Collin, Simon M, Nikolaus, Stephanie, Heron, Jon et al. · Journal of psychosomatic research · 2016 · DOI
This study looked at how ME/CFS symptoms vary from person to person by analyzing data from over 8,000 patients in the UK and Netherlands. Researchers found that ME/CFS patients fall into about 6 different groups based on which symptoms they experience—some have many symptoms, some mainly have pain, and others have very few symptoms beyond the core three (fatigue, brain fog, and sleep problems). Women and people who have been ill longer tended to have more symptoms overall.
This study provides robust evidence that ME/CFS is not a single condition but a heterogeneous illness with distinct presentations. Identifying these phenotypes could help clinicians better stratify patients, predict disease severity, and eventually develop targeted treatments rather than one-size-fits-all approaches.
This study describes symptom patterns at a single time point but does not prove these phenotypes are stable over time or predict which patients will improve with specific treatments. It also does not establish whether phenotypes reflect different underlying biological mechanisms or are simply variations of the same disease process.
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
Collin, Simon M, Nikolaus, Stephanie, Heron, Jon, Knoop, Hans, White, Peter D, & Crawley, Esther (2016). Chronic fatigue syndrome (CFS) symptom-based phenotypes in two clinical cohorts of adult patients in the UK and The Netherlands.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2015.12.006
BibTeX
@article{mecfsatlas-collin-2016-chronic-fatigue,
author = {Collin, Simon M and Nikolaus, Stephanie and Heron, Jon and Knoop, Hans and White, Peter D and Crawley, Esther},
title = {Chronic fatigue syndrome (CFS) symptom-based phenotypes in two clinical cohorts of adult patients in the UK and The Netherlands.},
journal = {Journal of psychosomatic research},
year = {2016},
doi = {10.1016/j.jpsychores.2015.12.006},
note = {PubMed: 26800634},
url = {https://www.mecfsatlas.com/evidence/collin-2016-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/collin-2016-chronic-fatigue
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