Neerinckx, E, Van Houdenhove, B, Lysens, R et al. · The Journal of rheumatology · 2000
This study looked at what 192 patients with ME/CFS, fibromyalgia, or chronic pain believed was causing their illness. Most patients thought their condition had both physical causes (like a virus or chemical imbalance) and emotional causes (like stress). The researchers found that patients' beliefs about what caused their illness were quite varied, and these beliefs did not differ much based on their specific diagnosis.
Understanding how ME/CFS and fibromyalgia patients perceive the causes of their illness is crucial for developing effective treatment strategies and improving the patient-clinician relationship. This study reveals that most patients hold mixed physical-psychological beliefs about their condition, suggesting that treatment approaches should address multiple causal frameworks rather than imposing a single explanatory model.
This study does not establish what actually causes ME/CFS or fibromyalgia—only what patients believe causes their symptoms. The cross-sectional design cannot determine whether attributions are a cause or consequence of symptom duration and self-help group involvement, and correlation between attributions and depression does not imply causation. The study was conducted in a tertiary care setting, so findings may not generalize to primary care or untreated populations.
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
Neerinckx, E, Van Houdenhove, B, Lysens, R, Vertommen, H, & Onghena, P (2000). Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care.. The Journal of rheumatology. https://pubmed.ncbi.nlm.nih.gov/10782836/
BibTeX
@article{mecfsatlas-neerinckx-2000-attributions-chronic,
author = {Neerinckx, E and Van Houdenhove, B and Lysens, R and Vertommen, H and Onghena, P},
title = {Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care.},
journal = {The Journal of rheumatology},
year = {2000},
note = {PubMed: 10782836},
url = {https://www.mecfsatlas.com/evidence/neerinckx-2000-attributions-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/neerinckx-2000-attributions-chronic
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