Ludwig, Birgit, Olbert, Elisabeth, Trimmel, Karin et al. · Der Nervenarzt · 2023 · DOI
This review examines what we currently know about ME/CFS, including how it is diagnosed and what treatments have been studied. The authors note that after many years of research, we still don't have clear answers about what causes ME/CFS or proven treatments that work for everyone. They suggest that the high rates of depression and anxiety seen in ME/CFS patients should make us consider whether psychological factors play a role in the condition.
This review is important because it provides a candid assessment of where ME/CFS research stands, highlighting that despite increased scientific interest (partly driven by long COVID), fundamental questions about the disease remain unanswered. The call for stricter diagnostic criteria and investigation of psychiatric comorbidity could help future research better identify effective treatments and understand disease heterogeneity.
This review does not prove that ME/CFS is primarily psychiatric in origin—it only notes that psychiatric comorbidity is common and suggests this warrants investigation. It does not establish whether psychiatric symptoms are a cause, consequence, or independent feature of ME/CFS. The review also does not propose or test any new treatments or diagnostic approaches; it only critiques existing evidence and recommends improvements to future research methodology.
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
Ludwig, Birgit, Olbert, Elisabeth, Trimmel, Karin, Seidel, Stefan, Rommer, Paulus S, Müller, Christian, et al. (2023). [Myalgic encephalomyelitis/chronic fatigue syndrome: an overview of current evidence].. Der Nervenarzt. https://doi.org/10.1007/s00115-022-01431-x
BibTeX
@article{mecfsatlas-ludwig-2023-myalgic-encephalomyelitis,
author = {Ludwig, Birgit and Olbert, Elisabeth and Trimmel, Karin and Seidel, Stefan and Rommer, Paulus S and Müller, Christian and Struhal, Walter and Berger, Thomas},
title = {[Myalgic encephalomyelitis/chronic fatigue syndrome: an overview of current evidence].},
journal = {Der Nervenarzt},
year = {2023},
doi = {10.1007/s00115-022-01431-x},
note = {PubMed: 36695893},
url = {https://www.mecfsatlas.com/evidence/ludwig-2023-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/ludwig-2023-myalgic-encephalomyelitis
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