Goodwin, Laura, White, Peter D, Hotopf, Matthew et al. · Annals of epidemiology · 2011 · DOI
This study followed over 11,000 people born in 1958 in Britain to see whether emotional or mental health problems, and physical activity levels before they got sick, were connected to developing ME/CFS later in life. Researchers found that people who had psychological difficulties in their twenties and thirties were more likely to later develop ME/CFS, but childhood emotional problems or exercise habits didn't show this connection.
This study provides replicated evidence that premorbid psychological symptoms in adulthood—rather than childhood factors or lack of exercise—are associated with increased CFS/ME risk. Understanding these risk markers helps identify vulnerable populations and challenges the notion that excessive exercise before illness onset contributes to CFS/ME development.
This study does not establish that psychological problems cause ME/CFS; the association could reflect early illness symptoms being misattributed to psychological distress. It also cannot determine whether psychological factors trigger ME/CFS or whether emerging (undiagnosed) ME/CFS produces psychological symptoms that are detected before formal diagnosis.
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
Goodwin, Laura, White, Peter D, Hotopf, Matthew, Stansfeld, Stephen A, & Clark, Charlotte (2011). Psychopathology and physical activity as predictors of chronic fatigue syndrome in the 1958 british birth cohort: a replication study of the 1946 and 1970 birth cohorts.. Annals of epidemiology. https://doi.org/10.1016/j.annepidem.2010.12.003
BibTeX
@article{mecfsatlas-goodwin-2011-psychopathology-physical,
author = {Goodwin, Laura and White, Peter D and Hotopf, Matthew and Stansfeld, Stephen A and Clark, Charlotte},
title = {Psychopathology and physical activity as predictors of chronic fatigue syndrome in the 1958 british birth cohort: a replication study of the 1946 and 1970 birth cohorts.},
journal = {Annals of epidemiology},
year = {2011},
doi = {10.1016/j.annepidem.2010.12.003},
note = {PubMed: 21458727},
url = {https://www.mecfsatlas.com/evidence/goodwin-2011-psychopathology-physical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/goodwin-2011-psychopathology-physical
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