Gadalla, T · Chronic diseases in Canada · 2008
This study found that people with ME/CFS, fibromyalgia, and certain digestive disorders are especially likely to also have mood disorders like depression and anxiety. When people with chronic illnesses develop these mood problems, their disability worsens significantly and they have more difficulty with daily activities. The researchers suggest that doctors should routinely screen patients with chronic illnesses for mood disorders, since treating them may improve overall quality of life.
This study directly identifies ME/CFS as having among the highest rates of comorbid mood disorders in a large Canadian population sample, highlighting an important clinical concern for ME/CFS patients. Understanding the relationship between mood disorders and disability in ME/CFS can inform targeted screening and treatment strategies that may improve patient outcomes and quality of life.
This cross-sectional design establishes association but not causation—it cannot determine whether chronic illness causes mood disorders, mood disorders worsen chronic illness outcomes, or whether both are driven by a common underlying mechanism. The study does not prove that treating comorbid mood disorders will reduce disability in ME/CFS, nor does it examine whether mood disorder screening improves patient outcomes.
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
Gadalla, T (2008). Association of comorbid mood disorders and chronic illness with disability and quality of life in Ontario, Canada.. Chronic diseases in Canada. https://pubmed.ncbi.nlm.nih.gov/18625088/
BibTeX
@article{mecfsatlas-gadalla-2008-association-comorbid,
author = {Gadalla, T},
title = {Association of comorbid mood disorders and chronic illness with disability and quality of life in Ontario, Canada.},
journal = {Chronic diseases in Canada},
year = {2008},
note = {PubMed: 18625088},
url = {https://www.mecfsatlas.com/evidence/gadalla-2008-association-comorbid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/gadalla-2008-association-comorbid
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