Erschens, R, Zipfel, S, Schröpel, C et al. · Journal of psychosomatic research · 2026 · DOI
Researchers compared fatigue levels across seven different conditions—including post-COVID, chronic pain, cancer, multiple sclerosis, inflammatory bowel disease, kidney failure, and ME/CFS—using the same measurement tools in 538 patients. They observed that fatigue burden varied substantially between conditions, with post-COVID, chronic pain, and cancer showing similar high levels, while inflammatory bowel disease showed lower levels. However, the study included only 25 ME/CFS patients, analysed descriptively rather than statistically, so findings specific to ME/CFS remain preliminary and require confirmation in larger cohorts.
This study provides a rare direct comparison of fatigue severity across multiple conditions using harmonised measurement tools, which may help contextualise how ME/CFS-associated fatigue compares to other disabling conditions. By analogy, the observation that post-COVID fatigue resembles chronic pain and cancer fatigue in severity could inform understanding of fatigue mechanisms across post-infectious and chronic conditions. However, the small ME/CFS sample (n=25) and descriptive-only analysis mean these findings offer limited direct evidence specific to ME/CFS populations.
This study does not establish causal mechanisms underlying fatigue in any cohort; it describes associations between diagnostic group and fatigue burden at a single point in time. The small ME/CFS sample (n=25) does not generalise to the wider ME/CFS population and does not support conclusions about fatigue phenotypes or severity rankings within ME/CFS. Cross-sectional design cannot determine whether fatigue precedes, follows, or co-occurs with other symptoms, and the study does not compare ME/CFS fatigue features (e.g., post-exertional malaise) to other conditions.
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
Erschens, R, Zipfel, S, Schröpel, C, Adam, S H, Rometsch, C, Bentele, M, et al. (2026). Fatigue across physical and mental health conditions: results from a multicenter study at the German Center for Mental Health.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2026.113004
BibTeX
@article{mecfsatlas-erschens-2026-fatigue-across,
author = {Erschens, R and Zipfel, S and Schröpel, C and Adam, S H and Rometsch, C and Bentele, M and Heitmann, H and Binneböse, M and Zimmermann-Schlegel, V and Reichert, J and Ottlewski, I and Schappert, A and Berthele, A and Martus, P and Friederich, H-C and Junne, F and Rose, M and Tesarz, J and Stengel, A and Henningsen, P},
title = {Fatigue across physical and mental health conditions: results from a multicenter study at the German Center for Mental Health.},
journal = {Journal of psychosomatic research},
year = {2026},
doi = {10.1016/j.jpsychores.2026.113004},
note = {PubMed: 42854285},
url = {https://www.mecfsatlas.com/evidence/erschens-2026-fatigue-across},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-10-10. https://www.mecfsatlas.com/evidence/erschens-2026-fatigue-across
Contribute
Private, reviewed by a human. Not a public comment thread.