Higgins, E S · Journal of the South Carolina Medical Association (1975) · 1992
This 1992 paper proposes that chronic fatigue syndrome (ME/CFS) may be a form of depression. The author suggests that the fatigue and other symptoms patients experience could be primarily psychiatric in nature rather than caused by physical illness.
This paper represents an important historical perspective on how ME/CFS was conceptualized in early clinical literature. Understanding past diagnostic frameworks—including now-discredited psychiatric-only models—helps patients and researchers recognize why ME/CFS was historically underestimated and misunderstood as a biomedical illness.
This study does not establish that ME/CFS is a depressive disorder. It presents only an opinion without empirical data, and it predates decades of immunological, virological, and neurobiological research demonstrating distinct biomarkers in ME/CFS separate from primary mood disorders. The argument does not account for patients with ME/CFS who develop depression secondary to chronic illness.
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
Higgins, E S (1992). Chronic fatigue syndrome: a depressive disorder.. Journal of the South Carolina Medical Association (1975). https://pubmed.ncbi.nlm.nih.gov/1548851/
BibTeX
@article{mecfsatlas-higgins-1992-chronic-fatigue,
author = {Higgins, E S},
title = {Chronic fatigue syndrome: a depressive disorder.},
journal = {Journal of the South Carolina Medical Association (1975)},
year = {1992},
note = {PubMed: 1548851},
url = {https://www.mecfsatlas.com/evidence/higgins-1992-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/higgins-1992-chronic-fatigue
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