Cho, Hyong Jin, Menezes, Paulo Rossi, Bhugra, Dinesh et al. · Journal of psychosomatic research · 2008 · DOI
This study compared how well doctors and the general public in Brazil and the United Kingdom recognize ME/CFS. Researchers found that far fewer people in Brazil were familiar with the condition compared to the UK—only 16% of Brazilian patients had heard of it, compared to 55% in Britain. Even among Brazilian specialist doctors, less than a third could identify ME/CFS from a typical case description.
Recognition and awareness of ME/CFS directly affect whether patients seek appropriate medical care and whether healthcare providers can accurately diagnose the condition. This study highlights that ME/CFS awareness is not universal globally, which may contribute to delayed diagnosis and inadequate support for patients in low- and middle-income countries. Understanding these disparities is essential for developing targeted educational initiatives to improve patient outcomes worldwide.
This study demonstrates differences in awareness between countries but does not prove why these differences exist or establish that low awareness directly causes poorer patient outcomes. The cross-sectional design means causation cannot be inferred, and the study does not measure the actual diagnostic accuracy of doctors or the impact of awareness on treatment quality. Geographic and economic differences are associated but not necessarily causally linked to the awareness disparity.
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
Cho, Hyong Jin, Menezes, Paulo Rossi, Bhugra, Dinesh, & Wessely, Simon (2008). The awareness of chronic fatigue syndrome: a comparative study in Brazil and the United Kingdom.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2007.12.006
BibTeX
@article{mecfsatlas-cho-2008-awareness-chronic,
author = {Cho, Hyong Jin and Menezes, Paulo Rossi and Bhugra, Dinesh and Wessely, Simon},
title = {The awareness of chronic fatigue syndrome: a comparative study in Brazil and the United Kingdom.},
journal = {Journal of psychosomatic research},
year = {2008},
doi = {10.1016/j.jpsychores.2007.12.006},
note = {PubMed: 18374733},
url = {https://www.mecfsatlas.com/evidence/cho-2008-awareness-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/cho-2008-awareness-chronic
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