Creed, Francis · PloS one · 2023 · DOI
This large study compared people with three functional conditions (IBS, fibromyalgia, and ME/CFS) to people with three medical illnesses (IBD, rheumatoid arthritis, and diabetes) to understand why depression and anxiety are more common in functional conditions. They found that psychiatric disorders were about twice as common in functional syndromes (17-27%) as in medical illnesses (10-12%), and this higher rate appeared to exist even before people developed these conditions.
This study provides important evidence that the high rates of depression and anxiety seen in ME/CFS are not unique to that condition and share common risk factors with other illnesses. Understanding that psychiatric comorbidity may reflect underlying vulnerability factors rather than being caused by the physical illness itself could change how clinicians approach and treat ME/CFS patients.
This study does not prove that psychiatric disorders cause ME/CFS or functional syndromes, nor does it establish the biological mechanisms linking these conditions. The findings are correlational and based on self-reported data, so they cannot definitively determine whether psychiatric symptoms preceded illness onset or whether shared underlying factors (genetic, neurobiological) explain both.
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
Creed, Francis (2023). Psychiatric disorders comorbid with general medical illnesses and functional somatic disorders: The Lifelines cohort study.. PloS one. https://doi.org/10.1371/journal.pone.0286410
BibTeX
@article{mecfsatlas-creed-2023-psychiatric-disorders,
author = {Creed, Francis},
title = {Psychiatric disorders comorbid with general medical illnesses and functional somatic disorders: The Lifelines cohort study.},
journal = {PloS one},
year = {2023},
doi = {10.1371/journal.pone.0286410},
note = {PubMed: 37253033},
url = {https://www.mecfsatlas.com/evidence/creed-2023-psychiatric-disorders},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/creed-2023-psychiatric-disorders
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