Chandan, Joht Singh, Keerthy, Deepiksana, Zemedikun, Dawit Tefra et al. · EClinicalMedicine · 2020 · DOI
This study looked at whether people who experienced childhood maltreatment are more likely to develop chronic pain and fatigue conditions like ME/CFS, fibromyalgia, and irritable bowel syndrome as adults. Researchers compared over 80,000 people with a history of childhood maltreatment to 161,000 similar people without this history and found that those with maltreatment exposure had a significantly higher risk of developing several of these conditions. The findings suggest that childhood trauma may be an important risk factor for developing these debilitating syndromes.
For ME/CFS patients and researchers, this study provides epidemiological evidence that childhood maltreatment is a significant risk factor for ME/CFS development and related central sensitivity syndromes, suggesting that trauma-informed assessment and care may be clinically important. The findings strengthen the biological plausibility of post-traumatic contributions to ME/CFS pathogenesis and highlight the need for prevention and early intervention strategies in trauma-exposed populations.
This observational study demonstrates association, not causation—it is possible that other unmeasured factors (genetic predisposition, infection exposure, other stressors) mediate or confound the relationship between childhood maltreatment and CSS. The study cannot establish the biological mechanisms linking maltreatment to disease or explain why some exposed individuals develop CSS while others do not. Additionally, the relatively short median follow-up (2.2 years) may miss delayed onset cases.
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
Chandan, Joht Singh, Keerthy, Deepiksana, Zemedikun, Dawit Tefra, Okoth, Kelvin, Gokhale, Krishna Margadhamane, Raza, Karim, et al. (2020). The association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes.. EClinicalMedicine. https://doi.org/10.1016/j.eclinm.2020.100392
BibTeX
@article{mecfsatlas-chandan-2020-association-between,
author = {Chandan, Joht Singh and Keerthy, Deepiksana and Zemedikun, Dawit Tefra and Okoth, Kelvin and Gokhale, Krishna Margadhamane and Raza, Karim and Bandyopadhyay, Siddhartha and Taylor, Julie and Nirantharakumar, Krishnarajah},
title = {The association between exposure to childhood maltreatment and the subsequent development of functional somatic and visceral pain syndromes.},
journal = {EClinicalMedicine},
year = {2020},
doi = {10.1016/j.eclinm.2020.100392},
note = {PubMed: 32637892},
url = {https://www.mecfsatlas.com/evidence/chandan-2020-association-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/chandan-2020-association-between
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