Kruesi, M J, Dale, J, Straus, S E · The Journal of clinical psychiatry · 1989
This study looked at 28 patients with ME/CFS to see how often they had been diagnosed with psychiatric conditions like depression. The researchers found that psychiatric diagnoses were common in this group. Importantly, when they reviewed medical records, they discovered that most of these psychiatric conditions had started before the ME/CFS illness began, not after.
This study addresses a critical misconception about ME/CFS by providing evidence that psychiatric conditions in these patients are often pre-existing rather than caused by the illness itself. Understanding this temporal relationship challenges the notion that ME/CFS is primarily psychiatric in origin and helps validate the experience of patients who have been told their condition is 'all in their head.'
This study does not prove that psychiatric conditions cause ME/CFS, nor does it establish that the higher rates of psychiatric diagnoses are unrelated to ME/CFS. The cross-sectional design and reliance on retrospective medical history cannot definitively establish causation. It also does not address whether ME/CFS triggers or exacerbates pre-existing psychiatric vulnerabilities.
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
Kruesi, M J, Dale, J, & Straus, S E (1989). Psychiatric diagnoses in patients who have chronic fatigue syndrome.. The Journal of clinical psychiatry. https://pubmed.ncbi.nlm.nih.gov/2536690/
BibTeX
@article{mecfsatlas-kruesi-1989-psychiatric-diagnoses,
author = {Kruesi, M J and Dale, J and Straus, S E},
title = {Psychiatric diagnoses in patients who have chronic fatigue syndrome.},
journal = {The Journal of clinical psychiatry},
year = {1989},
note = {PubMed: 2536690},
url = {https://www.mecfsatlas.com/evidence/kruesi-1989-psychiatric-diagnoses},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/kruesi-1989-psychiatric-diagnoses
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