McCue, Patricia, Buchanan, Tom, Martin, Colin R · The British journal of clinical psychology · 2006 · DOI
This study tested whether an online questionnaire called the HADS (Hospital Anxiety and Depression Scale) accurately measures anxiety and depression in people with ME/CFS. Researchers found that people with ME/CFS did have higher anxiety and depression scores than healthy controls, but the online format may have artificially inflated these scores. The questionnaire appears useful for screening but measures three different aspects of emotional distress rather than just two as previously thought.
Anxiety and depression are common in ME/CFS and can complicate diagnosis and treatment. This study provides evidence that the HADS can reliably identify these psychological symptoms in CFS populations, though users must understand how the assessment tool works and account for testing methodology when interpreting results.
This study does not establish that anxiety and depression cause ME/CFS, nor does it determine whether elevated psychological distress in ME/CFS patients results from the physical illness or represents a primary psychiatric condition. The cross-sectional design cannot establish temporal relationships or causality. The findings about internet administration artifacts require replication and do not definitively apply to all online assessment contexts.
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
McCue, Patricia, Buchanan, Tom, & Martin, Colin R (2006). Screening for psychological distress using internet administration of the Hospital Anxiety and Depression Scale (HADS) in individuals with chronic fatigue syndrome.. The British journal of clinical psychology. https://doi.org/10.1348/014466505X82379
BibTeX
@article{mecfsatlas-mccue-2006-screening-psychological,
author = {McCue, Patricia and Buchanan, Tom and Martin, Colin R},
title = {Screening for psychological distress using internet administration of the Hospital Anxiety and Depression Scale (HADS) in individuals with chronic fatigue syndrome.},
journal = {The British journal of clinical psychology},
year = {2006},
doi = {10.1348/014466505X82379},
note = {PubMed: 17076959},
url = {https://www.mecfsatlas.com/evidence/mccue-2006-screening-psychological},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/mccue-2006-screening-psychological
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