d'Incau, Emmanuel, Kaplan, Chelsea Marie, Micoulaud-Franchi, Jean-Arthur et al. · Journal of clinical medicine · 2026 · DOI
This evidence map examines chronic overlapping pain conditions—a group of ten disorders including fibromyalgia, migraine, irritable bowel syndrome, and ME/CFS that frequently occur together in the same patients. Researchers observed that when multiple conditions coexist, patients report greater pain, worse sleep, more fatigue, and lower quality of life, along with fragmented care across many specialists. The review proposes that integrated screening and coordinated care might help, though effectiveness of these approaches remains to be tested.
ME/CFS is formally recognized as one of ten chronic overlapping pain conditions by the NIH, placing it within a structured multimorbidity framework. By analogy, findings about symptom burden and fragmented care in overlapping conditions may apply to ME/CFS patients who experience comorbid pain, sleep, and gastrointestinal symptoms; the proposed integrated care approach could inform future ME/CFS management strategies. However, ME/CFS-specific research is needed to test whether mechanisms and care pathways derived from other COPCs directly translate to ME/CFS populations.
This evidence map does not establish causal relationships between overlapping conditions or prove that any specific integrated care intervention is effective—it identifies barriers and proposes strategies without testing them. It does not confirm shared mechanisms across COPCs or provide quantified treatment outcomes. Generalisability to ME/CFS specifically remains unclear; the study examines a diverse group of ten conditions, and mechanistic overlap between ME/CFS and other COPCs (e.g., fibromyalgia, IBS) has not been established.
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
d'Incau, Emmanuel, Kaplan, Chelsea Marie, Micoulaud-Franchi, Jean-Arthur, Veasley, Christin, & Ohrbach, Richard (2026). Multimorbidity in Chronic Overlapping Pain Conditions: From Burden to Integrated Care.. Journal of clinical medicine. https://doi.org/10.3390/jcm15124835
BibTeX
@article{mecfsatlas-dincau-2026-multimorbidity-chronic,
author = {d'Incau, Emmanuel and Kaplan, Chelsea Marie and Micoulaud-Franchi, Jean-Arthur and Veasley, Christin and Ohrbach, Richard},
title = {Multimorbidity in Chronic Overlapping Pain Conditions: From Burden to Integrated Care.},
journal = {Journal of clinical medicine},
year = {2026},
doi = {10.3390/jcm15124835},
note = {PubMed: 42356003},
url = {https://www.mecfsatlas.com/evidence/dincau-2026-multimorbidity-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-07-08. https://www.mecfsatlas.com/evidence/dincau-2026-multimorbidity-chronic
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