Manu, P, Lane, T J, Matthews, D A · International journal of psychiatry in medicine · 1992 · DOI
This 1992 review examined 32 published studies on ME/CFS to identify what researchers had consistently found, disagreed about, or only reported once. The review confirmed that ME/CFS primarily affects middle-aged white women and is often accompanied by depression, but found conflicting evidence about whether infections cause the illness and whether immune treatments help.
This systematic review was important for consolidating early ME/CFS research and identifying which biological findings had sufficient evidence versus those requiring replication. It highlights a critical historical moment when ME/CFS was often attributed to psychiatric causes, motivating subsequent research to better characterize its objective biological basis.
This review does not prove that ME/CFS is primarily psychiatric in origin, despite the overlapping features with depressive disorders noted. The authors' emphasis on psychiatric comorbidity does not establish causation, and the absence of confirmed infectious etiology in 1992 data does not exclude biological mechanisms discovered later. Additionally, the high prevalence of depression may reflect the burden of chronic illness rather than indicate psychiatric causation.
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
Manu, P, Lane, T J, & Matthews, D A (1992). The pathophysiology of chronic fatigue syndrome: confirmations, contradictions, and conjectures.. International journal of psychiatry in medicine. https://doi.org/10.2190/20AP-D23D-YMF5-ELTL
BibTeX
@article{mecfsatlas-manu-1992-pathophysiology-chronic,
author = {Manu, P and Lane, T J and Matthews, D A},
title = {The pathophysiology of chronic fatigue syndrome: confirmations, contradictions, and conjectures.},
journal = {International journal of psychiatry in medicine},
year = {1992},
doi = {10.2190/20AP-D23D-YMF5-ELTL},
note = {PubMed: 1338059},
url = {https://www.mecfsatlas.com/evidence/manu-1992-pathophysiology-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/manu-1992-pathophysiology-chronic
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