Lam, Marco Ho-Bun, Wing, Yun-Kwok, Yu, Mandy Wai-Man et al. · Archives of internal medicine · 2009 · DOI
This study followed SARS survivors for over 3 years and found that many experienced long-lasting mental health problems and severe tiredness. About 40% had psychiatric illnesses, 40% reported chronic fatigue, and 27% met criteria for chronic fatigue syndrome. Healthcare workers, unemployed survivors, and those who felt socially stigmatized were at higher risk for these problems.
This study demonstrates that post-viral fatigue syndrome and psychiatric comorbidities can persist for years after acute viral infection, with social and occupational factors significantly influencing outcomes. These findings are directly relevant to ME/CFS, as they provide real-world evidence that post-viral conditions require long-term multidisciplinary management and highlight the role of social support and employment in recovery.
This study does not establish causation between SARS infection and psychiatric illness or CFS—only association. It cannot distinguish whether psychiatric symptoms preceded infection or arose after, nor can it prove that the 27% meeting CFS criteria have the same etiology as ME/CFS cases not preceded by SARS. The study does not address pathophysiological mechanisms or compare outcomes to non-infected controls.
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
Lam, Marco Ho-Bun, Wing, Yun-Kwok, Yu, Mandy Wai-Man, Leung, Chi-Ming, Ma, Ronald C W, Kong, Alice P S, et al. (2009). Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up.. Archives of internal medicine. https://doi.org/10.1001/archinternmed.2009.384
BibTeX
@article{mecfsatlas-lam-2009-mental-morbidities,
author = {Lam, Marco Ho-Bun and Wing, Yun-Kwok and Yu, Mandy Wai-Man and Leung, Chi-Ming and Ma, Ronald C W and Kong, Alice P S and So, W Y and Fong, Samson Yat-Yuk and Lam, Siu-Ping},
title = {Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up.},
journal = {Archives of internal medicine},
year = {2009},
doi = {10.1001/archinternmed.2009.384},
note = {PubMed: 20008700},
url = {https://www.mecfsatlas.com/evidence/lam-2009-mental-morbidities},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/lam-2009-mental-morbidities
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