Lloyd, A, Hickie, I, Hickie, C et al. · Clinical and experimental immunology · 1992 · DOI
This study compared immune system function in patients with ME/CFS, people with depression, and healthy individuals. Researchers found that ME/CFS patients had weaker immune responses than both groups, suggesting their immune problems are distinct from depression-related immune changes. This indicates that ME/CFS involves direct immune system dysfunction rather than these problems simply being caused by depression.
This study helped establish that ME/CFS involves genuine immune dysfunction independent of depression, validating biological disease mechanisms rather than attributing symptoms solely to psychiatric causes. Understanding that immune abnormalities are intrinsic to ME/CFS rather than secondary to depression supports the search for biological treatments and changes perceptions of disease legitimacy.
This study does not prove that immune dysfunction causes ME/CFS symptoms—only that it is associated with the condition. It does not identify which specific immune mechanisms drive illness or explain why these abnormalities develop. The cross-sectional design cannot establish temporal relationships or determine whether immune changes precede or follow symptom onset.
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
Lloyd, A, Hickie, I, Hickie, C, Dwyer, J, & Wakefield, D (1992). Cell-mediated immunity in patients with chronic fatigue syndrome, healthy control subjects and patients with major depression.. Clinical and experimental immunology. https://doi.org/10.1111/j.1365-2249.1992.tb06416.x
BibTeX
@article{mecfsatlas-lloyd-1992-cell-mediated,
author = {Lloyd, A and Hickie, I and Hickie, C and Dwyer, J and Wakefield, D},
title = {Cell-mediated immunity in patients with chronic fatigue syndrome, healthy control subjects and patients with major depression.},
journal = {Clinical and experimental immunology},
year = {1992},
doi = {10.1111/j.1365-2249.1992.tb06416.x},
note = {PubMed: 1733640},
url = {https://www.mecfsatlas.com/evidence/lloyd-1992-cell-mediated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/lloyd-1992-cell-mediated
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