Ghahramani, M, Gooriah, V · The Bulletin of the American Academy of Psychiatry and the Law · 1995
This case study describes a young man who developed severe fatigue and depression following infectious mononucleosis, and later experienced a serious mental health crisis involving psychosis and grandiose delusions. The case highlights how severe infections can sometimes lead to complex psychiatric symptoms that took considerable time to properly diagnose and treat with antipsychotic medications.
This case illustrates that post-infectious conditions like those following mononucleosis can rarely present with severe psychiatric complications, and underscores the importance of comprehensive psychiatric evaluation in patients with post-viral fatigue. Understanding the full spectrum of potential complications helps clinicians provide appropriate care and support for ME/CFS patients experiencing mental health symptoms.
This single case report does not establish that psychosis is a typical or common feature of ME/CFS, nor does it prove that infection directly causes psychotic symptoms in most patients. The case involves extreme behavioral outcomes and cannot be generalized to the broader ME/CFS population. Causality between mononucleosis and psychosis remains unclear and may involve individual vulnerability factors.
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
Ghahramani, M & Gooriah, V (1995). Chronic fatigue syndrome associated with a psychotic state resulting in multiple murders.. The Bulletin of the American Academy of Psychiatry and the Law. https://pubmed.ncbi.nlm.nih.gov/8639989/
BibTeX
@article{mecfsatlas-ghahramani-1995-chronic-fatigue,
author = {Ghahramani, M and Gooriah, V},
title = {Chronic fatigue syndrome associated with a psychotic state resulting in multiple murders.},
journal = {The Bulletin of the American Academy of Psychiatry and the Law},
year = {1995},
note = {PubMed: 8639989},
url = {https://www.mecfsatlas.com/evidence/ghahramani-1995-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/ghahramani-1995-chronic-fatigue
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