Norris, Tom, Deere, Kevin, Tobias, Jon H et al. · The journal of pain · 2017 · DOI
This study looked at whether adolescents with ME/CFS (chronic fatigue syndrome) are more likely to also have chronic widespread pain. Researchers surveyed about 3,200 teenagers and found that those diagnosed with ME/CFS were nearly four times more likely to have widespread pain than those without ME/CFS. The study also found that depression and anxiety were more strongly linked to having both conditions together than to having either condition alone.
This is among the first population-based studies examining the overlap between ME/CFS and chronic widespread pain in adolescents, a group understudied compared to adults. Understanding comorbidity patterns and shared psychological risk factors helps clinicians recognize and manage these conditions appropriately in young patients. The findings suggest that treatment approaches must account for both pain and fatigue components, particularly in adolescents with both conditions.
This study cannot establish causality—it does not prove that ME/CFS causes pain, pain causes ME/CFS, or that depression/anxiety cause either condition. As a population-based study capturing mostly milder cases, the findings may not generalize to adolescents with severe ME/CFS seen in specialist services. The cross-sectional design means we cannot determine temporal relationships or rule out reverse causation.
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
Norris, Tom, Deere, Kevin, Tobias, Jon H, & Crawley, Esther (2017). Chronic Fatigue Syndrome and Chronic Widespread Pain in Adolescence: Population Birth Cohort Study.. The journal of pain. https://doi.org/10.1016/j.jpain.2016.10.016
BibTeX
@article{mecfsatlas-norris-2017-chronic-fatigue,
author = {Norris, Tom and Deere, Kevin and Tobias, Jon H and Crawley, Esther},
title = {Chronic Fatigue Syndrome and Chronic Widespread Pain in Adolescence: Population Birth Cohort Study.},
journal = {The journal of pain},
year = {2017},
doi = {10.1016/j.jpain.2016.10.016},
note = {PubMed: 27845196},
url = {https://www.mecfsatlas.com/evidence/norris-2017-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/norris-2017-chronic-fatigue
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