Castro-Marrero, Jesús, Faro, Mónica, Aliste, Luisa et al. · Psychosomatics · 2017 · DOI
This study looked at 1,757 people with ME/CFS in Spain to understand what other health conditions they commonly experience alongside their ME/CFS. Researchers found that more than 80% of patients had at least one additional condition, such as fibromyalgia, thyroid problems, vitamin D deficiency, or ligament issues. The study identified five different groups of ME/CFS patients based on their comorbidities, with some groups experiencing significantly worse fatigue and quality of life than others.
This large population-based study demonstrates that ME/CFS rarely occurs in isolation, with over 80% of patients experiencing comorbidities that significantly impact their health and functioning. Identifying distinct patient subgroups based on comorbidity patterns could inform personalized treatment approaches and help clinicians develop targeted, multidisciplinary management strategies. Understanding which comorbidities cluster together may reveal shared underlying biological mechanisms and guide future therapeutic interventions.
This study does not establish whether comorbidities cause ME/CFS, result from it, or arise from shared biological mechanisms—it only demonstrates that they occur together. The cross-sectional design prevents determination of temporal relationships or causality. Findings are specific to a Spanish population and may not generalize to other geographic or ethnic populations.
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
Castro-Marrero, Jesús, Faro, Mónica, Aliste, Luisa, Sáez-Francàs, Naia, Calvo, Natalia, Martínez-Martínez, Alba, et al. (2017). Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study.. Psychosomatics. https://doi.org/10.1016/j.psym.2017.04.010
BibTeX
@article{mecfsatlas-castro-marrero-2017-comorbidity-chronic,
author = {Castro-Marrero, Jesús and Faro, Mónica and Aliste, Luisa and Sáez-Francàs, Naia and Calvo, Natalia and Martínez-Martínez, Alba and de Sevilla, Tomás Fernández and Alegre, Jose},
title = {Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study.},
journal = {Psychosomatics},
year = {2017},
doi = {10.1016/j.psym.2017.04.010},
note = {PubMed: 28596045},
url = {https://www.mecfsatlas.com/evidence/castro-marrero-2017-comorbidity-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/castro-marrero-2017-comorbidity-chronic
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