McAndrew, Lisa M, Chandler, Helena K, Serrador, Jorge M et al. · Military behavioral health · 2016 · DOI
This study looked at veterans from the Iraq and Afghanistan wars who developed ME/CFS (a condition causing persistent fatigue and other symptoms) and compared them to veterans from the 1991 Gulf War who also had ME/CFS. The researchers found that about 1 in 6 Iraq/Afghanistan veterans developed ME/CFS, and while their physical symptoms were similar to Gulf War veterans with ME/CFS, they experienced more mental health challenges like depression or anxiety.
ME/CFS affects a substantial proportion of veterans exposed to combat deployments, suggesting environmental or deployment-related factors may contribute to disease development. Understanding how mental health complications co-occur with ME/CFS in different veteran cohorts helps clinicians provide more comprehensive care and informs investigation into deployment-related triggers.
This study does not establish whether deployment exposures directly caused ME/CFS or the mental health burden, nor does it determine whether mental health problems preceded or resulted from ME/CFS symptoms. The cross-sectional design cannot establish temporal relationships or clarify whether other unmeasured factors explain the differences between cohorts.
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
McAndrew, Lisa M, Chandler, Helena K, Serrador, Jorge M, Quigley, Karen S, Natelson, Benjamin H, & Lange, Gudrun (2016). Comparison of the functional health limitations of Iraq or Afghanistan Veterans to Desert Shield/Storm Veterans with chronic fatigue syndrome.. Military behavioral health. https://doi.org/10.1080/21635781.2016.1175980
BibTeX
@article{mecfsatlas-mcandrew-2016-comparison-functional,
author = {McAndrew, Lisa M and Chandler, Helena K and Serrador, Jorge M and Quigley, Karen S and Natelson, Benjamin H and Lange, Gudrun},
title = {Comparison of the functional health limitations of Iraq or Afghanistan Veterans to Desert Shield/Storm Veterans with chronic fatigue syndrome.},
journal = {Military behavioral health},
year = {2016},
doi = {10.1080/21635781.2016.1175980},
note = {PubMed: 33898110},
url = {https://www.mecfsatlas.com/evidence/mcandrew-2016-comparison-functional},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/mcandrew-2016-comparison-functional
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