Clements, A, Sharpe, M, Simkin, S et al. · Journal of psychosomatic research · 1997 · DOI
This study interviewed 66 people with ME/CFS to understand what they believe causes their illness and how they think they can manage it. Most patients believed their illness was primarily physical, though over half also thought stress played a role. Patients felt they could control symptoms by reducing activity, but believed they could not influence the underlying disease itself.
Understanding how ME/CFS patients develop their illness beliefs is important for clinical communication and patient support. Healthcare providers may have more opportunity than previously recognized to help patients develop more comprehensive and adaptive understandings of their condition when they first present for care. This suggests potential for improved patient outcomes through early educational intervention.
This study does not prove that patients' illness beliefs are correct or incorrect, nor does it establish whether activity avoidance is an effective management strategy. The study is cross-sectional and cannot determine causality—it identifies correlations between beliefs and experiences but does not show what causes certain belief patterns. The reliance on patient recall means beliefs may have been shaped by the illness experience rather than vice versa.
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
Clements, A, Sharpe, M, Simkin, S, Borrill, J, & Hawton, K (1997). Chronic fatigue syndrome: a qualitative investigation of patients' beliefs about the illness.. Journal of psychosomatic research. https://doi.org/10.1016/s0022-3999(97)00087-1
BibTeX
@article{mecfsatlas-clements-1997-chronic-fatigue,
author = {Clements, A and Sharpe, M and Simkin, S and Borrill, J and Hawton, K},
title = {Chronic fatigue syndrome: a qualitative investigation of patients' beliefs about the illness.},
journal = {Journal of psychosomatic research},
year = {1997},
doi = {10.1016/s0022-3999(97)00087-1},
note = {PubMed: 9226609},
url = {https://www.mecfsatlas.com/evidence/clements-1997-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/clements-1997-chronic-fatigue
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