Loades, Maria Elizabeth, Rimes, Katharine A, Ali, Sheila et al. · Clinical child psychology and psychiatry · 2018 · DOI
This study looked at mental health problems in 52 teenagers with ME/CFS to see how common depression and anxiety are in this group. About one-third of the teenagers had depression, and over a quarter had anxiety disorders. Teenagers with depression reported more difficulty with school and social life. The researchers found that using a proper psychiatric interview was better than just asking teenagers to fill out questionnaires for identifying these mental health conditions.
Mental health comorbidities significantly impact quality of life and functional outcomes in adolescents with ME/CFS. This study demonstrates that standard psychiatric assessment tools may miss anxiety in this population, suggesting clinicians need validated interviews to properly identify and treat these conditions alongside fatigue management. Understanding comorbidity prevalence helps guide integrated treatment approaches for this vulnerable population.
This study does not establish whether depression and anxiety cause ME/CFS, result from it, or are coincidental findings. The cross-sectional design cannot determine temporal relationships or causality. Additionally, because participants were recruited from specialist clinics, results may not represent all adolescents with ME/CFS, including those who are less severely affected or not seeking specialist care.
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
Loades, Maria Elizabeth, Rimes, Katharine A, Ali, Sheila, Lievesley, Kate, & Chalder, Trudie (2018). The presence of co-morbid mental health problems in a cohort of adolescents with chronic fatigue syndrome.. Clinical child psychology and psychiatry. https://doi.org/10.1177/1359104517736357
BibTeX
@article{mecfsatlas-loades-2018-presence-morbid,
author = {Loades, Maria Elizabeth and Rimes, Katharine A and Ali, Sheila and Lievesley, Kate and Chalder, Trudie},
title = {The presence of co-morbid mental health problems in a cohort of adolescents with chronic fatigue syndrome.},
journal = {Clinical child psychology and psychiatry},
year = {2018},
doi = {10.1177/1359104517736357},
note = {PubMed: 29096528},
url = {https://www.mecfsatlas.com/evidence/loades-2018-presence-morbid},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/loades-2018-presence-morbid
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