Nater, Urs M, Lin, Jin-Mann S, Maloney, Elizabeth M et al. · Psychosomatic medicine · 2009 · DOI
This study looked at how often people with ME/CFS also have psychiatric conditions like depression or anxiety. Researchers called random people in Georgia and invited those who were unwell to participate. They found that 57% of people with ME/CFS had at least one current psychiatric diagnosis, compared to 45% of people with similar but milder symptoms. Importantly, most people with ME/CFS who had these psychiatric conditions hadn't seen a mental health specialist in the past 6 months.
This study challenges the assumption that high psychiatric comorbidity in ME/CFS is merely a referral artifact from specialty clinics, showing it occurs in population-based samples. The finding that most ME/CFS patients with comorbid psychiatric conditions are not receiving mental health care highlights a critical gap in clinical management and points to the need for integrated psychiatric care in ME/CFS.
This study does not establish whether psychiatric conditions cause ME/CFS, result from ME/CFS, or occur independently. The cross-sectional design cannot determine temporal relationships or causality. Additionally, the study does not explain why psychiatric comorbidity rates are elevated or what mechanisms might link these conditions.
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
Nater, Urs M, Lin, Jin-Mann S, Maloney, Elizabeth M, Jones, James F, Tian, Hao, Boneva, Roumiana S, et al. (2009). Psychiatric comorbidity in persons with chronic fatigue syndrome identified from the Georgia population.. Psychosomatic medicine. https://doi.org/10.1097/PSY.0b013e31819ea179
BibTeX
@article{mecfsatlas-nater-2009-psychiatric-comorbidity,
author = {Nater, Urs M and Lin, Jin-Mann S and Maloney, Elizabeth M and Jones, James F and Tian, Hao and Boneva, Roumiana S and Raison, Charles L and Reeves, William C and Heim, Christine},
title = {Psychiatric comorbidity in persons with chronic fatigue syndrome identified from the Georgia population.},
journal = {Psychosomatic medicine},
year = {2009},
doi = {10.1097/PSY.0b013e31819ea179},
note = {PubMed: 19414619},
url = {https://www.mecfsatlas.com/evidence/nater-2009-psychiatric-comorbidity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/nater-2009-psychiatric-comorbidity
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