Michielsen, H J, Van Houdenhove, B, Leirs, I et al. · Clinical rheumatology · 2006 · DOI
This study looked at whether people with ME/CFS and fibromyalgia who blame external factors (rather than themselves) for problems are protected from depression. Researchers surveyed 85 patients and found that depression was common in both single diagnosis (ME/CFS only) and dual diagnosis (ME/CFS + fibromyalgia) groups. Blaming external factors did not prevent depression in patients with low self-esteem, suggesting that how we think about our situation may not be a key factor in whether we develop depression.
Depression is highly prevalent in ME/CFS populations but its mechanisms are poorly understood. This study highlights that depression in ME/CFS may not be primarily explained by how patients attribute their illness, suggesting clinicians should screen for and address depression as a significant clinical concern regardless of patients' psychological coping styles.
This study does not prove that attribution style has no relationship to depression in ME/CFS—only that it does not mediate the self-esteem to depression link in this specific analysis. The cross-sectional design prevents establishing causation. The findings cannot explain why depression rates are so high or identify what does protect or increase depression risk in these patients.
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 →
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