Endicott, N A · Psychosomatic medicine · 1998 · DOI
This study compared 46 ME/CFS patients with two groups of psychiatric patients without ME/CFS to see if there were differences in their past physical health histories. Researchers found that ME/CFS patients reported more lifetime infections (including repeated mono-like illnesses), irritable bowel syndrome, and allergies before developing ME/CFS than the comparison groups. This suggests that a pattern of poor overall physical health earlier in life may play a role in developing ME/CFS.
This study provides evidence that people who develop ME/CFS often have a history of recurring infections and chronic physical conditions before symptom onset, suggesting ME/CFS may develop in individuals with underlying susceptibility to illness. Understanding the premorbid health patterns of ME/CFS patients may help identify risk factors and inform prevention or early intervention strategies.
This study does not prove that past infections or poor health *cause* ME/CFS—it only shows they are more common in people who develop it. The cross-sectional, retrospective design cannot establish temporal relationships or rule out recall bias. Correlation between premorbid health and CFS development does not establish a causal mechanism.
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
Endicott, N A (1998). Chronic fatigue syndrome in psychiatric patients: lifetime and premorbid personal history of physical health.. Psychosomatic medicine. https://doi.org/10.1097/00006842-199811000-00017
BibTeX
@article{mecfsatlas-endicott-1998-chronic-fatigue,
author = {Endicott, N A},
title = {Chronic fatigue syndrome in psychiatric patients: lifetime and premorbid personal history of physical health.},
journal = {Psychosomatic medicine},
year = {1998},
doi = {10.1097/00006842-199811000-00017},
note = {PubMed: 9847035},
url = {https://www.mecfsatlas.com/evidence/endicott-1998-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/endicott-1998-chronic-fatigue
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