Knudsen, Ann Kristin, Henderson, Max, Harvey, Samuel B et al. · The British journal of psychiatry : the journal of mental science · 2011 · DOI
This study looked at ME/CFS patients who were on long-term sick leave from work and compared them to those still working. Patients taking sick leave had more severe physical fatigue and sleep problems than other patients. Interestingly, those on sick leave also tended to avoid situations they found embarrassing and rested more often as a coping strategy. The researchers suggest that helping patients manage embarrassment-related thoughts and avoidance behaviors might help them return to work.
Work disability is a major consequence of ME/CFS, yet factors determining who returns to work versus remains on sick leave are poorly understood. This study identifies specific psychological patterns and behavioral responses associated with long-term work absence, suggesting that psychological interventions might complement medical treatment to improve employment outcomes.
This study cannot establish whether avoidance behaviors and embarrassment cognitions cause prolonged sick leave or result from it. The cross-sectional design prevents determining the direction of causality. Additionally, the findings do not prove that addressing these psychological factors will actually help patients return to work—only that associations exist.
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
Knudsen, Ann Kristin, Henderson, Max, Harvey, Samuel B, & Chalder, Trudie (2011). Long-term sickness absence among patients with chronic fatigue syndrome.. The British journal of psychiatry : the journal of mental science. https://doi.org/10.1192/bjp.bp.110.082974
BibTeX
@article{mecfsatlas-knudsen-2011-long-term,
author = {Knudsen, Ann Kristin and Henderson, Max and Harvey, Samuel B and Chalder, Trudie},
title = {Long-term sickness absence among patients with chronic fatigue syndrome.},
journal = {The British journal of psychiatry : the journal of mental science},
year = {2011},
doi = {10.1192/bjp.bp.110.082974},
note = {PubMed: 21903665},
url = {https://www.mecfsatlas.com/evidence/knudsen-2011-long-term},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/knudsen-2011-long-term
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