Cleare, A J, Wessely, S C · British journal of hospital medicine · 1996
This paper explores whether ME/CFS might be connected to stress and how the body responds to stress. The authors examine the evidence around the relationship between stress responses and ME/CFS symptoms, considering whether stress-related factors play a role in the condition's development or persistence.
This work addresses a fundamental question about ME/CFS etiology by proposing a biologically plausible framework connecting stress physiology to chronic fatigue symptoms. Understanding potential stress-related mechanisms is important for developing targeted treatments and distinguishing ME/CFS from purely psychological conditions.
This review does not establish that stress causes ME/CFS, nor does it prove that all cases involve stress-related mechanisms. The paper cannot demonstrate causation from correlational evidence, and it does not address whether stress is a consequence rather than a cause of ME/CFS.
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 →
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Primary citation
Cleare, A J & Wessely, S C (1996). Chronic fatigue syndrome: a stress disorder?. British journal of hospital medicine. https://pubmed.ncbi.nlm.nih.gov/8735034/
BibTeX
@article{mecfsatlas-cleare-1996-chronic-fatigue,
author = {Cleare, A J and Wessely, S C},
title = {Chronic fatigue syndrome: a stress disorder?},
journal = {British journal of hospital medicine},
year = {1996},
note = {PubMed: 8735034},
url = {https://www.mecfsatlas.com/evidence/cleare-1996-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/cleare-1996-chronic-fatigue
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