Juruena, Mario Francisco, Cleare, Anthony James · Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) · 2007 · DOI
This review article examines whether ME/CFS, atypical depression, and seasonal affective disorder share common biological roots. The researchers found that all three conditions may involve underactivity in the body's stress-response system (particularly a part of the brain called the hypothalamic-pituitary-adrenal axis), rather than overactivity as seen in other types of depression. This suggests these conditions might be more closely related than previously thought, which could help explain why patients sometimes experience overlapping symptoms.
This work is significant because it provides a biological framework for understanding why ME/CFS patients often present with depressive and seasonal mood symptoms, and vice versa. Recognizing these shared mechanisms could improve clinical recognition, reduce diagnostic delays, and support development of targeted treatments addressing the underlying HPA axis dysfunction rather than treating symptoms in isolation.
This review does not establish causation or prove that HPA axis hypofunction directly causes ME/CFS. It also does not demonstrate that all patients with these conditions have identical HPA axis abnormalities, and it cannot establish whether HPA changes are primary pathogenic mechanisms or secondary consequences of chronic illness. The article is a literature synthesis rather than new empirical data.
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
Juruena, Mario Francisco & Cleare, Anthony James (2007). [Overlap between atypical depression, seasonal affective disorder and chronic fatigue syndrome].. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). https://doi.org/10.1590/s1516-44462007000500005
BibTeX
@article{mecfsatlas-juruena-2007-overlap-between,
author = {Juruena, Mario Francisco and Cleare, Anthony James},
title = {[Overlap between atypical depression, seasonal affective disorder and chronic fatigue syndrome].},
journal = {Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)},
year = {2007},
doi = {10.1590/s1516-44462007000500005},
note = {PubMed: 17546343},
url = {https://www.mecfsatlas.com/evidence/juruena-2007-overlap-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/juruena-2007-overlap-between
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