Krieger, John N, Stephens, Alisa J, Landis, J Richard et al. · The Journal of urology · 2015 · DOI
This study looked at people with chronic pelvic pain conditions and found that many of them also had other chronic illnesses like fibromyalgia, irritable bowel syndrome, or chronic fatigue syndrome. People who had both pelvic pain and these other conditions reported more severe symptoms and higher rates of depression and anxiety. The researchers found this pattern was more common in women than in men.
For ME/CFS patients and researchers, this study is important because chronic fatigue syndrome is one of the identified nonurological syndromes clustering with urological pelvic pain, suggesting shared biological mechanisms across conditions. The finding that comorbid somatic syndromes predict worse symptom severity and higher psychiatric comorbidity has implications for understanding ME/CFS presentation and the need for comprehensive, multisystem approaches to evaluation and treatment. The sex differences observed (higher NASS prevalence in women) may inform understanding of similar patterns seen in ME/CFS epidemiology.
This study does not establish causation or mechanistic links between these conditions—only that they commonly co-occur. The cross-sectional design means we cannot determine whether having one syndrome increases risk for developing another, whether they share common etiology, or whether symptom severity in one directly causes severity in another. Self-reported diagnoses were not always confirmed by objective criteria, so the actual prevalence of conditions like CFS may be misclassified.
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
Krieger, John N, Stephens, Alisa J, Landis, J Richard, Clemens, J Quentin, Kreder, Karl, Lai, H Henry, et al. (2015). Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: baseline evaluation of the MAPP study.. The Journal of urology. https://doi.org/10.1016/j.juro.2014.10.086
BibTeX
@article{mecfsatlas-krieger-2015-relationship-between,
author = {Krieger, John N and Stephens, Alisa J and Landis, J Richard and Clemens, J Quentin and Kreder, Karl and Lai, H Henry and Afari, Niloofar and Rodríguez, Larissa and Schaeffer, Anthony and Mackey, Sean and Andriole, Gerald L and Williams, David A and MAPP Research Network},
title = {Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: baseline evaluation of the MAPP study.},
journal = {The Journal of urology},
year = {2015},
doi = {10.1016/j.juro.2014.10.086},
note = {PubMed: 25444992},
url = {https://www.mecfsatlas.com/evidence/krieger-2015-relationship-between},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/krieger-2015-relationship-between
Contribute
Private, reviewed by a human. Not a public comment thread.