinct may be specifically how the body reacts to exertion rather than activity levels alone.
This study helps identify what distinguishes ME/CFS from other conditions with similar symptoms, which is critical for improving diagnosis and directing treatment efforts. Understanding that people with ME/CFS experience worse exertional capacity and quality of life despite similar activity and mood patterns as undiagnosed groups supports the biological reality of the condition and suggests energy management should be a focus of clinical care.
This study cannot establish causation or what causes ME/CFS, only that diagnosed and undiagnosed groups differ in certain ways. It does not identify biomarkers or objective tests for ME/CFS, nor does it explain why some people with similar symptoms receive an ME/CFS diagnosis while others do not. The cross-sectional design cannot determine whether differences existed before diagnosis or resulted from it.
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
Bernhoff, Gabriella, Rasmussen-Barr, Eva, & Bunketorp Käll, Lina (2022). A comparison of health-related factors between patients diagnosed with ME/CFS and patients with a related symptom picture but no ME/CFS diagnosis: a cross-sectional exploratory study.. Journal of translational medicine. https://doi.org/10.1186/s12967-022-03769-x
BibTeX
@article{mecfsatlas-bernhoff-2022-comparison-health,
author = {Bernhoff, Gabriella and Rasmussen-Barr, Eva and Bunketorp Käll, Lina},
title = {A comparison of health-related factors between patients diagnosed with ME/CFS and patients with a related symptom picture but no ME/CFS diagnosis: a cross-sectional exploratory study.},
journal = {Journal of translational medicine},
year = {2022},
doi = {10.1186/s12967-022-03769-x},
note = {PubMed: 36494693},
url = {https://www.mecfsatlas.com/evidence/bernhoff-2022-comparison-health},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/bernhoff-2022-comparison-health
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