Maes, Michael · Progress in neuro-psychopharmacology & biological psychiatry · 2011 · DOI
Depression and ME/CFS often occur together, and this study suggests they share common biological root causes involving inflammation and oxidative stress (damage to cells). While depression and ME/CFS look different clinically, they appear to involve similar underlying problems with the immune system, energy production, and antioxidant defenses. The authors argue these should be considered connected disorders rather than two separate conditions that happen to co-occur.
This framework helps explain why many ME/CFS patients experience depression as a disease feature rather than a psychological reaction. Understanding shared biological mechanisms could lead to targeted treatments addressing the underlying inflammation and oxidative stress rather than treating depression and fatigue as separate problems. This perspective validates that both conditions involve real physiological dysfunction.
This review does not prove that inflammation and oxidative stress definitively cause either condition—it identifies associations that may be correlational or secondary effects. It does not provide new experimental evidence, only synthesizes existing studies. The proposed distinction between 'sickness behavior,' depression, and ME/CFS remains theoretical and would require prospective studies to confirm.
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
Maes, Michael (2011). An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways.. Progress in neuro-psychopharmacology & biological psychiatry. https://doi.org/10.1016/j.pnpbp.2010.06.023
BibTeX
@article{mecfsatlas-maes-2011-intriguing-hitherto,
author = {Maes, Michael},
title = {An intriguing and hitherto unexplained co-occurrence: Depression and chronic fatigue syndrome are manifestations of shared inflammatory, oxidative and nitrosative (IO&NS) pathways.},
journal = {Progress in neuro-psychopharmacology & biological psychiatry},
year = {2011},
doi = {10.1016/j.pnpbp.2010.06.023},
note = {PubMed: 20609377},
url = {https://www.mecfsatlas.com/evidence/maes-2011-intriguing-hitherto},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/maes-2011-intriguing-hitherto
Contribute
Private, reviewed by a human. Not a public comment thread.