Rangel, L, Garralda, M E, Hall, A et al. · Psychological medicine · 2003 · DOI
This study compared psychiatric and emotional problems in children with ME/CFS versus children with juvenile arthritis, another serious chronic illness. Children with ME/CFS had significantly more depression, anxiety, and personality difficulties than the arthritis group, even though both groups faced similar challenges from living with chronic illness. This suggests that ME/CFS may involve specific factors that increase psychiatric risk beyond what chronic illness alone would explain.
This study provides evidence that psychiatric symptoms in ME/CFS are not simply a psychological reaction to chronic illness, which helps shift focus toward biological and disease-specific factors. Understanding that children with ME/CFS experience greater psychiatric burden than those with other serious chronic conditions may support better-tailored mental health interventions and reduce stigma that attributes all symptoms to psychological causes.
This cross-sectional study cannot establish causality or temporal relationships—it does not determine whether psychiatric disorders preceded or followed ME/CFS onset, or whether they are direct consequences of the disease mechanism. The findings do not prove that psychiatric symptoms are purely biological or non-reactive; they only suggest that ME/CFS involves additional risk factors beyond those associated with chronic physical illness generally. The study does not identify the specific mechanisms (immunological, neurological, etc.) driving elevated psychopathology.
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
Rangel, L, Garralda, M E, Hall, A, & Woodham, S (2003). Psychiatric adjustment in chronic fatigue syndrome of childhood and in juvenile idiopathic arthritis.. Psychological medicine. https://doi.org/10.1017/s0033291702006529
BibTeX
@article{mecfsatlas-rangel-2003-psychiatric-adjustment,
author = {Rangel, L and Garralda, M E and Hall, A and Woodham, S},
title = {Psychiatric adjustment in chronic fatigue syndrome of childhood and in juvenile idiopathic arthritis.},
journal = {Psychological medicine},
year = {2003},
doi = {10.1017/s0033291702006529},
note = {PubMed: 12622307},
url = {https://www.mecfsatlas.com/evidence/rangel-2003-psychiatric-adjustment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/rangel-2003-psychiatric-adjustment
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