Gadalla, Tahany M · Women & health · 2008 · DOI
This study looked at data from over 40,000 Canadian adults to understand how anxiety disorders affect people with chronic illnesses, particularly women. The researchers found that women with chronic physical illnesses—including ME/CFS, fibromyalgia, and digestive problems—are much more likely to also experience anxiety disorders. When anxiety and physical illness occur together, people report more disability in daily activities and higher rates of suicidal thoughts.
ME/CFS patients experience anxiety at notably high rates, and this study quantifies how comorbid anxiety substantially increases functional disability and suicide risk in women with chronic illnesses. Understanding these associations helps clinicians recognize that treating anxiety alongside the physical illness may be critical for improving outcomes and safety in ME/CFS populations.
This study cannot establish whether anxiety causes disability, disability causes anxiety, or whether both result from shared biological mechanisms. Cross-sectional design means temporal relationships cannot be determined. The study also does not examine whether screening and treating anxiety disorders actually reduces disability or suicide risk in this population.
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, Tahany M (2008). Disability associated with comorbid anxiety disorders in women with chronic physical illness in Ontario, Canada.. Women & health. https://doi.org/10.1080/03630240802131965
BibTeX
@article{mecfsatlas-gadalla-2008-disability-associated,
author = {Gadalla, Tahany M},
title = {Disability associated with comorbid anxiety disorders in women with chronic physical illness in Ontario, Canada.},
journal = {Women & health},
year = {2008},
doi = {10.1080/03630240802131965},
note = {PubMed: 18843837},
url = {https://www.mecfsatlas.com/evidence/gadalla-2008-disability-associated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/gadalla-2008-disability-associated
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