Jacob, Louis, Haro, Josep Maria, Kostev, Karel · Psychological medicine · 2022 · DOI
Researchers in Germany studied nearly 20,000 adults to see which health conditions are linked to developing ME/CFS. They compared people newly diagnosed with ME/CFS to similar people without it, looking at health problems they had in the year before diagnosis. They found that cancer, sleep disorders, and depression were the conditions most strongly associated with ME/CFS.
This study is one of the first to systematically examine how common physical and psychiatric conditions relate to ME/CFS risk. Understanding these associations may help clinicians recognize patients at higher risk and could point toward shared biological mechanisms underlying ME/CFS development.
This study shows correlation, not causation—it does not prove that cancer, sleep disorders, or depression cause ME/CFS or vice versa. The temporal relationship (conditions documented one year before diagnosis) does not establish whether these conditions increase ME/CFS risk, result from early ME/CFS symptoms, or share a common underlying cause. Findings are based on diagnoses recorded in primary care and may not capture all relevant conditions.
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
Jacob, Louis, Haro, Josep Maria, & Kostev, Karel (2022). Associations of physical and psychiatric conditions with chronic fatigue syndrome in Germany: an exploratory case-control study.. Psychological medicine. https://doi.org/10.1017/S0033291720002470
BibTeX
@article{mecfsatlas-jacob-2022-associations-physical,
author = {Jacob, Louis and Haro, Josep Maria and Kostev, Karel},
title = {Associations of physical and psychiatric conditions with chronic fatigue syndrome in Germany: an exploratory case-control study.},
journal = {Psychological medicine},
year = {2022},
doi = {10.1017/S0033291720002470},
note = {PubMed: 32686638},
url = {https://www.mecfsatlas.com/evidence/jacob-2022-associations-physical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/jacob-2022-associations-physical
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