Hickie, I, Lloyd, A, Wakefield, D et al. · The British journal of psychiatry : the journal of mental science · 1990 · DOI
This study looked at whether people with ME/CFS have higher rates of depression and other mental health conditions than the general population. Researchers found that while some patients developed depression after getting ME/CFS, their rates of pre-existing mental illness were similar to everyone else. The study suggests that depression in ME/CFS patients is likely a response to having the illness, not a cause of it.
This study challenges the notion that ME/CFS is primarily a psychiatric condition by showing that patients' pre-illness mental health rates are normal. It provides important evidence that depression occurring in ME/CFS patients is a consequence of living with a serious medical illness rather than an underlying psychiatric vulnerability, which has implications for how the condition is understood and treated.
This study does not establish causation—it only shows that psychiatric symptoms appear after CFS onset in some patients. It cannot determine whether depression is a direct biological consequence of CFS, a psychological response to disability, or both. The small sample size and 1990 date also mean findings may not apply to all CFS populations or reflect current diagnostic criteria.
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
Hickie, I, Lloyd, A, Wakefield, D, & Parker, G (1990). The psychiatric status of patients with the chronic fatigue syndrome.. The British journal of psychiatry : the journal of mental science. https://doi.org/10.1192/bjp.156.4.534
BibTeX
@article{mecfsatlas-hickie-1990-psychiatric-status,
author = {Hickie, I and Lloyd, A and Wakefield, D and Parker, G},
title = {The psychiatric status of patients with the chronic fatigue syndrome.},
journal = {The British journal of psychiatry : the journal of mental science},
year = {1990},
doi = {10.1192/bjp.156.4.534},
note = {PubMed: 2386862},
url = {https://www.mecfsatlas.com/evidence/hickie-1990-psychiatric-status},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/hickie-1990-psychiatric-status
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