Brenna, Elenka, Araja, Diana, Pheby, Derek F H · Medicina (Kaunas, Lithuania) · 2021 · DOI
Researchers surveyed people with ME/CFS in Italy, Latvia, and the UK to understand how the disease affects their lives and finances. They found that ME/CFS has a serious impact on income and quality of life across all three countries, and that graded exercise therapy (a treatment commonly used in the UK) did not work for patients. The study also revealed differences in how doctors diagnose and treat ME/CFS depending on which country people live in.
This study provides evidence that ME/CFS has consistent, serious impacts on patients' finances and well-being across different European healthcare systems, which supports the need for policy changes and better medical recognition. The finding that graded exercise therapy is ineffective challenges a treatment approach that has been widely recommended, potentially influencing clinical practice guidelines. Understanding these cross-national patterns helps identify what works and what doesn't in ME/CFS care.
This survey cannot establish cause-and-effect relationships or explain why graded exercise therapy failed—it only documents patient-reported experiences. The findings reflect patient perceptions and self-reported outcomes rather than objective clinical measurements. Differences between countries may reflect variations in how patients accessed care, their healthcare literacy, or reporting bias rather than true differences in disease presentation.
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
Brenna, Elenka, Araja, Diana, & Pheby, Derek F H (2021). Comparative Survey of People with ME/CFS in Italy, Latvia, and the UK: A Report on Behalf of the Socioeconomics Working Group of the European ME/CFS Research Network (EUROMENE).. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57030300
BibTeX
@article{mecfsatlas-brenna-2021-comparative-survey,
author = {Brenna, Elenka and Araja, Diana and Pheby, Derek F H},
title = {Comparative Survey of People with ME/CFS in Italy, Latvia, and the UK: A Report on Behalf of the Socioeconomics Working Group of the European ME/CFS Research Network (EUROMENE).},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57030300},
note = {PubMed: 33806902},
url = {https://www.mecfsatlas.com/evidence/brenna-2021-comparative-survey},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/brenna-2021-comparative-survey
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