Mousa, Rana Fadhil, Al-Hakeim, Hussein Kadhem, Alhaideri, Amer et al. · Metabolic brain disease · 2021 · DOI
This study looked at whether people with schizophrenia experience fatigue and pain symptoms similar to ME/CFS and fibromyalgia. Researchers measured blood markers related to immune system function and found that specific immune proteins and opioid system changes were associated with these physiosomatic symptoms. The findings suggest that abnormal immune activity and changes in the body's natural pain-relieving systems may contribute to these exhaustion and pain symptoms in schizophrenia patients.
This study provides evidence that ME/CFS-like symptoms in schizophrenia involve measurable immune and opioid system dysfunctions, suggesting shared biological pathways between these conditions. Understanding these mechanisms in schizophrenia may illuminate similar neuro-immune processes in ME/CFS, potentially leading to better biomarkers and targeted treatments for physiosomatic symptoms.
This study does not prove that schizophrenia causes ME/CFS or vice versa, nor does it establish that the immune markers directly cause the fatigue and pain symptoms—only that they are associated. The cross-sectional design cannot determine causality or the direction of relationships. Additionally, findings in schizophrenia patients may not directly apply to primary ME/CFS, which was not studied here.
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
Mousa, Rana Fadhil, Al-Hakeim, Hussein Kadhem, Alhaideri, Amer, & Maes, Michael (2021). Chronic fatigue syndrome and fibromyalgia-like symptoms are an integral component of the phenome of schizophrenia: neuro-immune and opioid system correlates.. Metabolic brain disease. https://doi.org/10.1007/s11011-020-00619-x
BibTeX
@article{mecfsatlas-mousa-2021-chronic-fatigue,
author = {Mousa, Rana Fadhil and Al-Hakeim, Hussein Kadhem and Alhaideri, Amer and Maes, Michael},
title = {Chronic fatigue syndrome and fibromyalgia-like symptoms are an integral component of the phenome of schizophrenia: neuro-immune and opioid system correlates.},
journal = {Metabolic brain disease},
year = {2021},
doi = {10.1007/s11011-020-00619-x},
note = {PubMed: 32965599},
url = {https://www.mecfsatlas.com/evidence/mousa-2021-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/mousa-2021-chronic-fatigue
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