Pinquart, Martin, Shen, Yuhui · Acta paediatrica (Oslo, Norway : 1992) · 2011 · DOI
This large review combined results from 332 studies to compare anxiety levels in children with chronic illnesses versus healthy children. Children with chronic illnesses, including ME/CFS, showed higher levels of anxiety than their healthy peers. ME/CFS was among the conditions most strongly linked to anxiety in children.
This study demonstrates that anxiety is a significant comorbidity in children and adolescents with ME/CFS, not merely a secondary consequence but a recognized clinical feature requiring attention. Recognizing anxiety as particularly elevated in ME/CFS may help clinicians implement earlier screening and support, potentially improving quality of life and treatment outcomes in this vulnerable population.
This meta-analysis establishes association between chronic illness and anxiety but does not establish causation—anxiety may precede illness onset, result from illness burden, or reflect shared biological pathways. The study does not provide individual patient-level data, condition-specific intervention efficacy, or mechanisms underlying the anxiety elevation. Effect sizes by specific condition are not detailed in the abstract, limiting condition-specific inferences.
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
Pinquart, Martin & Shen, Yuhui (2011). Anxiety in children and adolescents with chronic physical illnesses: a meta-analysis.. Acta paediatrica (Oslo, Norway : 1992). https://doi.org/10.1111/j.1651-2227.2011.02223.x
BibTeX
@article{mecfsatlas-pinquart-2011-anxiety-children,
author = {Pinquart, Martin and Shen, Yuhui},
title = {Anxiety in children and adolescents with chronic physical illnesses: a meta-analysis.},
journal = {Acta paediatrica (Oslo, Norway : 1992)},
year = {2011},
doi = {10.1111/j.1651-2227.2011.02223.x},
note = {PubMed: 21332786},
url = {https://www.mecfsatlas.com/evidence/pinquart-2011-anxiety-children},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/pinquart-2011-anxiety-children
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