Chandan, Joht Singh, Keerthy, Deepiksana, Gokhale, Krishna Margadhamane et al. · European journal of pain (London, England) · 2021 · DOI
This study looked at whether women who experienced domestic abuse were more likely to develop conditions involving chronic pain and nervous system sensitivity, such as fibromyalgia and ME/CFS. Researchers compared health records of over 22,000 women who had experienced abuse with nearly 45,000 women who had not. They found that abuse survivors had significantly higher rates of several pain-related conditions, suggesting that trauma may trigger or worsen these syndromes.
This study strengthens the evidence linking trauma exposure to central sensitivity syndromes, which includes ME/CFS. Understanding the relationship between domestic abuse and CSS development may help clinicians identify at-risk patients, inform trauma-informed care approaches, and highlight the need for preventive interventions—findings directly relevant to ME/CFS populations who often report traumatic histories.
This observational study cannot prove that domestic abuse *causes* CSS development, only that abuse and CSS are associated in the medical records. The study does not establish the mechanisms by which abuse might trigger these conditions, nor does it account for unmeasured confounders or reverse causation. Additionally, reliance on coded diagnoses in primary care means many cases of CSS may have gone undiagnosed or unrecorded.
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, Gokhale, Krishna Margadhamane, Bradbury-Jones, Caroline, Raza, Karim, Bandyopadhyay, Siddhartha, et al. (2021). The association between exposure to domestic abuse in women and the development of syndromes indicating central nervous system sensitization: A retrospective cohort study using UK primary care records.. European journal of pain (London, England). https://doi.org/10.1002/ejp.1750
BibTeX
@article{mecfsatlas-chandan-2021-association-between,
author = {Chandan, Joht Singh and Keerthy, Deepiksana and Gokhale, Krishna Margadhamane and Bradbury-Jones, Caroline and Raza, Karim and Bandyopadhyay, Siddhartha and Taylor, Julie and Nirantharakumar, Krishnarajah},
title = {The association between exposure to domestic abuse in women and the development of syndromes indicating central nervous system sensitization: A retrospective cohort study using UK primary care records.},
journal = {European journal of pain (London, England)},
year = {2021},
doi = {10.1002/ejp.1750},
note = {PubMed: 33559289},
url = {https://www.mecfsatlas.com/evidence/chandan-2021-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-2021-association-between
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