Gol, J M, Rosmalen, J G M, Gans, R O B et al. · Medical hypotheses · 2020 · DOI
This study explores how the environment and way doctors interact with patients affects treatment success for long-lasting physical symptoms that cannot be explained by standard medical tests. The researchers suggest that factors like a clean office, friendly behavior, and clear communication from doctors may help patients feel more confident in their care and potentially improve outcomes.
For ME/CFS patients, this study highlights that how and where treatment is delivered may be as important as what treatment is given, potentially explaining why some patients respond to interventions while others do not. Understanding contextual factors could improve clinical practice and help researchers design better trials by controlling for environmental variables that influence treatment perception and effectiveness.
This is a theoretical review synthesizing existing literature, not an original empirical study, so it does not directly prove that optimizing contextual aspects improves outcomes. The authors acknowledge that causal relationships between specific contextual factors and treatment response remain unclear and require future in vivo research. This work cannot establish whether contextual improvements would be equally beneficial across all functional somatic symptom presentations.
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
Gol, J M, Rosmalen, J G M, Gans, R O B, & Voshaar, R C Oude (2020). The importance of contextual aspects in the care for patients with functional somatic symptoms.. Medical hypotheses. https://doi.org/10.1016/j.mehy.2020.109731
BibTeX
@article{mecfsatlas-gol-2020-importance-contextual,
author = {Gol, J M and Rosmalen, J G M and Gans, R O B and Voshaar, R C Oude},
title = {The importance of contextual aspects in the care for patients with functional somatic symptoms.},
journal = {Medical hypotheses},
year = {2020},
doi = {10.1016/j.mehy.2020.109731},
note = {PubMed: 32335457},
url = {https://www.mecfsatlas.com/evidence/gol-2020-importance-contextual},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/gol-2020-importance-contextual
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