Elkins, L E, Pollina, D A, Scheffer, S R et al. · Applied neuropsychology · 1999 · DOI
This study looked at mood and thinking abilities in 30 people with post-Lyme syndrome (a condition that can develop after Lyme disease). Researchers found that these patients had lower levels of positive feelings (like happiness or hopefulness) compared to the general population, but their actual thinking and memory skills tested normally. The study suggests that reduced positive mood, rather than depression or other psychiatric conditions, may be the most important psychological marker of this illness.
This study is relevant to ME/CFS because it identifies a specific mood pattern (low positive affect without typical depression) that may characterize post-infectious conditions, offering a potential marker for clinical assessment. Understanding the relationship between mood states and cognitive complaints helps clinicians and patients better distinguish primary psychiatric symptoms from those related to organic illness.
This study does not prove that low positive affect causes cognitive symptoms or symptom severity—it only shows an association. The cross-sectional design prevents determination of causality or temporal relationships. The study also does not establish whether these findings apply to ME/CFS patients, as it examined a Lyme disease population, and results may not generalize beyond this specific post-infectious context.
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
Elkins, L E, Pollina, D A, Scheffer, S R, & Krupp, L B (1999). Psychological states and neuropsychological performances in chronic Lyme disease.. Applied neuropsychology. https://doi.org/10.1207/s15324826an0601_3
BibTeX
@article{mecfsatlas-elkins-1999-psychological-states,
author = {Elkins, L E and Pollina, D A and Scheffer, S R and Krupp, L B},
title = {Psychological states and neuropsychological performances in chronic Lyme disease.},
journal = {Applied neuropsychology},
year = {1999},
doi = {10.1207/s15324826an0601_3},
note = {PubMed: 10382567},
url = {https://www.mecfsatlas.com/evidence/elkins-1999-psychological-states},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/elkins-1999-psychological-states
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