Joustra, Monica L, Janssens, Karin A M, Bültmann, Ute et al. · Journal of psychosomatic research · 2015 · DOI
This large study of nearly 90,000 people compared how much functional somatic syndromes (like ME/CFS and fibromyalgia) affect quality of life and work ability compared to well-defined medical diseases (like multiple sclerosis and rheumatoid arthritis). The researchers found that people with functional somatic syndromes experience similar severe limitations in daily functioning and work as those with traditional medical diseases, challenging the idea that these conditions are less serious.
This study provides population-level evidence that ME/CFS and other functional somatic syndromes cause functional impairment equivalent to recognized organic diseases, validating patient experiences and supporting the legitimacy of these conditions in medical and occupational contexts. For ME/CFS specifically, the comparison with MS demonstrates that disease burden is comparable despite different underlying mechanisms, strengthening arguments for research funding and clinical recognition.
This study does not prove that functional somatic syndromes have an organic pathological basis—it only documents that their functional impact is as severe as conditions with known pathology. The cross-sectional design cannot establish causation or determine whether reduced QoL and work participation are direct consequences of the syndrome itself or confounded by comorbid mental health factors. Self-reported diagnoses without standardized case definitions may include heterogeneous populations and diagnostic misclassification.
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
Joustra, Monica L, Janssens, Karin A M, Bültmann, Ute, & Rosmalen, Judith G M (2015). Functional limitations in functional somatic syndromes and well-defined medical diseases. Results from the general population cohort LifeLines.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2015.05.004
BibTeX
@article{mecfsatlas-joustra-2015-functional-limitations,
author = {Joustra, Monica L and Janssens, Karin A M and Bültmann, Ute and Rosmalen, Judith G M},
title = {Functional limitations in functional somatic syndromes and well-defined medical diseases. Results from the general population cohort LifeLines.},
journal = {Journal of psychosomatic research},
year = {2015},
doi = {10.1016/j.jpsychores.2015.05.004},
note = {PubMed: 26026696},
url = {https://www.mecfsatlas.com/evidence/joustra-2015-functional-limitations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/joustra-2015-functional-limitations
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