Loades, Maria E, Stallard, Paul, Morris, Richard et al. · Journal of affective disorders · 2020 · DOI
This study looked at how adolescents with ME/CFS think about their symptoms, comparing those who also have anxiety or depression with those who don't. Teenagers with both ME/CFS and anxiety/depression were more likely to have negative thoughts in general and worry more about their fatigue causing damage or embarrassment. The thinking patterns of both groups together explained about 43% of why some teens developed anxiety or depression alongside their ME/CFS.
Understanding whether adolescents with ME/CFS develop distinct thinking patterns when anxiety or depression co-occurs is important for tailoring psychological treatments. This research suggests that targeting both general negative thinking and fatigue-specific catastrophic beliefs may help address the high rates of mental health problems in young people with ME/CFS.
This study cannot establish whether negative thinking patterns cause anxiety/depression or result from it, nor does it prove these thoughts are specific to ME/CFS rather than anxiety disorders alone. The cross-sectional design means we cannot determine the temporal sequence of symptom development or whether addressing these thought patterns would reduce psychopathology.
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 E, Stallard, Paul, Morris, Richard, Kessler, David, & Crawley, Esther (2020). Do adolescents with chronic fatigue syndrome (CFS/ME) and co-morbid anxiety and/or depressive symptoms think differently to those who do not have co-morbid psychopathology?. Journal of affective disorders. https://doi.org/10.1016/j.jad.2020.05.113
BibTeX
@article{mecfsatlas-loades-2020-adolescents-chronic,
author = {Loades, Maria E and Stallard, Paul and Morris, Richard and Kessler, David and Crawley, Esther},
title = {Do adolescents with chronic fatigue syndrome (CFS/ME) and co-morbid anxiety and/or depressive symptoms think differently to those who do not have co-morbid psychopathology?},
journal = {Journal of affective disorders},
year = {2020},
doi = {10.1016/j.jad.2020.05.113},
note = {PubMed: 32664011},
url = {https://www.mecfsatlas.com/evidence/loades-2020-adolescents-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/loades-2020-adolescents-chronic
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