Jason, Leonard A, Holtzman, Carly S, Sunnquist, Madison et al. · Journal of health psychology · 2021 · DOI
This study created a new questionnaire called the DePaul Post-Exertional Malaise Questionnaire to measure post-exertional malaise (PEM)—the worsening of symptoms that happens after physical or mental activity in ME/CFS patients. Researchers worked with hundreds of patients to develop questions that accurately capture what PEM feels like. Early testing showed the questionnaire works well and connects meaningfully with how much physical activity patients can do.
Post-exertional malaise is a defining feature of ME/CFS mentioned in virtually all diagnostic criteria, yet researchers and clinicians previously lacked a standardized, comprehensive tool to measure it. This questionnaire fills that critical gap, enabling better assessment of PEM in clinical practice and research studies. Having a validated PEM measurement tool could improve diagnosis, track disease progression, and help evaluate potential treatments.
This study develops and preliminarily validates an assessment tool; it does not establish new biological mechanisms of PEM or prove what causes post-exertional malaise. The preliminary validation phase does not constitute full psychometric validation, which would require larger, independent samples. The study cannot determine whether the questionnaire is superior to existing informal assessment methods used in clinical practice.
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 →
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